Clinical audit, the case for ethical scrutiny?

The UK Government's White paper stated their commitment to the development of medical audit. The subsequent growth of audit activity by all health-care professions has led to a proliferation of activity, often involving direct contact with the patient. However, there seems to be wide acceptance that there are no ethical dimensions to audit activity, even though it may be wide-ranging and uncoordinated. Argues that, while research has a well-developed mechanism for ethical scrutiny, audit activity can sometimes be indistinguishable from research and so, in some cases, it should be submitted to external scrutiny in order to protect the patient. Suggests five criteria as activities where ethical scrutiny should be considered.