Friday, August 25, 2006

No one expects the ethics police

This seems to be the season for ethics committee bashing. Something is in the air. First, you had the Science article by Gunsalus et. al. complaining of 'IRB mission creep'. I never heard of that term before, so naturally I turned to Wikipedia:

Mission creep is the expansion of a project or mission beyond its original goals, often after initial successes. The term often implies a certain disapproval of newly adopted goals by the user of the term. Mission creep is usually considered undesirable due to the dangerous path of each success breeding more ambitious attempts, only stopping when a final, often catastrophic, failure occurs. The term was originally applied exclusively to military operations, but has recently been applied to many different fields, mainly the growth of bureaucracies.

Unfortunately, the article by Gunsalus does not really say how IRBs have expanded beyond their original goal of protecting human subjects -- it just goes on (and on) about how the interaction between IRBs and researchers is becoming increasingly bogged down in a quicksand of paperwork. Talk of 'mission creep' sounds more sexy, though.

This month, members of Britain's scientific community are griping about ethical regulations concerning recruitment of research participants. Current regulations state that researchers can only approach patients to ask if they are prepared to take part in research if they have responded positively to a letter from their doctor about the possibility of being in a study. This 'opt in' approach lowers the number of potential research subjects and could create 'participation bias'. Some researchers would be more happy with an 'opt out' approach where they could take liberties in contacting potential research subjects more directly; ethics committees and all their regulations are just getting in the way of good science, again.

But not everyone is buying this. Before contacting potential research participants, you have to know whether they pass your study's inclusion criteria; to do that, you have to know quite a lot about them. And knowing quite a lot about people, say, through their medical records, raises questions about confidentiality that may best be handled by an ... ethics committee.


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