Restoring trust through bioethics education?

Ethically conducted research involving human participants is a cornerstone of the academic medical research establishment. However, there is public mistrust of clinical research and, as a result, low participation rates in research studies among minorities and in communities where health disparities are glaring. Specific initiatives have been undertaken by the National Institutes of Health (NIH) to restore public confidence in biomedical research and to ensure that research is conducted ethically and responsibly. The T15 program, instituted in 1997, made awards beginning in 1998 to institutions for up to three years to develop, conduct, and evaluate short-term courses on ethical issues in research. A companion solicitation (K01 program) targeted the career development of independent investigators in applied research ethics through mentored scientist development awards in research ethics. Both programs emphasized ethical research involving human participants and outreach to minority scientists. The author asks how the success of these programs should be gauged, especially in light of new--and often unforeseen--ethical challenges that are likely to confront the research community. Participation in some T15 programs indicates that few researchers and practitioners perceived the need to increase their proficiency in analyzing the ethical dimensions of their work. To improve participation and, ultimately, ethical approaches to human participants research, the NIH should foster appreciation for the centrality of bioethics in the biomedical research enterprise. The author calls on the NIH to provide leadership for bioethics by further developing a national agenda for bioethics training and research.