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Clinician gate-keeping in clinical research is not ethically defensible: an analysis
  1. Kerith Sharkey1,
  2. Julian Savulescu2,
  3. Sanchia Aranda1,3,
  4. Penelope Schofield1,3,4
  1. 1Department of Nursing and Supportive Care Research, Peter MacCallum Cancer Centre, East Melbourne, Australia
  2. 2Oxford Uehiro Centre for Practical Ethics, University of Oxford, Oxford, UK
  3. 3Melbourne School of Health Sciences, The University of Melbourne, Parkville, Australia
  4. 4Psychological Sciences, The University of Melbourne, Parkville, Australia
  1. Correspondence to Assistant Professor Penelope Schofield, Department of Nursing and Supportive Care Research, Peter MacCallum Cancer Centre, Locked bag 1, A'Beckett Street, Vic 8006, Australia; penelope.schofield{at}


Clinician gate-keeping is the process whereby healthcare providers prevent access to eligible patients for research recruitment. This paper contends that clinician gate-keeping violates three principles that underpin international ethical guidelines: respect for persons or autonomy; beneficence or a favourable balance of risks and potential benefits; and justice or a fair distribution of the benefits and burdens of research. In order to stimulate further research and debate, three possible strategies are also presented to eliminate gate-keeping: partnership with professional researchers; collaborative research design and clinician education.

  • Beneficence
  • ethics
  • justice
  • paternalism
  • personal autonomy
  • research
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  • Funding This work was funded by grants from the Cancer Council and the National Health and Medical Research Council (ID no 509143).

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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