Editors: Mildred Z. Solomon and Ann C. Bonham

The Institute of Medicine has called on health care leaders to transform their health systems into “learning health care systems,” in which care of patients is integrated with medical research so that the health care practices offered in the system are continuously studied and improved.  Traditionally, research and care have been seen as distinct, conceptually and in practice, and have had distinct oversight regimes. In this special report, two feature-length articles raise questions about the traditional distinction and propose a new moral framework that can provide guidance for both care and research. Half a dozen commentaries following the articles offer a range of critical perspectives.