Ethical considerations should apply to all medical practice and interventions that affect patients. This should include social caregiving, which at present is not seen as being in need of moral or ethical consideration. And if audit is potentially more likely to lead to change than research, as Wade claims,1 clearly it should be given equal consideration and outcomes followed up.

Sometimes, however, it feels as though ethics committees are putting up barriers to much needed research. As a former carer for my husband, a general practitioner who developed Alzheimer's disease in his 50s, I …