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Conflicts of Interest in Research on Children

Published online by Cambridge University Press:  29 July 2009

Martyn Evans
Martyn Evans
Affiliation:
University College fellow at the Centre for Philosophy and Health Care, University College of Swansea, Wales
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Extract

In a research proposal recently submitted to one of the research ethics committees in Wales, children suffering from otitis media, or ‘glue ear’ as it is more familiarly known, were to be tested for allergic reactions to a number of substances using skin-prick tests. Small lancets would be used to pierce the skin of the forearm, allowing the penetration of traces of the allergenic reagent. The size of the subsequent inflamed area of skin would be measured. To demonstrate the expected correlation between glue ear and an allergic reaction, it would be necessary to see whether other children who did not suffer from glue ear also had the same reactions. If they did not, of course, then some causal association between the reaction and the disease condition could be inferred and investigated, with the hope of improving the treatment of the disease itself.

Type
Special Section: Research Ethics: Ethics at the Borders of Medical Research
Information
Cambridge Quarterly of Healthcare Ethics , Volume 3 , Issue 4 , Fall 1994 , pp. 549 - 559
Copyright
Copyright © Cambridge University Press 1994

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References

Notes

1. This proposed study did not receive the approval of the research ethics committee concerned, and details concerning it are therefore subject to the confidentiality of the committee's proceedings. An anonymous version of the research protocol is included as an appendix to Evans, D. The Training of Members of Local Research Ethics Committees: A Report to the Department of Health. Swansea Wales: Centre for Philosophy and Health Care, University of Swansea, 1992.Google Scholar

2. I am indebted to Dr. Timothy Chambers, consultant pediatrician at the Southmead Hospital, Bristol, U.K., for observations and advice regarding present needs in pediatric medicine and the associated trends in pediatric research. I owe several of the examples referred to in this paper to him.

3. It is a wry consequence of John Harris's advocacy of treating children as persons - in the special sense of the word in which he is interested-that, through being valued no less than the rest of us, they are valued no more greatly either. More generally, he dislikes any position that places special value on being in a particular age group. Harris, J. The Value of Life. London: Routledge and Kegan Paul, 1985.Google Scholar

4. I owe this suggestion to Dr. Priscilla Alderson.

5. Golding, J, Greenwood, R, Birmingham, K, Mott, M. Childhood cancer, intramuscular vitamin K, and pethidine given during labour. British Medical Journal 1992;305:341–6.CrossRefGoogle ScholarPubMed

6. Hull, D. Vitamin K and childhood cancer [editorial]. British Medical Journal 1992;305:326–327.CrossRefGoogle Scholar

7. Dr. Priscilla Alderson argues that even in therapeutic research, the therapeutic gain enjoyed by any given research subject is first of all the result of the treatment she has received rather than of the fact that the treatment is being given as part of a piece of research and secondly is incidental to the purposes of the research, which are to do with the gaining of knowledge concerning the subjects and their medical conditions as a group and are not to do with the benefits enjoyed by any particular one of their number.

8. I am grateful to Dr. Dewi Evans, pediatrician at Singleton Hospital, Swansea, U.K., for describing this study to me and for drawing my attention to its implications.

9. Nicholson, R. Medical Research with Children: Ethics, Law and Practice. Oxford, England: Oxford University Press, 1986.Google Scholar

10. Black, D. Inequalities in Health. Harmondsworth, England: Penguin, 1982.Google Scholar

11. Royal College of Physicians. Guidelines on the Practice of Ethics Committees in Medical Research. London: Royal College of Physicians, 1984.Google ScholarReaffirmed word-for-word in Royal College of Physicians. Research Involving Patients. London: Royal College of Physicians, 1990.Google Scholar