RT Journal Article SR Electronic T1 At the coalface--medical ethics in practice. First, do no harm. JF Journal of Medical Ethics JO J Med Ethics FD BMJ Publishing Group Ltd and Institute of Medical Ethics SP 377 OP 378 DO 10.1136/jme.23.6.377 VO 23 IS 6 A1 S Groudine A1 P D Lumb YR 1997 UL http://jme.bmj.com/content/23/6/377.abstract AB When a physician acts as both doctor and researcher conflicts can develop. When a doctor does not know whether a patient is taking active drug or placebo, any new medical problems can result in a dilemma. Is the patient's suffering a side effect of the medication or is this a new medical problem? Mrs W's case demonstrates the problem that can occur when the physician is blinded in the name of research.