Place, Virtue Ethics and Physician-Researcher Dual-Role Consent in Clinical Research

Stephanie R. Morain and colleagues (2019) are right to claim that it is time for a more nuanced and specific approach to dual-role consent in clinical research. Here we show how philosophy of place and virtue ethics provide robust theoretical support for their claim. Drawing on our previous work applying neo-Aristotelian virtue theory to dual and multiple therapeutic relationships in clinical and research practice (Crowden 2008, 2016), and our arguments about why understanding an extended Heideggerian concept of “place” in clinical practice is important (Gildersleeve and Crowden 2018), we outline how potential challenges related to investigator role conflict, fear of diminished participant voluntariness, and therapeutic misconception can be better understood, captured, explained and resolved. Our virtue ethics place-focused framework recognizes the distinct ethical aspects of different physician-investigator relationships and the diverse nature of clinical research. We advance a philosophical analysis about how our “distinct ethics of place” influences ethical decision making in dual-role situations.