Proposal of Ethical Guidelines for Research in Student-Run Clinics: A Three-Clinic Collaboration

Abstract

Student-run clinics (SRCs) serve as vital healthcare access points for underserved populations while providing medical students with hands-on experience and reinforcing values of service and community care. As SRCs expand their services and reach, integrating clinical research into their operations has become increasingly common. However, research conducted in SRCs presents unique ethical challenges, particularly regarding informed consent, potential coercion, and maintaining the integrity of patient care. This paper examines some of the ethical concerns associated with conducting research in SRCs, including risks of coercion among vulnerable patients, challenges related to health literacy and language barriers, and the potential for lapses in oversight due to student-led administration. To address these concerns, a framework for ethical research in Student-Run Clinics (SRCs) has been developed through collaboration among three SRCs and discussions held during the 2024 Society of Student-Run Free Clinics 'Bridging the Gap' workshop. The framework emphasizes the establishment of research committees, the implementation of comprehensive needs assessments, prioritization of patient-centered research, and safeguards to ensure truly informed and voluntary participation. By implementing these ethical standards, SRCs can conduct meaningful research that enhances clinic operations and improves patient outcomes while proactively addressing the ethical challenges inherent in these settings. This approach ensures that research within SRCs remains a tool for advocacy and improvement rather than exploitation, allowing these clinics to continue their mission of providing equitable healthcare to vulnerable communities.