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Thinking and practice have evolved about the role that academics play in civic discourse, particularly about the influence of their scholarly, peer-reviewed research in the policy world. This chapter reviews different types of impact that academics have and can have inside the academy through publishing in academic journals, and outside the academy by translating knowledge to policy including through participating on and leading committees and other policy organisations. Both environments also include an under-appreciated type of impact, namely the legacy of one’s work through interactions with others. The chapter describes the changing landscape in which knowledge production and dissemination occur, highlighting the growth of international, collaborative work, to place the changing faces of impact into a broader environmental context. Finally, these two strands of impact and legacy are brought together for some concluding reflections about their future importance.
In many counties, there is a loose ecosystem of advisory committees, experts, lobbyists and interested groups that are variously used to provide governments with expert advice and input on matters of policy. This chapter focuses on how governments make use of expertise to inform health regulation, where the expertise comes from sources connected to, but somewhat on the periphery of, the formal processes of policy development through legislation or judicial review. Two examples are drawn upon from direct experience (and are therefore somewhat subjective): (1) the use of expert panels supported by scholarly academies that are organised to provide input to government; and (2) advisory committees established by government with a focus on the former US National Bioethics Advisory Commission. Both types play particular roles in the ecosystem of a country’s policy advice regime but have different features. There is a both a rich scholarly literature and a grey literature on other structures and examples. The main emphasis is that expert advice in its many iterations forms part of the regulatory apparatus that governments do make use of in developing regulation and other policy. However, these are often underappreciated and therefore difficult to assess with respect to impact.
This chapter reviews the basics of being a research subject, including the potential benefits and risks of making important decision. Of course, patients are not the only people approached to participate in medical research. Many projects involve healthy people. In fact, the earliest stages of research on any new medication almost always involve testing healthy people to determine side effects and correct dosages. The first step in deciding whether to participate in a research study is to understand what research is and how it differs from medical treatment. The goal of medical research is to obtain information that can improve health and medical care in the future. Some clinical trials are designed to study a medical procedure or device, rather than a drug. Although research involves some type of inconvenience, not all research is physically risky.
Dr. A is a family practitioner with a special interest in the treatment of chronic obstructive pulmonary disease. He receives a letter from the coordinator of a study to evaluate a promising new treatment for this condition. The letter invites Dr. A to submit the names of potentially eligible patients. He will be paid $100 for each name provided.
Dr. B, a psychiatrist in private practice, is approached by a pharmaceutical company to assist with a clinical trial to test the efficacy of a new drug in the treatment of acute psychosis. The study will enroll acutely psychotic patients with no history of psychosis (or of treatment with antipsychotic drugs) through physicians' offices and emergency departments. Patients enrolled in the study will be randomly assigned to receive the new medication or a placebo and will remain in hospital for eight weeks. During this time, they will not be permitted to receive antipsychotic medications other than the study drug. Informed consent will be obtained from each participant or a proxy. Patients may be withdrawn from the study if their medical condition worsens substantially.
What is research ethics?
Research involving human subjects can raise difficult and important ethical and legal questions. The field of research ethics is devoted to the systematic analysis of such questions to ensure that study participants are protected and, ultimately, that clinical research is conducted in a way that serves the needs of such participants and of society as a whole.
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