Ethical Mindfulness in Directing Research at a Student Run Free Clinic: A Case Study

Abstract

Ethical Mindfulness in Directing Research at a Student Run Free Clinic: A Case Study Background Student-run free clinics (SRFCs) often conduct research to evaluate clinical offerings, improve operations, and contribute to the distribution of knowledge. While Institutional Review Boards (IRBs) ensure regulatory compliance, ethical tensions frequently arise in the day-to-day oversight of research involving underserved and structurally vulnerable populations. At this SRFC, student research co-chairs hold a leadership role in reviewing, guiding, and managing research activity. This case study examines how ethical decision-making was integrated into this role, beyond formal IRB review. Methods Over an 8-month period, the student research co-chairs documented key decisions, policy developments, and stakeholder discussions surrounding research activities at the clinic. A narrative case study approach was used to reflect on ethical questions related to project selection, patient autonomy, data stewardship, and clinic-wide collaboration. The ethical frameworks of Beauchamp and Childress’s Four Principles of Biomedical Ethics1 and the Structural Competency Framework2 were used to analyze the decision-making process. Results The case study will describe several ethically complex moments in clinic research leadership, such as implementing new research bylaws, evaluating proposals from external collaborators, addressing concerns around patient burden, and negotiating the impact to clinic flow. Each scenario will be interpreted using the selected ethical frameworks, offering insight into how abstract ethical principles were applied in real-world student leadership contexts. Particular attention will be paid to how justice and beneficence were balanced in a structurally vulnerable patient population. Conclusion Ethical leadership in SRFC research requires proactive reflection, shared decision-making, and sensitivity to both biomedical ethics and social context. This case study illustrates how student leaders can meaningfully engage with ethical frameworks to guide research oversight and shape institutional norms. The lessons drawn may inform similar leadership roles at other SRFCs seeking to ethically ground their research infrastructure. References

Beauchamp TL, Childress JF. Principles of Biomedical Ethics. 8th ed. Oxford University Press; 2019. ISBN: 9780190640873 Metzl JM, Hansen H. Structural competency: Theorizing a new medical engagement with stigma and inequality. Soc Sci Med. 2014;103:126-133. doi:10.1016/j.socscimed.2013.06.032