Ethics and methodology, not bureaucracy

We have a dream that within ten years, patients admitted to teaching hospitals will long to be enrolled in “researcher driven”*randomized clinical trials. Patients will be fully aware of the reduced complication rates and the improved outcomes that occur in patients involved in randomized clinical trials, the so-called “Hawthorne effect”. We have a dream that within ten years scientists will not have to spend months waiting for ethics committee approval and will not have to raise thousands of Euros in funds to carry out their research. On the contrary, they will have a 50% salary increase as they are spending their creative and enthusiastic energies to perform clinical trials (at present, hospitals receive several thousand Euros from the Ministry of Health for each published article, yet the clinical scientist generally knows nothing about it). Although both “company driven” and “researcher driven” research are important and useful, the differences are striking. Unfortunately, patients, medical doctors and legislators do not seem to be fully aware of these differences. One reason for this might be the influence of international insurance, pharmaceutical and quality-control lobbies. Today, a clinical scientist who wants to compare two forms of treatment that have routinely been used in clinical practice for around 20 E di to ri al Ethics and methodology, not bureaucracy