Can Research and Care: Be Ethically Integrated‪?‬

Medical ethics assumes a clear boundary between clinical research and clinical medicine: one produces knowledge for the benefit of future patients, while the other provides optimal care to individuals right now. It also assumes that the two cannot be integrated without sacrificing the needs of the current patient to those of future patients. But integration could allow us to provide better care to everyone, now and in the future. Historically, clinical medical research and clinical medical care were viewed as similar and as intertwined. Physicians considered research on patients to be an integral part of the care they delivered. (1) After all, the good physician constantly made observations and formulated and tested hypotheses; he turned to the literature and experimented with different treatments to find the one most efficacious for the patient in front of him. Moreover, he learned from these experiences to improve his treatment of future patients. On this model, both medical care and research were scientifically guided, therapeutically oriented activities conducted within the physician-patient relationship. (2)