Theoretical Medicine and Bioethics

, Volume 33, Issue 1, pp 45–56 | Cite as

The historical foundations of the research-practice distinction in bioethics

Article

Abstract

The distinction between clinical research and clinical practice directs how we partition medicine and biomedical science. Reasons for a sharp distinction date historically to the work of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, especially to its analysis of the “boundaries” between research and practice in the Belmont Report (1978).Belmont presents a segregation model of the research-practice distinction, according to which research and practice form conceptually exclusive sets of activities and interventions. This model is still the standard in federal regulations today. However, the Commission’s deliberations and conclusions about the boundaries are more complicated, nuanced, and instructive than has generally been appreciated. The National Commission did not conclude that practice needs no oversight comparable to the regulation of research. It debated the matter and inclined to the view that the oversight of practice needed to be upgraded, though the Commission stopped short of proposing new regulations for its oversight, largely for prudential political reasons.

Keywords

Belmont report Research Practice Innovative treatment IRBs History of medical ethics Nonvalidated treatment Politics of bioethics Regulation Research ethics 

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Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  1. 1.Kennedy Institute of Ethics, Georgetown UniversityWashingtonUSA

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