ABSTRACT
Clinical research, in Renee Fox's treatment, drew legitimation for the privilege of employing risky procedures from both the investigational and the patient care value complexes. The physician-investigators, clinical staff, and, indeed, patients on Ward F-Second shared beliefs that research should improve clinical care and that investigational treatment should often benefit patients who received their medical care on the unit. In Fox's discussion the clinician-investigator is an existentialist actor caught in moral dilemmas and trying to reach workable resolutions under trying circumstances. The clinician-investigator strives to create knowledge that will help entire categories of patients in the long run, but must decide on research protocols for particular patients in the immediate setting. Academic Institutional Review Boards (IRBs) in particular have drawn nearly constant criticism for seeming to restrict the investigational freedoms of faculty members. IRBs in clinical institutions have jurisdiction over the points of conflict between the values of therapeutic innovation and the values of clinical care for patients.
