 In response, commentators have called for developing learning health care systems. According to one definition, a learning health care system is one in which “science, informatics, incentives, and culture are aligned for continuous improvement and innovation, with best practices seamlessly embedded in the care process, patients and families active participants in all elements, and new knowledge captured as an integral by-product of the care experience” (Committee on Learning 2013). The important point for present purposes is that these commentators are calling for the desegregation of clinical research and clinical care, with clinical research once again being conducted in the context of clinical care. This approach offers what seems a potentially appealing response to the central challenge of justifying the risks to which research participants are exposed. Put simply, this practice would be justified by the fact that the practice of exposing individuals to research risks is an essential component of a learning health care system which continuously evaluates methods of providing clinical care and passes the benefits of the improvements on to its members (Faden et al 2013).