Do Clinicians Have a Duty to Participate in Pragmatic Clinical Trials?

• Published in: American journal of bioethics Vol. 23; no. 8; pp. 22 - 32
• Main Authors: Garland, Andrew, Morain, Stephanie, Sugarman, Jeremy
• Format: Journal Article
• Language: English
• Published: United States Taylor & Francis 03.08.2023
• Subjects: Conscience; conscientious objection; Health services research; Humans; Morals; pragmatic clinical trials; Pragmatic Clinical Trials as Topic; professional duties; professional ethics; Refusal to Treat; research ethics; professional ethics; pragmatic clinical trials; research ethics; conscientious objection; professional duties; Health services research
• ISSN: 1526-5161; 1536-0075; 1536-0075
• DOI: 10.1080/15265161.2022.2146784

Clinicians have good moral and professional reasons to contribute to pragmatic clinical trials (PCTs). We argue that clinicians have a defeasible duty to participate in this research that takes place in usual care settings and does not involve substantive deviation from their ordinary care practices. However, a variety of countervailing reasons may excuse clinicians from this duty in particular cases. Yet because there is a moral default in favor of participating, clinicians who wish to opt out of this research must justify their refusal. Reasons to refuse include that the trial is badly designed in some way, that the trial activities will violate the clinician's conscience, or that the trial will impose excessive burdens on the clinician.