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A dilemma confronts physician-investigators in the conduct of research with patient-subjects. As physicians they are dedicated to caring for their patients, healing their pain, reducing their suffering. As investigators they are dedicated to caring for their research, advancing knowledge for the benefit of science and future patients. These two commitments conflict whenever an individual physician-investigator comes face to face with an individual patient-subject. Indeed, in this encounter between two persons, four personae confront one another: the physician, the investigator, the patient in need of immediate help, and the subject who may himself be helped or who may help future patients.
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