Coronary artery bypass grafting for the reduction of mortality: an analysis of the trials.

from hospital specialists to general practitioners, and the presence of a general practitioner research group might stimulate a healthy state of affairs in which the hospital disciplines might learn something from general practice. Some form of ethical control is needed for research in general practice. Ethical considerations should be included in the research element of vocational training courses, and advice is available through the Royal College of General Practitioners, but again a local body would be helpful. Local medical committees might see this as within their scope, or again postgraduate centres might be a focus for an ethical committee. Membership of such committees might include representatives of patient groups such as community health councils as well as general practitioners and hospital doctors. At present the only arbiters of ethical and scientific quality seem to be the journals to which completed papers are sub- mitted for publication. Unfortunately, by then the damage may have already been done, both to the future enthusiasm of the researchers, who (with the best intentions) may have produced an ill conceived and poorly executed piece of research, and to the patients on whom it was carried out.