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The Invisible Hand in Clinical Research: The Study Coordinator's Critical Role in Human Subjects Protection

Published online by Cambridge University Press:  01 January 2021

Extract

Over the past decade, the number of clinical trials registered with the Food and Drug Administration (FDA) has increased dramatically. The business of clinical research has become more diverse, involving academic institutions, clinician-researchers in community settings, pharmaceutical companies, and contract research organizations. This growth has been accompanied by increasing concerns about the ethical conduct of research. Much of this concern has been directed to procedural issues including institutional review board (IRB) review, data monitoring, and informed consent forms. However, the protection of human subjects cannot be achieved by relying solely on procedural safeguards. There are more nuanced issues related to recruitment and retention of subjects, and to the process of informed consent, that are generated during the interaction between study staff and subjects. It is only through an examination of these relationships that one can more fully define and understand the challenges of protecting subjects in research.

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Article
Copyright
Copyright © American Society of Law, Medicine and Ethics 2002

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References

Hovde, M. Seskin, R., “Selecting U.S. Clinical Investigators,” Applied Clinical Trials, 8 (1997): 3442.Google Scholar
Department of Health and Human Services, Office of Inspector General, The Globalization of Clinical Trials: A Growing Challenge in Protecting Human Subjects, OEI-01-00-00190 (September 2001), available at <http://oig.hhs.gov/oei/reports/oei-01-00-00190.pdf>..>Google Scholar
Annas, G.J., “Reforming Informed Consent to Genetic Research,” JAMA, 286 (2001): 2326–28.CrossRefGoogle Scholar
King, N. Henderson, G. Stein, J., Beyond Regulations: Ethics in Human Subjects Research (Chapel Hill: University of North Carolina Press, 1999).Google Scholar
Papke, A., “The ACRP National Job Analysis of the Clinical Research Coordinator,” The Monitor, Winter (1996): 4553, at 46.Google Scholar
Cooper, J. Lomax, J., “The Role of the Research Nurse in Clinical Trials,” British Journal of Clinical Practice, 43 (1989): 167–68;.Google Scholar
Isaacman, D.J. Reynolds, E.A., “Effect of a Research Nurse on Patient Enrollment in a Clinical Study,” Pediatric Emergency Care, 12 (1996): 340–42.CrossRefGoogle Scholar
Good, M. Schuler, L., “Subject Retention in a Controlled Clinical Trial,” Journal of Advanced Nursing, 26 (1997): 351–55.CrossRefGoogle Scholar
McKinney, J. Vermeulen, W, “Research Nurses Play a Vital Role in Clinical Trials,” Oncology Nurse Forum, 27 (2000): 2829, at 28.Google Scholar
Grady, C., “Ethical Issues in Clinical Trials,” Seminars in Oncology Nursing, 7 (1991): 288–96; Di Giulio, P. et al. , “Expanding the Role of the Nurse in Clinical Trials: The Nursing Summaries,” Cancer Nursing, 19 (1996): 343–47.CrossRefGoogle Scholar
Ecklund, D.J., “Establishing a Research Coordinator Network: The Birth of an Idea,” Journal of Nursing Administration, 29 (1999): 2025; Hicks, C., “Nurse-Researcher: A Study of a Contradiction in Terms?,” Journal of Advanced Nursing, 24 (1996): 357–63;.CrossRefGoogle Scholar
Johnson, J.M., “Clinical Trials: New Responsibilities and Roles for Nurses,” Nursing Outlook, 34 (1986): 149–53.Google Scholar
Gamache, V.,“Chasing Away Phantom Investigators,” CenterWatch, 8, no. 11 (2001): 1, 59 at 1.Google Scholar
Stewart, D.W. Shamfasani, P.N., Focus Groups: Theory and Practice (Newbury Park, California: SAGE Publications, 1990);. Krueger, R.A., Focus Groups: A Practical Guide for Applied Research, 2d ed. (Thousand Oaks, California: SAGE Publications, 1994).Google Scholar
Merton, R.K. Fiske, M. Kendall, P.L., The Focused Interview: A Manual of Problems and Procedures, 2d ed. (New York: The Free Press, 1990).Google Scholar
Entwisle, B. et al. , “Designing Points of Convergence: Methods for Integrating Qualitative Approaches into Quantitative Analysis” (2002) (unpublished).Google Scholar
N5, QSR International Pty Ltd, Melbourne, Australia.Google Scholar
Annas, G.J., Standard of Care: The Law of American Bioethics (New York: Oxford University Press, 1993).Google Scholar
Ragin, C., The Comparative Method: Moving Beyond Qualitative and Quantitative Strategies (Berkeley: University of California Press, 1987).Google Scholar
See Grady, , supra note 9;.Google Scholar
Di Giulio, et al. , supra note 9;.Google Scholar
Ecklund, , supra note 10;.Google Scholar
Hicks, , supra note 10;.Google Scholar
Johnson, , supra note 10.Google Scholar
See Di Giulio, et al. , supra note 9; Seguin, D.A., “My Role as a Research Nurse Coordinator,” Critical Care Nursing, 12 (1990): 3944.CrossRefGoogle Scholar
See Papke, , supra note 5;. Cooper, Lomax, , supra note 6;.Google Scholar
Isaacman, Reynolds, , supra note 6;.Google Scholar
Good, Schuler, , supra note 7;.Google Scholar
McKinney, Vermeulen, , supra note 8.Google Scholar
Abbott, A., The System of Professions (Chicago: University of Chicago Press, 1988).CrossRefGoogle Scholar
See Johnson, , supra note 10;.Google Scholar
Hubbard, S.M. Donehower, M.G., “The Nurse in a Cancer Research Setting,” Seminars in Oncology, 7 (1980): 917.Google Scholar
National Institutes of Health, Required Education in the Protection of Human Research Participants, Notice OD-00-039 (June 5, 2000) (revised August 25, 2000), available at <http://grants.nih.gov/grants/guide/notice-files/NOT-OD-00-039.html>..>Google Scholar
Churchill, L.R., “Physician-Investigator/Patient-Subject: Exploring the Logic and the Tension,” Journal of Medical Philosophy, 5 (1980): 215–24;.CrossRefGoogle Scholar
Katz, J., “Human Experimentation and Human Rights,” Saint Louis University Law Journal, 38 (1993): 754;.Google Scholar
Slatkoff, S.F. Curtis, P. Coker, A., “Patients as Subjects for Research: Ethical Dilemmas for the Primary Care Clinician-Investigator,” Journal of the American Board of Family Practice, 7 (1994): 196201;.Google Scholar
Miller, F.G. Rosenstein, D.L. DeRenzo, E.G., “Professional Integrity in Clinical Research,” JAMA, 280 (1998): 1449–54;.CrossRefGoogle Scholar
Elks, M.L., “Conflict of Interest and the Physician-Researcher,” Journal of Laboratory Clinical Medicine, 126 (1995): 1923.Google Scholar
Reverby, S.M., “Rethinking the Tuskegee Syphilis Study: Nurse Rivers, Silence and the Meaning of Treatment,” Nursing History Review, 7 (1999): 328;. Reverby, S.M., ed., Tuskegee Truths: Rethinking the Tuskegee Syphilis Study (Chapel Hill: University of North Carolina Press, 2000).CrossRefGoogle Scholar
See Gamache, , supra note 11.Google Scholar