Ethical Principles in Research

  • D. J. Roy
  • P. McL. Black
  • B. McPeek
  • M. F. McKneally


Research ethics is as integral a part of scientific judgment as clinical ethics is of clinical judgment. 2 Many ethical issues in research arise from a failure to think as rigorously about the conditions for ethical consistency as about those for scientific validity. The ethical principles governing all surgical, clinical, and biomedical research with human subjects are fundamentally the same. They have been listed and discussed in numerous documents and countless publications over the past 40 years. 3-10.


Ethical Principle Clinical Investigator Surgical Research Surgical Trial Ethical Justifiability 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Walt AJ. Presidential address: the uniqueness of American surgical education and its preservation. ACS Bull 1994;79:8–20Google Scholar
  2. 2.
    Pellegrino ED. The anatomy of clinical judgments; some notes on right reason and right action. In: Engelhardt HT Jr, Spicker SF, Towers B, eds. Clinical Judgment: A Critical Appraisal. Dordrecht-London-Boston: Reidel, 1979, pp. 169–195CrossRefGoogle Scholar
  3. 3.
    Bankowski Z, Howard-Jones N. Human Experimentation and Medical Ethics. Geneva: CIOMS, 1982Google Scholar
  4. 4.
    Beecher HK. Research and the Individual. Boston: Little, Brown, 1970Google Scholar
  5. 5.
    Freund PA, ed. Experimentation with Human Subjects. New York: Braziller, 1970Google Scholar
  6. 6.
    Gray BH. Human Subjects in Medical Experimentation. New York: Wiley, 1975Google Scholar
  7. 7.
    Katz J. Experimentation with Human Beings. New York: Russell Sage Foundation, 1972Google Scholar
  8. 8.
    Levine R. Ethics and Regulation of Clinical Research. Baltimore-Munich: Urban & Schwarzenberg, 1981Google Scholar
  9. 9.
    Shapiro SH, Louis TA, eds. Clinical Trials. New York: Dekker, 1983Google Scholar
  10. 10.
    WHO and CIOMS. Proposed International Guidelines for Biomedical Research Involving Human Subjects. Geneva: CIOMS, 1982Google Scholar
  11. 11.
    Sackett DL. Bias in analytic research. J Chronic Dis 1979;32–60Google Scholar
  12. 12.
    Toulmin S. How medicine saved the life of ethics. Perspect Biol Med 1982;25:736–750PubMedGoogle Scholar
  13. 13.
    Levine RJ. Clinical trials and physicians as double agents. Yale J Biol Med 1992;65:65–74PubMedGoogle Scholar
  14. 14.
    Fried C. Medical Experimentation: Personal Integity and Social Policy. Amsterdam: North Holland, 1974, p. 151Google Scholar
  15. 15.
    Green FHK. Quoted by Jackson DM. Moral responsibility in clinical research. Lancet, 1958;1: 903. This reference comes from Feinstein AR. Clinical biostatistics: XXVI. Medical ethics and the architecture of clinical research. Clin Pharmacol Ther 1974;15:320Google Scholar
  16. 16.
    Gilbert JP, McPeek B. Mosteller F. Statistics and ethics in surgery and anesthesia. Science 1977; 198:684–689PubMedCrossRefGoogle Scholar
  17. 17.
    Silverman WA. The lesson of retrolental fibroplasia. Sci Am 1977;236:100–107PubMedCrossRefGoogle Scholar
  18. 18.
    Freedman B. Equipoise and the ethics of clinical research. New Engl J Med 1987;317:141–145PubMedCrossRefGoogle Scholar
  19. 19.
    Gail MH. Monitoring and stopping clinical trials. In: Mike V, Stanley KE, eds. Statistics in Medical Research. New York: Wiley, 1982, p. 455Google Scholar
  20. 20.
    Bernard C. An Introduction to the Study of Experimental Medicine. Greene HC, transl. New York: Henry Schuman, 1949, pp. 101–261Google Scholar
  21. 21.
    Engelhardt HT Jr. Bioethics in the People’s Republic of China. Hastings Cen Rep 1980;10:8CrossRefGoogle Scholar
  22. 22.
    Department of Health and Human Services Rules and Regulations. 45 CFR 46 (Title 45: Code of Federal Regulations; Part 46), 46.111, (a) (3), here cited from: Levine RJ. Ethics and Regulation of Clinical Research. Baltimore-Munich: Urban & Schwarzenberg, 1981, appendix 1, p. 264Google Scholar
  23. 23.
    McCarthy CR. Historical background of clinical trials involving women and minorities. Acad Med 1994;69(9):695–698PubMedCrossRefGoogle Scholar
  24. 24.
    Veressayev V. The Memoirs of a Physician. Linden S, trans.(Russian) New York: Knopf, 1916, here quoted from: Katz J, ed. Experimentation with Human Beings. New York: Russell Sage Foundation, 1972, pp. 291Google Scholar
  25. 25.
    Merkatz RB, White Junod, S. Historical background of changes in FDA policy on the study and evaluation of drugs in women. Acad Med 1994;69(9):703–707PubMedCrossRefGoogle Scholar
  26. 26.
    Savitt TL. Medicine and Slavery: The Diseases and Health Care of Blacks in Antebellum Virginia. Urbana, IL: University of Illinois, 1978, pp. 297–298Google Scholar
  27. 27.
    Pernick MS. The calculus of suffering in 19th century surgery. In: Leavitt JW, Numbers RL, eds. Sickness and Health in America. Madison, WI: University of Wisconsin, 1985, p. 100Google Scholar
  28. 28.
    Ethridge E. Pellagra: an unappreciated reminder of southern distinctiveness. In: Savitt TL, Young JH, eds. Disease and Distinctiveness in the American South. Knoxville, TN: University of Tennessee, 1988, pp. 110–119Google Scholar
  29. 29.
    Mitford J. Cheaper than chimpanzees. In: Mit-ford J, ed. Kind and Usual Punishment. The Prison Business. New York: Vintage Books, 1974, pp. 151–184Google Scholar
  30. 30.
    Beecher HK. Ethics and clinical research. New Engl J Med 1966;274:1354–1366PubMedCrossRefGoogle Scholar
  31. 31.
    Brandt AM. Racism and research: the case of the Tuskegee Syphilis Study. Hastings Cent Rep 1978;8(6):21–29PubMedCrossRefGoogle Scholar
  32. 32.
    Ward R, Krugman S, Giles JP, Jacobs AM, Bodansky O. Infectious hepatitis: studies of its natural history and prevention. New Engl J Med 1958; 258:407–416PubMedCrossRefGoogle Scholar
  33. 33.
    Katz J. Experimentation with Human Beings. New York: Russell Sage Foundation, 1972, pp. 1007–1010Google Scholar
  34. 34.
    Merkatz RB, Temple R, Subel S, Feiden K, Kessler DA. Women in clinical trials of new drugs. A change in Food and Drug Administration policy. New Engl J Med 1993;329:292–296PubMedCrossRefGoogle Scholar
  35. 35.
    U.S. Congress Public Law 103–43. National Institutes of Health Revitalization Amendment. Washington, DC, June 10, 1993Google Scholar
  36. 36.
    Bennett JC. Inclusion of women in clinical trials—policies for population subgroups. New Engl J Med 1993;329:288–292PubMedCrossRefGoogle Scholar
  37. 37.
    Marshall E. New law brings affirmative action to clinical research. Science 1994;263:602PubMedCrossRefGoogle Scholar
  38. 38.
    Piantadosi S, Wittes J. Politically correct clinical trials. Control Clin Trials 1993;14:562–567 LetterPubMedCrossRefGoogle Scholar
  39. 39.
    Freeman HP. The impact of clinical trial protocols on patient care systems in a large city hospital. Cancer 1993;72:2834–2838PubMedCrossRefGoogle Scholar
  40. 40.
    El-Sadr W, Capps L. The challenge of minority recruitment in clinical trials for AIDS. JAMA 1992;267:954–957PubMedCrossRefGoogle Scholar
  41. 41.
    Brown LS. Enrollment of drug abusers in HIV clinical trials: a public health imperative for communities of color. J Psychoactive Drugs 1993; 25(l):45–52PubMedCrossRefGoogle Scholar
  42. 42.
    The Nuremberg Code. Trials of war criminals before the Nuremberg military tribunals under control council law, no. 10, vol 2. Washington, DC: Government Printing Office, 1949, pp. 181-182. Reprinted as Appendix 3 in Ethics and Regulation of Clinical Research. 8 Google Scholar
  43. 43.
    World Medical Association Declaration of Helsinki: Recommendations guiding medical doctors in biomedical research involving human subjects. Reprinted as Appendix 4 in Ethics and Regulation of Clinical Research. 8 Google Scholar
  44. 44.
    Anderston WF, Fletcher JC. Gene therapy in human beings: when is it ethical to begin? New Engl J Med 1980;303:1293–1297CrossRefGoogle Scholar
  45. 45.
    Cline MJ, Mercola KE. The potential of inserting new genetic information. New Engl J Med 1980; 303:1297–1300PubMedCrossRefGoogle Scholar
  46. 46.
    Gene therapy: how ripe the time? Lancet 1981;1:196-197. EditorialGoogle Scholar
  47. 47.
    Grobstein C, Flower M. Gene therapy: proceed with caution. Hastings Cent Rep 1984;14:13–17PubMedGoogle Scholar
  48. 48.
    Wade N. UCLA. Gene therapy racked by friendly fire. Science 1980;210:509–511PubMedCrossRefGoogle Scholar
  49. 49.
    Rutstein DD. The ethical design of human experiments. In: Experimentation with human subjects, Freund A, ed. New York: Braziller, 1970: 383–401Google Scholar
  50. 50.
    Sackett DL. The competing objectives of randomized trials. New Engl J Med 1980;303:1059–1060PubMedCrossRefGoogle Scholar
  51. 51.
    Frederickson DS. Welcoming remarks, national conferences in clinical trials methodology. Clin Pharmacol Ther 1979;25:630–631Google Scholar
  52. 52.
    Zelen M. A new design for randomized clinical trials. New Engl J Med 1979;300:1242–1245PubMedCrossRefGoogle Scholar
  53. 53.
    Feinstein AR. An additional basic science for clinical medicine. I. The constraining fundamental paradigms. Ann Intern Med 1983;99:393–397PubMedGoogle Scholar
  54. 54.
    Feinstein AR. An additional basic science for clinical medicine. IV. The development of clinimetrics. Ann Intern Med 1983;99:843–848PubMedGoogle Scholar
  55. 55.
    Katz J. “Ethics and clinical research” revisited. A tribute to Henry K. Beecher. Hastings Cent Rep 1993:23(5);31–39PubMedCrossRefGoogle Scholar
  56. 56.
    Woodward FR Informed consent of volunteers: a direct measurement of comprehension and retention of information. Clin Res 1979;27:248–252PubMedGoogle Scholar
  57. 57.
    Dickens BM. The modern law on informed consent. Mod Med Can 1982;37:706–710Google Scholar
  58. 58.
    Reibl v. Hughes. 1980;2 S.C.R. 882Google Scholar
  59. 59.
    Thornton H. Clinical trials—A brave new partnership? J Med Ethics 1994;20:19–22PubMedCrossRefGoogle Scholar
  60. 60.
    Baum M. Clinical trials —A brave new partnership: a response to Mrs. Thornton. J Med Ethics 1994;20:23–25PubMedCrossRefGoogle Scholar
  61. 61.
    Kluge E-HW. Informed consent and the competent patient. In: Kluge E-HW, ed. Readings in Biomedical Ethics, A Canadian Focus. Scarborough, Ontario: Prentice-Hall Canada, 1993, pp. 129–152Google Scholar
  62. 62.
    Cancer Research Campaign Working Party on Breast Conservation. Informed consent: ethical, legal, and medical implications for doctors and patients who participate in randomized clinical trials. Br Med J 1983;286:1117–1121CrossRefGoogle Scholar
  63. 63.
    Fayerweather WE, Higginson J, Beauchamp TL, eds. Ethics in epidemiology. J Clin Epidemiol 1991;44(supplI):1S–170SGoogle Scholar
  64. 64.
    CIOMS. International guidelines for ethical review of epidemiological studies. Law Med Health Care 1991;19(3-4)(appendix I):247–258Google Scholar
  65. 65.
    Tancredi L, ed. Ethical Issues in Epidemiological Research. New Brunswick, NJ: Rutgers University, 1986Google Scholar
  66. 66.
    Bayer R, Levine C, Murray TH. Guidelines for confidentiality in research on AIDS. IRB 1984; 6(6):1–9Google Scholar
  67. 67.
    Boe E. Pseudo-identities in health registers? Information technology as a vehicle for privacy protection. Int Privacy Bull 1994;2(3):8–13Google Scholar
  68. 68.
    World Medical Association Declaration of Helsinki. Recommendations guiding medical doctors in biomedical research involving human subjects, here cited from: Levine RJ. Ethics and Regulation of Clinical Research. Baltimore-Munich: Urban & Schwarzenberg, 1981, appendix 4, p. 288Google Scholar
  69. 69.
    Department of Health and Human Services Rules and Regulations. 45 CFR 46 (Tide 45: Code of Federal Regulations; Part 46), 46.111, (a) (7), here cited from: Levine RJ. Ethics and Regulation of Clinical Research. Baltimore-Munich: Urban & Schwarzenberg, 1981, appendix 1, p. 264Google Scholar
  70. 70.
    McCarthy CR, Porter J. Confidentiality: the protection of personal data in epidemiological and clinical research trials. Law Med Health Care 1991;19(3-4):240Google Scholar
  71. 71.
    Meinert CL, Tonascia S. Clinical Trials. Design, Conduct, and Analysis. New York, Oxford: Oxford University, 1986, p. 164Google Scholar
  72. 72.
    Beecher HK. Ethics and clinical research. New Engl J Med 1966;274:1354–1360PubMedCrossRefGoogle Scholar
  73. 73.
    Jonsen AR. Do no harm. Ann Intern Med 1978; 88:827–832PubMedGoogle Scholar
  74. 74.
    Feinstein AR. Clinical biostatics. XLI. Hard science, soft data, and the challenges of choosing clinical variables in research. Clin Pharmacol Ther 1977;22:485–498PubMedGoogle Scholar
  75. 75.
    Schafer RA. Ethics of the randomized controlled trial. New Engl J Med 1982;307:717–724CrossRefGoogle Scholar
  76. 76.
    Marquis D. Leaving therapy to chance. Hastings Cent Rep 1983;13(4):40–47PubMedCrossRefGoogle Scholar
  77. 77.
    Gifford F The conflict between randomized clinical trials and the therapeutic obligation. J Med Philos 1986;11:347–366PubMedCrossRefGoogle Scholar
  78. 78.
    Hellman S., Hellman DS. Of mice but not men. Problems of the randomized clinical trial. New Engl J Med 1991;324:1585–1589PubMedCrossRefGoogle Scholar
  79. 79.
    Passamani E. Clinical trials—are they ethical? New Engl J Med 1991;324:1589–1592PubMedCrossRefGoogle Scholar
  80. 80.
    Johnson N, Lilford RJ, Brazier W. At what level of collective equipoise does a clinical trial become ethical? J Med Ethics 1991;17:30–34PubMedCrossRefGoogle Scholar
  81. 81.
    Botros S. Equipoise, consent and the ethics of randomized clinical trials. In: Byrne P, ed. Ethics and Law in Health Care and Research. Chichester: John Wiley &aamp; Sons, 1990, pp. 9–24Google Scholar
  82. 82.
    Gifford F Community—equipoise and the ethics of randomized clinical trials. Bioethics 1995;9: 125–148CrossRefGoogle Scholar
  83. 83.
    Feinstein AR. Clinical biostatistics. XXVI, Medical ethics and the architecture of clinical research. Clin Pharmacol Ther 1974;15:316–334PubMedGoogle Scholar
  84. 84.
    Dresser R. Book reviews: In: Dodds WJ, Barbara F, Orlans, eds. Scientific Perspectives on Animal Welfare. New York: Academic, 1982. Also in J Med Philos 1984;9:423-425Google Scholar
  85. 85.
    Naverson J. Animal rights. Can J Phil 1977;vii: 161–178Google Scholar
  86. 86.
    Regan T, Singer P. Animal Rights and Human Obligations. Englewood Cliffs, NJ: Prentice Hall, 1976Google Scholar
  87. 87.
    Rowan AN, Rollin BE. Animal research—for and against: a philosophical, social, and historical perspective. Perspect Biol Med 1983;27:1–17PubMedGoogle Scholar
  88. 88.
    Singer P. Animal Liberation. New York: Random House, 1975Google Scholar
  89. 89.
    Mcintosh A. Animal rights and medical research. Future Health, 1985;Winter: 10–11Google Scholar
  90. 90.
    Editorial. Animal experiments. Br Med J 1982; 284:368-369Google Scholar
  91. 91.
    Lane-Petter W. The place and importance of the experimental animal in research. Proc R Soc Med 1972;65:343–344PubMedGoogle Scholar
  92. 92.
    Russell JC, Secord DC. Holy dogs and the laboratory, some Canadian experiences with animal research. Perspect Biol Med 1985;28:374–381PubMedGoogle Scholar
  93. 93.
    Bonchek LI. Are randomized trials appropriate for evaluation new operations? New Engl J Med 1979;301:44–45PubMedCrossRefGoogle Scholar
  94. 94.
    Chalmers TC. Randomized clinical trials in surgery. In: Varco RL, Delaney JP, eds. Controversy in Surgery. Philadelphia: Saunders, 1976, pp. 3–11Google Scholar
  95. 95.
    Feinstein AR. The scientific and clinical tribulations of randomized clinical trials. Clin Res 1978; 26:241–244Google Scholar
  96. 96.
    Haines SJ. Randomized clinical trials in the evaluation of surgical innovation. J Neurosurg 1979; 51:5–11PubMedCrossRefGoogle Scholar
  97. 97.
    Loop FD. A surgeon’s view of randomized prospective studies. J Thorac Cardiovasc Surg 1979; 78:161–165PubMedGoogle Scholar
  98. 98.
    Spodick DH. Randomized controlled clinical trials. The behavioral case. JAMA 1982;247:2258–2260PubMedCrossRefGoogle Scholar
  99. 99.
    Spodick DH, Aronow W, Barber B, Blackburn H, Boyd D, Conti CR, LoGerfo JP, Lown B, Ma-thur VS, Mcintosh HD, Preston TA, Selzer A, Takaro T Standards for surgical trials. Ann Thorac Surg 1979;27:284PubMedCrossRefGoogle Scholar
  100. 100.
    Van der Linden W. On the generalization of surgical trials results. Acta Chir Scand 1980;146: 229–234PubMedGoogle Scholar
  101. 101.
    Feinstein AR. An additional basic science for clinical medicine. II. The limitations of randomized trials. Ann Intern Med 1983;99:544–550PubMedGoogle Scholar
  102. 102.
    Feinstein AR. An additional basic science for clinical medicine. III. The challenges of comparison and measurements. Ann Intern Med 1983; 99:705–712PubMedGoogle Scholar
  103. 103.
    Fisher LD, Kennedy JW. Randomized surgical clinical trials for treatment of coronary artery disease. Controlled Clin Trials 1982;3:235–258PubMedCrossRefGoogle Scholar
  104. 104.
    Merlo G. Surgical trial: possibilities and objections. Eur Surg Res 1984; 16:1–4PubMedCrossRefGoogle Scholar
  105. 105.
    Blindness in surgical trials. Lancet 1980;1:1229-1230. EditorialGoogle Scholar
  106. 106.
    Van der Linden W. Pitfalls in randomized surgical trials. Surgery 1980;87:258–262PubMedGoogle Scholar
  107. 107.
    Moore FD. Perspectives, surgery. Perspect Biol Med 1982;25:698–720PubMedGoogle Scholar
  108. 108.
    Dudley HAF. The controlled clinical trial and the advance of reliable knowledge: an outsider looks in. Br Med J 1983;237:957–960CrossRefGoogle Scholar
  109. 109.
    Norman C. Clinical trial stirs legal battles. Science 1985;227:1316–1318PubMedCrossRefGoogle Scholar
  110. 110.
    Waring GO, Lynn MJ, Fielding B, Asbell PA, Balyeat HD, Cohen EA, Culbertson W, Doughman DJ, Fecko P, McDonald MB, et al. Results of the Prospective Evaluation of Radial Keratotomy (PERK) Study 4 years after surgery for myopia. JAMA 1990;263:1083–1091PubMedCrossRefGoogle Scholar
  111. 111.
    Radial keratotomy. Lancet 1990;335:1131–1132. EditorialCrossRefGoogle Scholar
  112. 112.
    Fyfe IM. The randomized clinical trial: panacea or placebo? Can Med Assoc J 1984;131:1336–1339PubMedGoogle Scholar
  113. 113.
    EC/IC Bypass Study Group. Failure of extracranial-intracranial arterial bypass to reduce the risk of ischemic stroke: results of an international randomized trial. New Engl J Med 1985;313:1191–1200CrossRefGoogle Scholar
  114. 114.
    Spodick DH. Randomize the first patient: scientific, ethical, and behavioral bases. Am J Cardiol 1983;51:916–917PubMedCrossRefGoogle Scholar
  115. 115.
    Managing severe head injury—doing more and faring worse? Lancet 1980;1:1229. EditorialGoogle Scholar
  116. 116.
    McKinlay JB. From promising report to standard procedure: seven stages in the career of a medical innovation. MilbankMem 1981;59:374–411Google Scholar
  117. 117.
    Fielding LP, Stewart-Brown S, Dudley HA. Surgeon-related variables and the clinical trial. Lancet 1978;ii:778–779CrossRefGoogle Scholar
  118. 118.
    Hill Sir Austin Bradford. Medical ethics and controlled trials. Br Med J 1963;1:1043–1049CrossRefGoogle Scholar
  119. 119.
    Esenberg L. The social imperatives of medical research. Science 1977;198:1105–1110CrossRefGoogle Scholar
  120. 120.
    Angell M. Patients’ preference in randomized clinical trials. New Engl J Med 1984;310:1385–1387PubMedCrossRefGoogle Scholar
  121. 121.
    Brewin TB. Consent to randomized treatment. Lancet 1982;ii:919–921CrossRefGoogle Scholar
  122. 122.
    Sade RM, Miller III, Clinton M. Letter. New Engl J Med 1983;308:344Google Scholar
  123. 123.
    Taylor K, Margolese RG, Soskolne CL. Physicians’ reasons for not entering eligible patients in a randomized clinical trial of adjuvant surgery for breast cancer. New Engl J Med 1984;310: 1363–1367PubMedCrossRefGoogle Scholar
  124. 124.
    Dudley HAE Informed consent in surgical trials. Br Med J 1984;289:937-938Google Scholar
  125. 125.
    Consent: how informed? Lancet 1984;1:1445-1447. EditorialGoogle Scholar
  126. 126.
    Ellenberg SS. Randomization designs in comparative clinical trials. New Engl J Med 1984;310: 1404–1408PubMedCrossRefGoogle Scholar
  127. 127.
    St. Augustine. The Confessions, book II. Ryan JK, trans. New York: Image Books, Doubleday, 1960, p. 287Google Scholar
  128. 128.
    The Compact Edition of the Oxford English Dictionary. New York, 1971:1462Google Scholar
  129. 129.
    Council on Scientific Affairs and Council on Ethical and Judicial Affairs. Conflicts of interest in medical center/industry research relationships. JAMA 1990;263:2790–2793. The Councils here use the definition of conflict of interest given in Webster’s Third New International DictionaryCrossRefGoogle Scholar
  130. 130.
    Thompson DF. Understanding financial conflicts of interest. New Engl J Med 1993;329:573–576PubMedCrossRefGoogle Scholar
  131. 131.
    Rodwin MA. Medicine, Money, and Morals: Physician’s Conflict of Interest. New York: Oxford University, 1993Google Scholar
  132. 132.
    Perry CB. Conflicts of interest and the physician’s duty to inform. Am J Med 1994;96:375–382PubMedCrossRefGoogle Scholar
  133. 133.
    Terry PB, Strauss M. The price of trust: conflicts of interest in medicine. Ann Allergy Asthma Immunol 1995;74:115–117PubMedGoogle Scholar
  134. 134.
    Council on Ethical and Judicial Affairs, American Medical Association. Conflicts of interest. Physician ownership of medical facilities. JAMA 1992;267:2366–2369CrossRefGoogle Scholar
  135. 135.
    Council on Ethical and Judicial Affairs, American Medical Association. Guidelines on gifts to physicians from industry: an update. Food Drug Law J 1992;47:445–458Google Scholar
  136. 136.
    Iglehart JK. Efforts to address the problem of physician self-referral. New Engl J Med 1991; 325:1820–1824PubMedCrossRefGoogle Scholar
  137. 137.
    Relman AS. “Self-referral”—what’s at stake? New Engl J Med 1992;327:1522–1524PubMedCrossRefGoogle Scholar
  138. 138.
    Wilkinson P. “Self-referral”: a potential conflict of interest. The GMC should produce tighter guidelines. Br Med J 1993;306:1083–1084CrossRefGoogle Scholar
  139. 139.
    Elks ML. Conflict of interest and the physicianresearcher. J Lab Clin Med 1995;126:19–23PubMedGoogle Scholar
  140. 140.
    Kassirer JP, Angell M. Financial conflicts of interest in biomedical research. New Engl J Med 1993;329:570–571PubMedCrossRefGoogle Scholar
  141. 141.
    Frankel MS. Ethics in research: current issues for dental researchers and their professional society. J Dent Res 1994;73(11);1759–1765PubMedGoogle Scholar
  142. 142.
    Gostin LO, Witt MD. Conflict of interest dilemmas in biomedical research. JAMA 1994;271: 547–551PubMedCrossRefGoogle Scholar
  143. 143.
    Ellis SJ. Peer review and conflicts of interest. J Intern Med 1995;237:219–220PubMedCrossRefGoogle Scholar
  144. 144.
    Pitkin RM. Conflict of interest revisited. Obstet Gynecol 1995, 86:293PubMedCrossRefGoogle Scholar
  145. 145.
    Smith R. Conflict of interest and the BMJ. Time to take it more seriously. Br Med J 1994;308:4–5CrossRefGoogle Scholar
  146. 146.
    Angell M, Kassirer JP. The Inglefinger rule revisited. New Engl J Med 1991;325:1371–1373PubMedCrossRefGoogle Scholar
  147. 147.
    Freestone DS, Miller R, Woodgush G, Pearl S, Pinching AJ, Sleight P, Partridge N, Richmond C, Goodwin P, Smith R. Supplemental Issue on Conflict of Interest. J R Soc Med 1995;88(suppl. 24):1–33PubMedGoogle Scholar
  148. 148.
    Goldrick BA, Larson E, Lyons D. Conflict of interest in academia. Image J Nurs Sch 1995; 27(1):65–69PubMedCrossRefGoogle Scholar
  149. 149.
    Emanuel EJ, Steiner D. aaatInstitutional conflict of interest. New Engl J Med 1995;332:262–267PubMedCrossRefGoogle Scholar
  150. 150.
    The PHS Regulation on Objectivity in Research. Federal Register. 11 July, 1995. Cited and summarized in: Mervis J. Conflict of interest. Final rules put universities in charge. Science 1995; 269:294Google Scholar
  151. 151.
    Rodwin MA. Physicians— conflicts of interest: the limitations of disclosure. New Engl J Med 1989;321:1405–1408PubMedCrossRefGoogle Scholar
  152. 152.
    Harvard University Faculty of Medicine. Policy on Conflicts of Interest and Commitment. Cambridge, Mass.: Harvard Univeristy, March 22, 1990Google Scholar
  153. 153.
    Lock S. Research misconduct: a résumé of recent events. In: Lock S, Wells F. (ed.) Fraud and Misconduct in Medical Research. London: BJM Publishing Group, 1993, pp. 5–24Google Scholar
  154. 154.
    Pellegrino ED. Teaching medical ethics: some persistent questions and some responses. Acad Med 1989;December:701–703Google Scholar
  155. 155.
    Sulmasy D, Terry P, Faden R, Levine D. Longterm effects of ethics education on the quality of care for patients who have do-not-resuscitate orders. J Gen Intern Med 1994;9:622–626PubMedCrossRefGoogle Scholar
  156. 156.
    Pollock RE, Curley SA, Lotzova E. Ethics of research training for NIH T32 surgical investigators. J Surg Res 1995;58:247–251PubMedCrossRefGoogle Scholar
  157. 157.
    Sachs GA, Siegler M. Teaching scientific integrity and the responsible conduct of research. Acad Med 1993;68(12):871–875PubMedCrossRefGoogle Scholar
  158. 158.
    U.S. National Academy of Sciences, Committee on Science, Engineering and Public Policy. On Being a Scientist: Responsible Conduct in Research. Washington, DC: National Academy, 1995Google Scholar
  159. 159.
    Korenman SG, Shipp AC. Teaching the Responsible Conduct of Research Through a Case Study Approach: A Handbook for Instructors. Washington, DC: Association of American Medical Colleges, 1994Google Scholar

Copyright information

© Springer Science+Business Media New York 1998

Authors and Affiliations

  • D. J. Roy
  • P. McL. Black
  • B. McPeek
  • M. F. McKneally

There are no affiliations available

Personalised recommendations