BMJ  2005;330:473 (26 February), doi:10.1136/bmj.330.7489.473

Commentary

ethical review and ethical behaviour

John McMillan, senior lecturer in medical ethics1, Mark Sheehan, lecturer2

1 Hull York Medical School, Department of Philosophy, University of Hull, Hull HU6 7RX, 2 Centre for Professional Ethics, Keele University, Keele ST5 5NA

Correspondence to: J McMillan john.mcmillan@hyms.ac.uk

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

Wade's main concern is that the distinction between audit and research is arbitrary and often means that attention is not paid to what is really ethically important in many aspects of medicine.1 We agree that the distinction between audit and research is difficult to sustain. He is right to insist that the features specific to proposed research or audit are what determine it's ethical importance and whether it should be scrutinised. Whether a proposal is audit or research does not and cannot affect its ethical importance.

That said, the intuitive distinction between audit and research often tracks the burdens and risks that Wade points to. So, by and large, audit involves gentler burdens and risks than (clinical) research. Although this is not always the case, audit and studies that do not require ethical scrutiny are likely to roughly correspond. (Confidentiality and consent are likely to remain important in audit-type studies.)

. . . [Full text of this article]


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