Academic medicine: who is it for?

Editor—Wright and Wedge contend that the academic freedom of clinical academics is constrained by the primacy of patients' welfare, putting them in a different position to non-clinical academics.¹ However, they may be more similar to other academics than they think.

Academic freedom has two aspects: the freedom to research whatever the academic wishes, and the freedom to interpret data free from outside influence. The first freedom was lost by all academics because of the research assessment exercise.

The second freedom is arguably more important. Patients' safety may be compromised by inappropriate conclusions being drawn, but this is part of the scientific debate central to all research. Patients' safety can be compromised by non-academic clinicians whose practice is affected by other interests—for example, links with the drug industry.

All researchers have a duty not to harm research participants or place the public at risk while carrying out their research. As universities move to require ethical approval for all research, including that on humans, this becomes ever more clear. A different issue is the use to which some research is put.

Finally, the authors raise issues of competence and unacceptable behaviour. All researchers, in any discipline, can carry out research ethically and safely only if they have the appropriate skills so to do. Unacceptable behaviour, to research participants or members of the department, can lead to complaints and disciplinary action, which might have an impact on research.

Medicine's particular role has meant that ethical guidelines for research have led other disciplines. Rather than seek to see itself as apart it would be more helpful to engage in the wider discussions on ethical research, public safety, and the use of research.