Human Subjects
Case 3: Physician/Scientist Conflict of Interest
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Dr. Overstreet is a fellow in neurology who has just joined a research team recruiting patients for a double-blinded clinical trial comparing two drugs for treating multiple sclerosis, a severely debilitating disease. In anticipation of this project, Dr. Overstreet thoroughly reviews previous studies of the properties of these drugs. His opinion is that drug A has been shown to be superior to drug B in relatively small trials. The trial now being undertaken should provide definitive results.

One day, Dr. Overstreet approaches a patient to enter the trial. The patient asks, "Doctor, what do you think of these drugs? Should I enter this trial?" Dr. Overstreet feels conflicted. Until the trial is over, neither he nor the patient will know which drug the patient is receiving. As a physician, Dr. Overstreet believes it is his duty to provide the best treatment possible for his patients, which under other circumstances would mean giving his patients drug A. As a scientist, however, Dr. Overstreet understands that his opinions concerning the respective benefits of these drugs require validation by this larger controlled study.


  1. Are Dr. Overstreet's roles as clinician and scientist in conflict? If so, how, if at all, can these roles be reconciled?

  2. If Drugs A and B are already available clinically, how should Dr. Overstreet answer his patient's question about the drugs?

  3. How might his answer change if drug A was not yet available clinically? or if drug B was not yet available clinically?


This case is modified from Case H4 (p. 155) of the Teaching the Responsible Conduct of Research Through a Case Study Approach handbook prepared by the Association of American Medical Colleges (Korenman SG and Shipp AC, 1994)