Table 1.

The translational continuum in healthcare research and in bioethics

Stage	Healthcare research stage	Bioethics equivalent
1	Basic science	Discussion of normative theory without any attempt to think about the applicability of moral theory to real life cases
2	Proof of concept—e.g. Phase 0 trial, testing pharmacodynamics and pharmacokinetics of drug to see that it could in principle be an effective therapy	Working out what ought to be done in thought experiments
3	Proof of efficacy—e.g. Phase 2 and 3 trials, demonstrating that the drug has a clinical effect under idealised conditions	Working out what ought to be done in simplified but somewhat realistic cases
4	Proof of effectiveness e.g. Pragmatic trial, to determine the effectiveness of the drug in real world clinical settings	Working out what we should do, all things considered, in real world situations
5	Implementation e.g. Policy changes, supported by healthcare research to benefit patients	Policy changes or other actions to make the world closer to how it should be