Research ethics in the COVID-19 pandemic
2020 - 2023
The COVID-19 pandemic has had a devastating effect globally. Hundreds of millions of people have been infected with the SARS-CoV-2 virus and, according to the Economist Intelligence Unit, between 7 and 15 million people have died globally. The pandemic has highlighted difficult research ethics issues, including ethical issues in human challenge studies, cluster trials to evaluate public health measures, and reporting randomized controlled trials impacted by the pandemic. My research and public outreach explore each of these issues.
Developing a framework for the ethical design and conduct of pragmatic randomized trials
2017 - 2021
To make informed decisions, patients, health providers and health system managers need reliable evidence of treatment safety, effectiveness and cost. Pragmatic randomized controlled trials (RCTs) are designed to provide such evidence by evaluating treatments in real-world conditions. But pragmatic RCTs raise difficult ethical issues that challenge researchers and research ethics committees. Our research team, comprising 25 philosophers, trialists and biostatisticians from five countries, will develop guidance for the ethical design and conduct of pragmatic RCTs.
Ethical issues in neuroimaging after serious brain injury
2014 - 2018
With 50,000 new cases occurring each year in Canada, serious brain injuries place an enormous burden on patients, families, and the healthcare system. Following a period of coma, some patients make a good recovery, while others progress into a vegetative state. Neuroimaging offers the prospect of improved prediction of patient outcome and increased diagnostic accuracy. Remarkably, in 3 cases, neuroimaging has been used to communicate with patients thought to be vegetative. Neuroimaging after serious brain injury raises difficult ethical issues that must be addressed before it can be responsibly adopted in practice. Our research team brings together philosophers, neurologists, and neuroscientists to provide answers to these difficult problems.
Ethical and policy issues in cluster randomized trials
2008 - 2013
The gap between medical evidence and medical practice is one of the most important challenges for the health of Canadians. The cluster randomized trial (CRT) is the major methodological tool in use in the development of new interventions to bridge the gap between evidence and practice. This project brings together clinical trialists, biostatisticians, and philosophers to address ethical and policy obstacles to the conduct of CRTs. The project uses an innovative “mixed methods” approach to document current practice and analyze ethical issues. A major outcome is the development of international ethics guidelines for CRTs.