Clinicians and patients' welfare: where does academic freedom fit in?

doi:10.1136/bmj.329.7469.795

BMJ 2004;329:795-796 (2 October), doi:10.1136/bmj.329.7469.795

Education and debate

Clinicians and patients' welfare: where does academic freedom fit in?

James G Wright, professor¹, John H Wedge, professor¹

¹ Department of Surgery, University of Toronto, Hospital for Sick Children, 555 University Avenue, Toronto, ON, Canada M5G 1X8

Correspondence to: J G Wright jim.wright@sickkids.ca

Academic freedom has accompanying responsibilities, and boundaries;but are there additional constraints specific to clinicians,such that research and teaching would conflict with caring forpatients?

The first 150 words of the full text of this article appear below.

Introduction

Suppose you are a surgeon who wants to do a randomised clinicaltrial comparing open with thoracoscopic spinal instrumentationand fusion. You prepare the trial and receive funding from anational funding agency—but the chief of surgery at yourhospital deems that you fail to meet acceptable standards ofcompetence and withdraws your privileges, effectively endingyour research. Privileges in hospital can be limited or revokedfor many reasons in addition to clinical proficiency: unacceptablestandards of behaviour towards patients, failure to maintainadequate medical records, and substance abuse, for example.Inability to proceed with your trial means your academic freedomhas been limited. Academic freedom for clinicians is contentiousbecause the missions of universities and their faculty differfundamentally from those of hospitals and their clinicians.^1-4This article addresses a practical issue; are clinical facultydifferent from faculty in the rest of the university, and ifso, what is . . . [Full text of this article]

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