Journal of Medical Ethics 43 (12):816-818 (2017)

Luke Gelinas
Albany Medical College
Ensuring that clinical trials, once launched, successfully complete and generate useful knowledge is an important and indeed ethically imperative goal, given the risks and burdens borne by research participants. Since there are insufficient willing research participants to power all the trials that are currently undertaken,1 addressing underenrolment will require prioritisation decisions that reduce the number of trials competing for participants. While there are multiple levels at which research priority-setting can and does take place, competition between trials often plays out in real time at the institutional or site level, where complex decisions must be made about how to manage overlapping trials in ways that balance different considerations, including the risk of non-completion. We sought to explore what research institutions in particular might ethically do to mitigate the risk that competition between trials will contribute to recruitment shortfalls. Against this backdrop, we appreciate the thoughtful replies to our article and are especially encouraged that all three respondents acknowledge the importance and indeed necessity of setting research priorities in ways that respect the rights and interests of various parties. The key question raised by the commentaries primarily concerns not whether research prioritisation should take place but rather how it is best accomplished. In what follows, we clarify our argument in the original article, and then focus on several points raised in the commentaries regarding the role of institutions in research priority-setting. Our approach is animated by the risk that competition between clinical trials for the same population of participants can be a cause of underenrolment when there are insufficient participants to meet the statistical needs of all open studies. In such situations, one or more of the competing studies will fail to meet recruitment targets, reducing their statistical ability to answer the research question. There are strong ethical reasons to avoid …
Keywords No keywords specified (fix it)
Categories (categorize this paper)
DOI 10.1136/medethics-2017-104165
Edit this record
Mark as duplicate
Export citation
Find it on Scholar
Request removal from index
Revision history

Download options

PhilArchive copy

Upload a copy of this paper     Check publisher's policy     Papers currently archived: 60,842
Through your library

References found in this work BETA

An Argument for Fewer Clinical Trials.Kirstin Borgerson - 2016 - Hastings Center Report 46 (6):25-35.
Priority, Prediction and the Ethical Research Enterprise.Spencer Phillips Hey - 2017 - Journal of Medical Ethics 43 (12):812-813.

Add more references

Citations of this work BETA

No citations found.

Add more citations

Similar books and articles

Priority, Prediction and the Ethical Research Enterprise.Spencer Phillips Hey - 2017 - Journal of Medical Ethics 43 (12):812-813.


Added to PP index

Total views
20 ( #527,255 of 2,438,931 )

Recent downloads (6 months)
1 ( #434,842 of 2,438,931 )

How can I increase my downloads?


My notes