Article Text
Abstract
Clinicians and administrators have a professional obligation to contribute (OTC) to improvement of healthcare quality. At the same time, participation in embedded research poses risks to healthcare institutions. Disclosure of an institution’s sensitive information could endanger relationships with patients and undermine its reputation. The existing ethical framework (EF) for learning healthcare systems (LHSs) does not address the conflict between the OTC and institutional interests. Ethical guidance and policy regulation are needed to create a safe environment for embedded research. In this article we analyse the EF for LHSs and the concept of professionalism. We suggest that the EF should be supplemented with an obligation to protect provider’s legitimate interests. We define legitimate interests as those that enable providers to discharge their primary duties. We argue that both the OTC and the obligation to protect legitimate interests are grounded in the concept of medical professionalism and can be understood as a matter of contract between a democratic society and medical professionals. The proposed supplemented EF can be implemented into a regulatory system in three different ways: the self-regulating: where providers decide themselves how to balance the ethical claims, the centralised: where a governmental institution decides the right balance between providers’ interests and interests of a health system; and the mediating: where medical professionals, the state and patients negotiate their interests. Our article contributes to the discussion on ethical relevance of providers’ interests and the regulatory model for weighing opposite interests in LHSs.
- interests of health personnel/institutions
- public health ethics
- quality of healthcare
- research ethics
- applied and professional ethics
Statistics from Altmetric.com
Request Permissions
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.
Copyright information:
Read the full text or download the PDF:
Other content recommended for you
- Enabling individualised health in learning healthcare systems
- Ensuring respect for persons in COMPASS: a cluster randomised pragmatic clinical trial
- Using a network organisational architecture to support the development of Learning Healthcare Systems
- Pharmacotherapy within a learning healthcare system: rationale for the Dutch Santeon Farmadatabase
- Making sense of the shadows: priorities for creating a learning healthcare system based on routinely collected data
- Evaluation protocol of the implementation of a learning healthcare system in clinical practice: the Connected Health Cities programme in the north of England
- Can the NHS be a learning healthcare system in the age of digital technology
- Research or clinical care: what ’s the difference
- Identifying positively deviant elderly medical wards using routinely collected NHS Safety Thermometer data: an observational study
- How should we think about clinical data ownership