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PPI, paradoxes and Plato: who's sailing the ship?
  1. Jonathan Ives,
  2. Sarah Damery,
  3. Sabi Redwod
  1. Department of Primary Care Clinical Sciences, University of Birmingham, Birmingham, UK
  1. Correspondence to Dr Jonathan Ives, Medicine, Ethics, Society & History (MESH), School of Health and Population Sciences, The University of Birmingham, 90 Vincent Drive, Edgbaston, Birmingham, B15 2TT, UK; j.c.ives{at}


Over the last decade, patient and public involvement (PPI) has become a requisite in applied health research. Some funding bodies demand explicit evidence of PPI, while others have made a commitment to developing PPI in the projects they fund. Despite being commonplace, there remains a dearth of engagement with the ethical and theoretical underpinnings of PPI processes and practices. More specifically, while there is a small (but growing) body of literature examining the effectiveness and impact of PPI, there has been relatively little reflection on whether the concept/practice of PPI is internally coherent. Here, the authors unpick a ‘paradox’ within PPI, which highlights a tension between its moral and pragmatic motivations and its implementation. The authors argue that this ‘professionalisation paradox’ means we need to rethink the practice, and purpose, of PPI in research.

  • Medical ethics
  • philosophy of the family
  • research ethics
  • fatherhood
  • ethics in medical education
  • epidemiology
  • primary care
  • research on special populations
  • sociology
  • applied and professional ethics
  • ethics committees/consultation

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  • Funding Sabi Redwood is funded by the National Institute for Health Research (NIHR) through the Birmingham and Black Country Collaborations in Leadership in Health Research and Care (CLAHRC-BBC). The views expressed in this publication are not necessarily those of the NIHR, the Department of Health, NHS Partner Trusts, or the CLAHRC-BBC.

  • Competing interests None.

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

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