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Article
April 10, 1991

Ethical Aspects of Human Experimentation in Health Services Research

Author Affiliations

From the Department of Medicine, New England Deaconess Hospital and Harvard Medical School, Boston, Mass, and The Program in Ethics and the Professions, Harvard University, Cambridge, Mass (Dr Brett); and City of Boston Department of Health and Hospitals, Boston University Schools of Medicine and Public Health (Dr Grodin).

From the Department of Medicine, New England Deaconess Hospital and Harvard Medical School, Boston, Mass, and The Program in Ethics and the Professions, Harvard University, Cambridge, Mass (Dr Brett); and City of Boston Department of Health and Hospitals, Boston University Schools of Medicine and Public Health (Dr Grodin).

JAMA. 1991;265(14):1854-1857. doi:10.1001/jama.1991.03460140082031
Abstract

OVER the past several decades, ethical issues in human experimentation have received increasing attention in the medical literature. Most of this literature presumes a fairly standard conception of modern medical research, ie, the application of a therapeutic intervention to a group of persons with a specific diagnosis. Prototypic examples include comparisons of two drugs, or drug and placebo, for specific diagnostic entities such as cancer. For lack of better terminology, we will refer to these studies collectively as conventional research.

In contrast, the organizational, procedural, and economic aspects of health care provision have themselves become the focus of an enlarging body of research, termed health services research. Until recently, these studies were characterized primarily by either retrospective data collection or concurrent observation without experimental intervention. However, in an attempt to achieve greater scientific rigor, health services research has increasingly included prospective interventions involving human subjects.

The scope of this research

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