As someone who fulfills the roles of both clinician and bioethicist, I am increasingly aware of the ethical ramifications of the intertwining of clinical care and clinical research and the implications it has for patient care and outcomes. Is it possible for physician-investigators to simultaneously fulfill their ethical obligations to their patients and to science when these obligations conflict? Addressing this fundamental question is the focus of my career development proposal. Through the development of this study and the mentored scholarly activity that will precede it, I will develop into a bioethicist committed to both the practice of clinical bioethics and the exploration of ethical issues through the application of empirical research methods. This study will focus on the perceptions of physician-investigators about their dual role as physician and investigator, and how they view their ethical obligations to their research subjects and their research. To accomplish these goals, vignettes and semi-structured interviews will be administered to a sample of physician-investigators at three university-affiliated academic centers located in the Cleveland area.
The specific aims of this study are to: 1) describe physician-investigators' perceptions about their simultaneous roles as investigators and physicians; 2) describe the sources of conflict present in the conduct of human subjects research by physician-investigators; 3) elucidate the mechanisms described by this group to resolve these conflicts; and 4) evaluate the implications of these to the conduct of research involving human subjects.
