This paper explores how a particular form of regulation—prior ethical review of research—developed over time in a specific context, testing the claims of standard explanations for such change against more recent theoretical approaches to institutional changes, which emphasize the role of gradual change. To makes its case, this paper draws on archival and interview material focusing on the research ethics review system in the UK National Health Service. Key insights center on the minimal role scandals play in shaping changes in (...) this regulatory setting and how these depend upon the absence of a single coherent profession associated with biomedical research. (shrink)

Life sciences research is increasingly international and data-intensive. Researchers work in multi-jurisdictional teams or formally established research consortia to exchange data and conduct research using computation of multiple sources and volumes of data at multiple sites and through multiple pathways. Despite the internationalization and data intensification of research, the same ethics review process as applies to single-site studies in one country tends to apply to multi-site studies in multiple countries. Because of the standard requirement for multi-jurisdictional or multi-site ethics review, (...) international research projects are subjected to multiple ethics reviews of the same research protocol. Consequently, the reviews may be redundant and resource-consuming, whilst the opinions delivered by ethics committees may be inconsistent both within and across jurisdictions. In this article, we present findings based on interviews conducted with international experts in research ethics on the topic of et... (shrink)

We have followed with interest the commentaries arising from Moore and Donnellys1 argument that authorities in charge of research ethics committees should focus primarily on establishing code-consistent reviews.1 We broadly agree with Savulescu’s2 argument that ethics committees should become more expert, but in a different way and for a different reason. We have recently been working with the UK Health Research Authority analysing the outcomes of their ‘Shared Ethical Debate’ exercises.3 Each ShED exercise involves the circulation of a single research (...) project to a number of RECs. The resulting minutes from each REC are compared along with the final decisions made by each REC on the project under consideration. This process was originally an administrative exercise designed to promote greater consistency among the 60 or so ethics committees that were brought under the HRA ) umbrella within the UK National Health Service. Over 20 ShEDs have been run, and although the process has significant weaknesses and has not always been run consistently, the results of the exercises are fascinating. Broadly speaking, NHS RECs have been getting more consistent over time in terms of their decision-making, but the reasons for the final decisions as described in the committee minutes continue to vary widely. Qualitative research now needs to be done to understand why different committees can have such different discussions in relation to exactly the same research project and yet come to essentially the same conclusion. As part of our analysis of the ShED data, we looked at …. (shrink)

Institutional Review Boards have substantial power and authority over research with human subjects, and in turn, their decisions have substantial implications for those subjects, investigators, and the public at large. However, there is little transparency about IRB processes and decisions. This article provides the first comprehensive taxonomy of what transparency means for IRBs — answering the questions “to whom, about what, and by what mechanisms?” It also explains why the status quo of nontransparency is problematic, and presents arguments for greater (...) transparency from the perspective of a variety of stakeholders. IRB transparency will make boards more accountable, improve the quality of their decision-making, facilitate consistency in board decisions, permit empirical study of IRBs, promote research efficiency, and advance trust in the research enterprise, among a variety of other benefits. Regulators should promote IRB transparency, IRBs themselves should commit to sharing as much information as they can within the confines of confidentiality requirements, and investigators can endeavor to take matters into their own hands by sharing IRB correspondence and IRB-approved protocols and consent materials. (shrink)

The new National Institutes of Health (NIH) Policy on the Use of a Single Institutional Review Board (sIRB) for Multi-Site Research was adopted primarily to simplify and speed the review of complex multisite clinical trials. However, speeding review requires overcoming a number of obstacles. Perhaps the most substantial obstacle is the time and effort needed to develop reliance agreements among the participating sites. We conducted 102 semistructured interviews with sIRB personnel, including directors, chairs, reviewers, and staff, from 20 IRBs that (...) acted as sIRBs for multisite research, including 6 commercial/independent sIRBs, and 10 university-based academic and 4 federal sIRBs. Almost without exception, the interviewees agreed that reliance agreements were complex, difficult to develop, and time-consuming. A major problem for relying sites was that different agreements specified different responsibilities for the relying sites. Attitudes differed about whether these problems will be resolved as IRB staff and managers become more experienced with sIRBs. However it is clear that the process of developing reliance agreements must be simplified. Federal assistance in standardizing at least some sections of reliance agreements might reduce the difficulties involved. (shrink)