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The interest of pragmatic randomized controlled trials continues to increase as they are much better
suited for studies of how to get medical and health services out into wider practice. However, despite the
advantage that such trials have, there are several ethical issues and medical ethics issues that persist with the
trial. The ethical and medical ethics issues involve research-practice distinction, consent, disclosure,
vulnerable populations, oversight, ethical principles, ethical framework, regulatory frameworks, and conflicts
of interest. Through performing an elaborate literature review and analyzing claims and arguments made
within the literature, we will provide a critical and comprehensive ethical analysis on pragmatic randomized
controlled trials, and we will begin the discussion on conflicts of interest in pragmatic RCTs, arguing that
conflicts of interest occur in pragmatic RCTs.