Seeking to determine if the physician’s obligation to treat can be commingled with the physician’s desire to research, the question falls to the dictates of utilitarianism. According to this paradigm the need to maximize pleasure serves as the impetus to minimize pain. According to Bentham “By utility is meant that property in any object, where by it tends to produce benefit, advantage, pleasure, good or happiness or to prevent the happening of mischief, pain evil or unhappiness to the party whose interest is considered”. When put in this perspective, it seems reasonable to argue that the roles of the physician as healer and researcher need to be separated because they are not commensurate with one another.
To justify this point, one only needs to consider what Newton writes on the differentiation between practice and research. According to Newton, “Practice of medicine refers to a class of activities designed solely to enhance the well-being of an individual patient or client.” Research, on the other hand, refers to “a class of activities deigned to develop to contribute to generalizable knowledge…”. In the process of research, the happiness and safety of the patient cannot be guaranteed with great certainty. While the same can be said of practice in medicine, the reality is that the objectives or outcomes of the processes are markedly different. As such, it is not the activities per se that raise question, but rather their ultimate intent.
In the case of research, most individuals would labor under the assumption that the intent is to promote the generalized happiness of the overall community. By this justification, there is a clear argument for an individual to enter a scientific research study. Mill contends that many individuals make decisions for the aggregate good of the community. While no direct happiness is derived from the process, the ends justify the means, so the martyr does his job willingly knowing that what he has produced will have positive ramifications for society in the end. By this reasoning, if the physician’s intents are altruistic for the betterment of society, the processes of practice and research can be reconciled. However, the patient must be clear that these process fundamentally different in nature.