title: The Ethics of Clinical Care and the Ethics of Clinical Research: Yin and Yang.
abstract: The Belmont Report's distinction between research and the practice of accepted therapy has led various authors to suggest that these purportedly distinct activities should be governed by different ethical principles. We consider some of the ethical consequences of attempts to separate the two and conclude that separation fails along ontological, ethical, and epistemological dimensions. Clinical practice and clinical research, as with yin and yang, can be thought of as complementary forces interacting to form a dynamic system in which the whole exceeds the sum of its parts. Just as effective clinical practice cannot exist without clinical research, meaningful clinical research requires the context of clinical practice. We defend this thesis by triangulation, that is, by outlining how multiple investigators have reached this conclusion on the basis of varied theoretical and applied approaches. More confidence can be placed in a result if different methods/viewpoints have led to that result.
authors.affiliation: University of Michigan, Ann Arbor, Michigan, USA chuckk@umich.edu.|University of Michigan Medical School, Ann Arbor, Michigan, USA chuckk@umich.edu.|University of Michigan, Ann Arbor, Michigan, USA chuckk@umich.edu.
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Kowalski
authors.affiliation: University of Michigan, Ann Arbor, Michigan, USA.|University of Michigan Medical School, Ann Arbor, Michigan, USA.|University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Raymond J
authors.initials: RJ
authors.lastname: Hutchinson
authors.affiliation: University of Michigan, Ann Arbor, Michigan, USA.|University of Michigan Medical School, Ann Arbor, Michigan, USA.|University of Michigan, Ann Arbor, Michigan, USA.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Mrdjenovich
mesh_terms: D035843:Biomedical Research / Q000941:ethics*; D002986:Clinical Trials as Topic / Q000941:ethics; D003695:Delivery of Health Care / Q000941:ethics*; D006302:Health Services Research / Q000941:ethics; D006801:Humans; D010686:Philosophy, Medical; D012108:Research Personnel / Q000523:psychology
keywords: Belmont Report; epistemology; ethics; ontology; triangulation