Research Versus Practice: The Dilemmas of Research Ethics in the Era of Learning Health‐Care Systems

8 Pages Posted: 30 Apr 2020

See all articles by Jan Piasecki

Jan Piasecki

Jagiellonian University in Krakow - Medical College

Vilius Dranseika

Independent

Date Written: June 2019

Abstract

In this article we attempt to answer the question of how the ethical and conceptual framework (ECF) for a learning health‐care system (LHS) affects some of the main controversies in research ethics by addressing five key problems of research ethics: (a) What is the difference between practice and research? (b) What is the relationship between research ethics and clinical ethics? (c) What is the ethical relevance of the principle of clinical equipoise? (d) Does participation in research require a higher standard of informed consent than the practice of medicine? and (e) What ethical principle should take precedence in medicine? These questions allow us to construct two opposite idealized positions on the distinction between research and practice: the integration model and the segregation model of research and practice. We then compare the ECF for an LHS with these two idealized positions. We argue that the ECF for a LHS does not, in fact, solve these problems, but that it is a third, separate position in the relationship between research ethics and clinical ethics. Moreover, we suggest that the ECF for a LHS raises new ethical problems that require additional ethical analysis and justification. Our article contributes to the discussion on the relationship between research ethics and clinical ethics, revealing that although a learning health‐care system may significantly change the landscape of health care, some ethical dilemmas still require resolving on both theoretical and policy‐making levels.

Keywords: clinical equipoise, clinical ethics, distinction between research and practice, learning activity, learning health‐care system, research ethics

Suggested Citation

Piasecki, Jan and Dranseika, Vilius, Research Versus Practice: The Dilemmas of Research Ethics in the Era of Learning Health‐Care Systems (June 2019). Bioethics, Vol. 33, Issue 5, pp. 617-624, 2019, Available at SSRN: https://ssrn.com/abstract=3588696 or http://dx.doi.org/10.1111/bioe.12571

Jan Piasecki (Contact Author)

Jagiellonian University in Krakow - Medical College ( email )

Grzegorzecka 20
Kraków, 31-531
Poland

Vilius Dranseika

Independent ( email )

Do you have a job opening that you would like to promote on SSRN?

Paper statistics

Downloads
0
Abstract Views
53
PlumX Metrics