This article explores the problematic relationship between ethics review and interpretive research that uses qualitative methods. Many investigators feel that the structure and process of ethics review—which is based on assumptions relevant to biomedical research—penalize those pursuing interpretive research. We locate the origins of the problem in issues of epistemology and power, then provide an overview of how these issues—as well as the current social organization of ethical review—affect the review of interpretive research. Finally, we summarize several solutions that have (...) been proposed in the literature, then propose our own novel “two stage/two body” review structure and process. (shrink)