Before coming to graduate school, I worked as a clinical research coordinator with a large hospital system in Greenville, SC. Ethical research was central to my job. I submitted and oversaw intuitional review board (IRB) applications, patient enrollment, data collection, and adverse events related to the study. So naturally, I picked a case study that related back to the work I did in clinical research. The case study, Taking Advantage of Patient Trust, presented interesting details and a conversation I witnessed many times in my previous job.
Earning a patient’s trust is pivotal to the doctor patient relationship. Patients want to trust their doctor and the recommendations they provide. They see them as the expert. Patients I worked with would ask their doctor whether they should be in the study. Their opinion mattered most. The case of Dr. Joanna and Duncan is a similar situation. Duncan trusts that Joanna will put his medical interest ahead of her research interest, which there in lies the ethical dilemma. Doctors want to discover new treatments and push medicine forward, however it can’t be done at the sacrifice of current patient needs.
What I find interesting about the case study is the placebo is less than the standard of care. I am curious how this study even got approved by the IRB. When I worked in orthopaedics, the placebo had to be the standard of care or something equivalent. The study could not put patients at risk of receiving less than the standard. This protected patients and helped minimize risk. If I were Dr. Joanna, the study would only be an option if all standard treatments had failed and the patient could safety be off of medicine if in the placebo group.
While I am not pursuing a research career in medicine, this case study represents ethical challenges with human subjects research. My future research involves minimal risk to human participants, however this does not negate the importance of proper consenting and considerations for their health and wellbeing. I think we as researchers need to be open about ethical issues and discuss remedies that balance participant and researcher interests.