Institutional and Professional Orders of Ethics in the Discourse Practices of Research Recruitment in Oncology

Abstract

The focus of this volume is ‘the changing relationship between clinical professionals and the organizations they work in … trac[ing] whether and how clinicians deal with increased pressure … from having to coordinate increasingly complex kinds of clinical work’ (see Iedema, Chapter 1 in this volume). The focus of this chapter is the recruitment of patients to participate in medical research in the United States, specifically recruitment to clinical trials in cancer research.1 A clinical trial is defined formally as a protocol for experimental treatment, including chemotherapy in cancer research (http://www.cancer.gov), and a serious problem in medicine today is that too few patients enrol in clinical trials in cancer research, creating significant obstacles to progress in medical research and patient care (Harris Interactive, 2001; Russo, 1999). The National Cancer Institute (NCI) estimates that fewer than 5 per cent of patients nationwide enter clinical trials, a number that is even lower for minority groups, and many trials are delayed or even discontinued due to low enrolment (www.cancer.gov/clinicaltrials/digestpage/boostingtrial-participation).