Ethics, audit, and research: all shades of grey

doi:10.1136/bmj.330.7489.468

BMJ 2005;330:468-471 (26 February), doi:10.1136/bmj.330.7489.468

Education and debate

Ethics, audit, and research: all shades of grey

Derick T Wade, professor of neurological rehabilitation¹

¹ Oxford Centre for Enablement, Oxford OX3 7LD derick.wade@dsl.pipex.com

Decisions about the need for ethical review should be basedon the morality of all actions rather than arbitrary distinctionsbetween audit and research

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

Introduction

Ethical considerations should apply to all medical practice,but many people act as if they apply only to research. For example,all research studies have to be scrutinised by an ethics committee(institutional review board in the United States), but mostethics committees specifically exclude audit studies from theirremit. Similarly, journal editors and funding agencies willrequire evidence of ethical review before accepting researchfor publication or funding but do not require this for auditstudies. Consequently, the distinction between audit and researchcan have important implications, and the temptation to labelresearch as audit is considerable.¹ Unfortunately, the distinctionis at best difficult. This article reviews the distinction betweenaudit and research, and the nature of ethics.

Audit or research?

Research and audit have many similarities. They both start witha question, both expect the answer to change or influence clinicalpractice, both require formal data collection on patients, andboth . . . [Full text of this article]

When is additional ethical scrutiny needed?

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What factors influence need for ethical review?

External ethical review

Lead investigators: one way forward?

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