Hastings examines QI, research, ethics crossover
Writings analyze similarities and differences
Are research and quality improvement (QI) mutually exclusive, or natural partners? When QI crosses over into research, what ethical issues can arise?
The Hastings Center bioethics research center has assembled a collection of original papers that delve into the ethical and regulatory aspects of QI. Health Care Quality Improvement: Ethical and Regulatory Issues, edited by Bruce Jennings, Mary Ann Baily, Melissa Bottrell, and Joanne Lynn, is available as a free download from The Hastings Center web site (see editor's note).
Among the topics are discussions of how QI differs from research; the duty of physicians, nurses, and administrators in initiating and participating in QI activities; how to manage troublesome research ethics questions; and what oversight will ensure that QI does not harm patients.
The editors point out that ethical issues arise in QI because attempts to improve the quality of care for some patients may sometimes inadvertently cause harm, may benefit some patients at the expense of others, or may waste scarce health-care resources. Ethical issues also arise because some activities aimed at improvement have been interpreted as a form of medical research in which patients are used as subjects. If this interpretation is correct, QI would be subject to the same complex review and regulatory requirements that have been set up to govern biomedical and other types of human-subjects research.
(For more information and to download Health Care Quality Improvement: Ethical and Regulatory Issues, go to www.thehastingscenter.org.)
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