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Experts aim to redefine healthcare and research ethics
Date:1/11/2013

s or treatments work best, and patients are suffering for that lack of knowledge," says Nancy E. Kass, deputy director for public health at the Johns Hopkins Berman Institute of Bioethics, and lead author of the article. "We're finding that patients are both underprotected from risks in medical treatment and over-protected from low-risk quality-improvement research, bringing progress to a dangerous stalemate that is costing lives," the authors write.

Instead, the authors say that healthcare should be moving toward a system in which clinical research and clinical practice are integrated, and every clinical encounter is simultaneously an opportunity to provide needed care to patients and also to learn from that to improve the care provided to future patients.

In their second article, the authors put forward a new ethical framework for the integration of research with practice in what the Institute of Medicine calls a learning healthcare system. The framework includes seven obligations, six of which fall on health professionals and institutions, and the 7th on patients:

  1. Respect the rights and dignity of patients
  2. Respect the clinical judgment of clinicians
  3. Provide optimal care to each patient
  4. Avoid imposing nonclinical risks and burdens on patients
  5. Address health inequalities among populations
  6. Conduct continuous learning activities that improve the quality of clinical care and health care systems
  7. Contribute to the common purpose of improving the quality and value of clinical care and health care systems

The framework includes familiar tenets of both medical and research ethics, but also new obligations that the authors acknowledge "substantially revise traditional conceptions" of the roles played by health systems, providers and patients. "In addition to long-standing ethical obligations to ensure that burdens and benefits of research are fairly distributed and that patients
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Contact: Leah Ramsay
lramsay@jhu.edu
202-642-9640
Johns Hopkins Medicine
Source:Eurekalert

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