Skip to main content
Log in

Ethical Considerations in Decentralized Clinical Trials

  • Symposium: COVID-19
  • Published:
Journal of Bioethical Inquiry Aims and scope Submit manuscript


As a consequence of the COVID-19 pandemic, the number of decentralized clinical trials, trials conducted in whole or in part at locations other than traditional clinical trial sites, significantly increased. While these trials have the potential advantage of access, participant centricity, convenience, lower costs, and efficiency, they also raise a number of important ethical and practical concerns. Here we focus on a number of those concerns, including participant safety, privacy and confidentiality, remote consent, digital access and proficiency, and trial oversight. Awareness of these ethical complexities will help foster the development of processes and cooperative solutions to promote safe, ethical trials going forward, optimized to decrease burden and increase access for all participants.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. While not an ethical concern, remuneration to the HCPs for their research time and work must also be arranged, as they cannot bill these services to payers. Some national health insurance plans include clinical research in allowable provider activities.


Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Barbara E. Bierer.

Ethics declarations

Competing interest

There are no competing interests to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bierer, B.E., White, S.A. Ethical Considerations in Decentralized Clinical Trials. Bioethical Inquiry 20, 711–718 (2023).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: