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To the Editor: I take exception to the definition of clinical research offered by Dr Nathan¹ as "patient-oriented research." This misnomer fails to acknowledge the significant conflict inherent in clinical research between a physician-scientist's devotion to the promotion of health for the individual patient and allegiance to the outcome of human research.

A luncheon discussion last year with a well-known researcher illustrates my point. The researcher was commenting on the differences between the mindsets of military brass and those of noncommissioned field officers who are in the trenches, directly leading their troops. He pointed out that war may at times require a strategic loss of life in 1 sector to win the war or protect more life in another sector. Thus, a general may draw battle plans with "acceptable" troop casualty projections. However, it is the field officer's goal to reach the objective while protecting individual troops. These differences in . . . [Full Text of this Article]

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RELATED ARTICLE

Clinical Research: Perceptions, Reality, and Proposed Solutions
David G. Nathan and for the National Institutes of Health Director's Panel on Clinical Research
JAMA. 1998;280(16):1427-1431.
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