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  1. David Coggon
  1. Professor David Coggon, MRC Environmental Epidemiology Unit, Southampton General Hospital, Southampton S016 6YD, UK dnc{at}

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Ethical aspects of medical research have had a high public profile in the UK lately. There has been concern, for example, about the level of information provided to participants when consenting to clinical trials; regarding the retention of organs removed at necropsy without the knowledge or permission of next of kin; and about the rights and wrongs of cloning human tissues. In general, occupational health research is less controversial. Most studies involving human subjects are observational rather than experimental, and do not entail hazardous clinical procedures. Nevertheless, difficult ethical questions do sometimes arise, both in the design of occupational studies and in the communication and application of their findings. Moreover, the acceptability of some epidemiological methods that have been widely used in occupational health research is now being questioned. It is important that the potential consequences of abandoning or restricting such techniques are properly considered before limitations are imposed.


The ethics of medical research come into question most obviously where investigations entail risks or disadvantages to individual participants that are not clearly outweighed by concomitant personal benefits. However, the range of ethical issues in occupational health research extends wider than just the design and conduct of studies (box 1).

Study question

There may be doubts about the acceptability even of posing some research questions, if there is a possibility that doing so could in itself cause harm. For example, some people nowadays suffer severely disabling symptoms, which they (and sometimes their medical advisers) attribute to low levels of synthetic chemicals in their environment.1 It is hypothesised that they are unusually sensitive to a wide range of substances, although the evidence for underlying toxic or immune mechanisms that might explain the phenomenon is currently unconvincing. An alternative explanation might be that the symptoms represent a conditioned response to exposures perceived, for example, …

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