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Teodorowski P, Jones E, Tahir N, Ahmed S, Rodgers SE, Frith L. Public Involvement and Engagement in Big Data Research: Scoping Review. J Particip Med 2024; 16:e56673. [PMID: 39150751 PMCID: PMC11364952 DOI: 10.2196/56673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 05/06/2024] [Accepted: 06/22/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND The success of big data initiatives depends on public support. Public involvement and engagement could be a way of establishing public support for big data research. OBJECTIVE This review aims to synthesize the evidence on public involvement and engagement in big data research. METHODS This scoping review mapped the current evidence on public involvement and engagement activities in big data research. We searched 5 electronic databases, followed by additional manual searches of Google Scholar and gray literature. In total, 2 public contributors were involved at all stages of the review. RESULTS A total of 53 papers were included in the scoping review. The review showed the ways in which the public could be involved and engaged in big data research. The papers discussed a broad range of involvement activities, who could be involved or engaged, and the importance of the context in which public involvement and engagement occur. The findings show how public involvement, engagement, and consultation could be delivered in big data research. Furthermore, the review provides examples of potential outcomes that were produced by involving and engaging the public in big data research. CONCLUSIONS This review provides an overview of the current evidence on public involvement and engagement in big data research. While the evidence is mostly derived from discussion papers, it is still valuable in illustrating how public involvement and engagement in big data research can be implemented and what outcomes they may yield. Further research and evaluation of public involvement and engagement in big data research are needed to better understand how to effectively involve and engage the public in big data research. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-https://doi.org/10.1136/bmjopen-2021-050167.
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Affiliation(s)
- Piotr Teodorowski
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, United Kingdom
| | - Elisa Jones
- Department of Public Health, Policy & Systems, University of Liverpool, Liverpool, United Kingdom
| | - Naheed Tahir
- National Institute for Health and Care Research Applied Research Collaboration North West Coast, Liverpool, United Kingdom
| | - Saiqa Ahmed
- National Institute for Health and Care Research Applied Research Collaboration North West Coast, Liverpool, United Kingdom
| | - Sarah E Rodgers
- Department of Public Health, Policy & Systems, University of Liverpool, Liverpool, United Kingdom
| | - Lucy Frith
- Centre for Social Ethics and Policy, University of Manchester, Manchester, United Kingdom
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Teodorowski P, Rodgers SE, Fleming K, Tahir N, Ahmed S, Frith L. 'To me, it's ones and zeros, but in reality that one is death': A qualitative study exploring researchers' experience of involving and engaging seldom-heard communities in big data research. Health Expect 2023; 26:882-891. [PMID: 36691930 PMCID: PMC10010102 DOI: 10.1111/hex.13713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/21/2022] [Accepted: 01/05/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Big data research requires public support. It has been argued that this can be achieved by public involvement and engagement to ensure that public views are at the centre of research projects. Researchers should aim to include diverse communities, including seldom-heard voices, to ensure that a range of voices are heard and that research is meaningful to them. OBJECTIVE We explored how researchers involve and engage seldom-heard communities around big data research. METHODS This is a qualitative study. Researchers who had experience of involving or engaging seldom-heard communities in big data research were recruited. They were based in England (n = 5), Scotland (n = 4), Belgium (n = 2) and Canada (n = 1). Twelve semistructured interviews were conducted on Zoom. All interviews were audio-recorded and transcribed, and we used reflexive thematic analysis to analyse participants' experiences. RESULTS The analysis highlighted the complexity of involving and engaging seldom-heard communities around big data research. Four themes were developed to represent participants' experiences: (1) abstraction and complexity of big data, (2) one size does not fit all, (3) working in partnership and (4) empowering the public contribution. CONCLUSION The study offers researchers a better understanding of how to involve and engage seldom-heard communities in a meaningful way around big data research. There is no one right approach, with involvement and engagement activities required to be project-specific and dependent on the public contributors, researchers' needs, resources and time available. PATIENT AND PUBLIC INVOLVEMENT Two public contributors are authors of the paper and they were involved in the study design, analysis and writing.
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Affiliation(s)
- Piotr Teodorowski
- Department of Public Health, Policy & Systems, University of Liverpool, Liverpool, UK
| | - Sarah E Rodgers
- Department of Public Health, Policy & Systems, University of Liverpool, Liverpool, UK
| | - Kate Fleming
- National Disease Registration Service, NHS Digital, Liverpool, UK
| | | | | | - Lucy Frith
- Department of Law, University of Manchester, Manchester, UK
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Olsson IAS, Nielsen BL, Camerlink I, Pongrácz P, Golledge HD, Chou JY, Ceballos MC, Whittaker AL. An international perspective on ethics approval in animal behaviour and welfare research. Appl Anim Behav Sci 2022. [DOI: 10.1016/j.applanim.2022.105658] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Kalkman S, van Delden J, Banerjee A, Tyl B, Mostert M, van Thiel G. Patients' and public views and attitudes towards the sharing of health data for research: a narrative review of the empirical evidence. JOURNAL OF MEDICAL ETHICS 2022; 48:3-13. [PMID: 31719155 PMCID: PMC8717474 DOI: 10.1136/medethics-2019-105651] [Citation(s) in RCA: 98] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/24/2019] [Accepted: 10/28/2019] [Indexed: 05/12/2023]
Abstract
INTRODUCTION International sharing of health data opens the door to the study of the so-called 'Big Data', which holds great promise for improving patient-centred care. Failure of recent data sharing initiatives indicates an urgent need to invest in societal trust in researchers and institutions. Key to an informed understanding of such a 'social license' is identifying the views patients and the public may hold with regard to data sharing for health research. METHODS We performed a narrative review of the empirical evidence addressing patients' and public views and attitudes towards the use of health data for research purposes. The literature databases PubMed (MEDLINE), Embase, Scopus and Google Scholar were searched in April 2019 to identify relevant publications. Patients' and public attitudes were extracted from selected references and thematically categorised. RESULTS Twenty-seven papers were included for review, including both qualitative and quantitative studies and systematic reviews. Results suggest widespread-though conditional-support among patients and the public for data sharing for health research. Despite the fact that participants recognise actual or potential benefits of data research, they expressed concerns about breaches of confidentiality and potential abuses of the data. Studies showed agreement on the following conditions: value, privacy, risk minimisation, data security, transparency, control, information, trust, responsibility and accountability. CONCLUSIONS Our results indicate that a social license for data-intensive health research cannot simply be presumed. To strengthen the social license, identified conditions ought to be operationalised in a governance framework that incorporates the diverse patient and public values, needs and interests.
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Affiliation(s)
- Shona Kalkman
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Johannes van Delden
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Amitava Banerjee
- Farr Institute of Health Informatics Research, University College London, London, UK
| | - Benoît Tyl
- Cardiovascular Center for Therapeutic Innovation, Institut de Recherches Internationales Servier, Suresnes, France
| | - Menno Mostert
- Julius Center for Health Sciences and Primary Care, Medical Humanities, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Ghislaine van Thiel
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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Muller SHA, Kalkman S, van Thiel GJMW, Mostert M, van Delden JJM. The social licence for data-intensive health research: towards co-creation, public value and trust. BMC Med Ethics 2021; 22:110. [PMID: 34376204 PMCID: PMC8353823 DOI: 10.1186/s12910-021-00677-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 08/03/2021] [Indexed: 11/10/2022] Open
Abstract
Background The rise of Big Data-driven health research challenges the assumed contribution of medical research to the public good, raising questions about whether the status of such research as a common good should be taken for granted, and how public trust can be preserved. Scandals arising out of sharing data during medical research have pointed out that going beyond the requirements of law may be necessary for sustaining trust in data-intensive health research. We propose building upon the use of a social licence for achieving such ethical governance. Main text We performed a narrative review of the social licence as presented in the biomedical literature. We used a systematic search and selection process, followed by a critical conceptual analysis. The systematic search resulted in nine publications. Our conceptual analysis aims to clarify how societal permission can be granted to health research projects which rely upon the reuse and/or linkage of health data. These activities may be morally demanding. For these types of activities, a moral legitimation, beyond the limits of law, may need to be sought in order to preserve trust. Our analysis indicates that a social licence encourages us to recognise a broad range of stakeholder interests and perspectives in data-intensive health research. This is especially true for patients contributing data. Incorporating such a practice paves the way towards an ethical governance, based upon trust. Public engagement that involves patients from the start is called for to strengthen this social licence. Conclusions There are several merits to using the concept of social licence as a guideline for ethical governance. Firstly, it fits the novel scale of data-related risks; secondly, it focuses attention on trustworthiness; and finally, it offers co-creation as a way forward. Greater trust can be achieved in the governance of data-intensive health research by highlighting strategic dialogue with both patients contributing the data, and the public in general. This should ultimately contribute to a more ethical practice of governance. Supplementary Information The online version contains supplementary material available at 10.1186/s12910-021-00677-5.
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Affiliation(s)
- Sam H A Muller
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CX, Utrecht, The Netherlands.
| | - Shona Kalkman
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CX, Utrecht, The Netherlands
| | - Ghislaine J M W van Thiel
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CX, Utrecht, The Netherlands
| | - Menno Mostert
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CX, Utrecht, The Netherlands
| | - Johannes J M van Delden
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CX, Utrecht, The Netherlands
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Milne R, Morley KI, Almarri MA, Anwer S, Atutornu J, Baranova EE, Bevan P, Cerezo M, Cong Y, Costa A, Critchley C, Fernow J, Goodhand P, Hasan Q, Hibino A, Houeland G, Howard HC, Hussain SZ, Malmgren CI, Izhevskaya VL, Jędrzejak A, Jinhong C, Kimura M, Kleiderman E, Leach B, Liu K, Mascalzoni D, Mendes Á, Minari J, Nicol D, Niemiec E, Patch C, Pollard J, Prainsack B, Rivière M, Robarts L, Roberts J, Romano V, Sheerah HA, Smith J, Soulier A, Steed C, Stefànsdóttir V, Tandre C, Thorogood A, Voigt TH, Wang N, West AV, Yoshizawa G, Middleton A. Demonstrating trustworthiness when collecting and sharing genomic data: public views across 22 countries. Genome Med 2021; 13:92. [PMID: 34034801 PMCID: PMC8147072 DOI: 10.1186/s13073-021-00903-0] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 05/04/2021] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Public trust is central to the collection of genomic and health data and the sustainability of genomic research. To merit trust, those involved in collecting and sharing data need to demonstrate they are trustworthy. However, it is unclear what measures are most likely to demonstrate this. METHODS We analyse the 'Your DNA, Your Say' online survey of public perspectives on genomic data sharing including responses from 36,268 individuals across 22 low-, middle- and high-income countries, gathered in 15 languages. We examine how participants perceived the relative value of measures to demonstrate the trustworthiness of those using donated DNA and/or medical information. We examine between-country variation and present a consolidated ranking of measures. RESULTS Providing transparent information about who will benefit from data access was the most important measure to increase trust, endorsed by more than 50% of participants across 20 of 22 countries. It was followed by the option to withdraw data and transparency about who is using data and why. Variation was found for the importance of measures, notably information about sanctions for misuse of data-endorsed by 5% in India but almost 60% in Japan. A clustering analysis suggests alignment between some countries in the assessment of specific measures, such as the UK and Canada, Spain and Mexico and Portugal and Brazil. China and Russia are less closely aligned with other countries in terms of the value of the measures presented. CONCLUSIONS Our findings highlight the importance of transparency about data use and about the goals and potential benefits associated with data sharing, including to whom such benefits accrue. They show that members of the public value knowing what benefits accrue from the use of data. The study highlights the importance of locally sensitive measures to increase trust as genomic data sharing continues globally.
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Affiliation(s)
- Richard Milne
- Society and Ethics Research Group, Wellcome Connecting Science, Wellcome Genome Campus, Cambridge, CB10 1SA, UK.
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB2 0SR, UK.
| | - Katherine I Morley
- RAND Europe, Cambridge, CB4 1YG, UK
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
- Centre for Epidemiology and Biostatistics, Melbourne School of Global and Population Health, The University of Melbourne, Melbourne, 3010, Australia
| | - Mohamed A Almarri
- Wellcome Sanger Institute, Cambridge, CB10 1SA, UK
- Department of Forensic Science and Criminology, Dubai Police GHQ, Dubai, United Arab Emirates
| | | | - Jerome Atutornu
- Society and Ethics Research Group, Wellcome Connecting Science, Wellcome Genome Campus, Cambridge, CB10 1SA, UK
| | - Elena E Baranova
- Russian Medical Academy of Continuous Professional Education, Moscow, 119049, Russia
| | - Paul Bevan
- Wellcome Sanger Institute, Cambridge, CB10 1SA, UK
| | - Maria Cerezo
- EMBL-EBI, Wellcome Genome Campus, Cambridge, CB10 1SA, UK
| | - Yali Cong
- Medical Ethics Program, Peking University Health Science Center, Beijing, 100191, China
| | - Alessia Costa
- Society and Ethics Research Group, Wellcome Connecting Science, Wellcome Genome Campus, Cambridge, CB10 1SA, UK
| | - Christine Critchley
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, 3122, Australia
- Centre for Law and Genetics, University of Tasmania, Hobart, 7001, Australia
| | - Josepine Fernow
- Centre for Research Ethics & Bioethics (CRB), Uppsala University, SE-751 22, Uppsala, Sweden
| | - Peter Goodhand
- Ontario Institute for Cancer Research, MaRS Centre, Toronto, M5G 0A3, Canada
| | - Qurratulain Hasan
- Department of Genetics & Molecular Medicine, Kamineni Hospitals, Hyderabad, 500 068, India
- SAAZ Genetics, Hyderabad, 500033, India
| | - Aiko Hibino
- Faculty of Humanities and Social Sciences, Hirosaki University, Hirosaki, 036-8560, Japan
| | - Gry Houeland
- Centre for Research Ethics & Bioethics (CRB), Uppsala University, SE-751 22, Uppsala, Sweden
| | - Heidi C Howard
- Medical Ethics, Lund Universitet, Sölvegatan, 19, Lund, Sweden
| | | | - Charlotta Ingvoldstad Malmgren
- Department of Public Health and Caring Scienec, Uppsala University, 751 22, Uppsala, Sweden
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 76, Solna, Sweden
| | | | | | - Cao Jinhong
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, Wuhan, 430071, China
| | - Megumi Kimura
- Institute of Innovation Research, Hitotsubashi University, Tokyo, 186-8603, Japan
| | - Erika Kleiderman
- Centre of Genomics and Policy, McGill University, Montreal, H3A 0G1, Canada
| | | | - Keying Liu
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
- School of Public Health, Peking University Health Science Center, Beijing, 100191, China
| | - Deborah Mascalzoni
- Centre for Research Ethics & Bioethics (CRB), Uppsala University, SE-751 22, Uppsala, Sweden
- EURAC, Institute of Biomedicine, 39100, Bolzano, Italy
| | - Álvaro Mendes
- UnIGENe and CGPP - Centre for Predictive and Preventive Genetics, IBMC - Institute for Molecular and Cell Biology, i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, 4200-135, Porto, Portugal
| | - Jusaku Minari
- Uehiro Research Division for iPS Cell Ethics, Center for iPS Cell Research and Application (CiRA), Kyoto University, Kyoto, 606-8507, Japan
| | - Dianne Nicol
- Centre for Law and Genetics, University of Tasmania, Hobart, 7001, Australia
| | - Emilia Niemiec
- Centre for Research Ethics & Bioethics (CRB), Uppsala University, SE-751 22, Uppsala, Sweden
| | - Christine Patch
- Society and Ethics Research Group, Wellcome Connecting Science, Wellcome Genome Campus, Cambridge, CB10 1SA, UK
- Genomics England, Queen Mary University of London, London, EC1M 6BQ, UK
| | | | - Barbara Prainsack
- Department of Political Science, University of Vienna, 1010, Vienna, Austria
- Department of Global Health & Social Medicine, King's College London, London, WC2R 2LS, UK
| | | | - Lauren Robarts
- Society and Ethics Research Group, Wellcome Connecting Science, Wellcome Genome Campus, Cambridge, CB10 1SA, UK
| | - Jonathan Roberts
- Society and Ethics Research Group, Wellcome Connecting Science, Wellcome Genome Campus, Cambridge, CB10 1SA, UK
| | - Virginia Romano
- Centre for Research Ethics & Bioethics (CRB), Uppsala University, SE-751 22, Uppsala, Sweden
- EURAC, Institute of Biomedicine, 39100, Bolzano, Italy
| | - Haytham A Sheerah
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
| | - James Smith
- Wellcome Sanger Institute, Cambridge, CB10 1SA, UK
| | - Alexandra Soulier
- Centre for Research Ethics & Bioethics (CRB), Uppsala University, SE-751 22, Uppsala, Sweden
| | - Claire Steed
- Wellcome Sanger Institute, Cambridge, CB10 1SA, UK
| | - Vigdis Stefànsdóttir
- Landspitali, the National University Hospital of Iceland, 101, Reykjavík, Iceland
| | - Cornelia Tandre
- Centre for Research Ethics & Bioethics (CRB), Uppsala University, SE-751 22, Uppsala, Sweden
| | - Adrian Thorogood
- Centre of Genomics and Policy, McGill University, Montreal, H3A 0G1, Canada
| | - Torsten H Voigt
- Institute of Sociology, RWTH Aachen University, 52062, Aachen, Germany
| | - Nan Wang
- Medical Ethics Program, Peking University Health Science Center, Beijing, 100191, China
| | - Anne V West
- Indiana University Maurer School of Law, Bloomington, 47405, USA
| | - Go Yoshizawa
- Work Research Institute (AFI), Oslo Metropolitan University, 0130, Oslo, Norway
| | - Anna Middleton
- Society and Ethics Research Group, Wellcome Connecting Science, Wellcome Genome Campus, Cambridge, CB10 1SA, UK
- Faculty of Education, University of Cambridge, Cambridge, CB2 8PQ, UK
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Fylan F, Fylan B. Co-creating social licence for sharing health and care data. Int J Med Inform 2021; 149:104439. [PMID: 33756337 DOI: 10.1016/j.ijmedinf.2021.104439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/24/2021] [Accepted: 03/10/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Optimising the use of patient data has the potential to produce a transformational change in healthcare planning, treatment, condition prevention and understanding disease progression. Establishing how people's trust could be secured and a social licence to share data could be achieved is of paramount importance. METHODS The study took place across Yorkshire and the Humber, in the North of the England, using a sequential mixed methods approach comprising focus groups, surveys and co-design groups. Twelve focus groups explored people's response to how their health and social care data is, could, and should be used. A survey examined who should be able to see health and care records, acceptable uses of anonymous health and care records, and trust in different organisations. Case study cards addressed willingness for data to be used for different purposes. Co-creation workshops produced a set of guidelines for how data should be used. RESULTS Focus group participants (n = 80) supported sharing health and care data for direct care and were surprised that this is not already happening. They discussed concerns about the currency and accuracy of their records and possible stigma associated with certain diagnoses, such as mental health conditions. They were less supportive of social care access to their records. They discussed three main concerns about their data being used for research or service planning: being identified; security limitations; and the potential rationing of care on the basis of information in their record such as their lifestyle choices. Survey respondents (n = 1031) agreed that their GP (98 %) and hospital doctors and nurses (93 %) should be able to see their health and care records. There was more limited support for pharmacists (37 %), care staff (36 %), social workers (24 %) and researchers (24 %). Respondents thought their health and social care records should be used to help plan services (88 %), to help people stay healthy (67 %), to help find cures for diseases (67 %), for research for the public good (58 %), but only 16 % for commercial research. Co-creation groups developed a set of principles for a social licence for data sharing based around good governance, effective processes, the type of organisation, and the ability to opt in and out. CONCLUSION People support their data being shared for a range of purposes and co-designed a set of principles that would secure their trust and consent to data sharing.
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Affiliation(s)
- Fiona Fylan
- Leeds Sustainability Institute, Leeds Beckett University, Leeds, LS2 8AG, UK.
| | - Beth Fylan
- School of Pharmacy and Medical Sciences, University of Bradford, BD7 1DP, UK; Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, BD9 6RJ, UK.
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Ballantyne A, Stewart C. Big Data and Public-Private Partnerships in Healthcare and Research: The Application of an Ethics Framework for Big Data in Health and Research. Asian Bioeth Rev 2019; 11:315-326. [PMID: 33717319 PMCID: PMC7747238 DOI: 10.1007/s41649-019-00100-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 08/29/2019] [Accepted: 08/30/2019] [Indexed: 12/11/2022] Open
Abstract
Public-private partnerships (PPPs) are established to specifically harness the potential of Big Data in healthcare and can include partners working across the data chain-producing health data, analysing data, using research results or creating value from data. This domain paper will illustrate the challenges that arise when partners from the public and private sector collaborate to share, analyse and use biomedical Big Data. We discuss three specific challenges for PPPs: working within the social licence, public antipathy to the commercialisation of public sector health data, and questions of ownership, both of the data and any resulting intellectual property or products. As a specific example we consider the case of the UK National Health Service (NHS) providing patient data to Google's DeepMind AI program to develop a diagnostic app for kidney disease. This article is an application of the framework presented in this issue of ABR (Xafis et al. 2019). Please refer to that article for more information on how this framework is to be used, including a full explanation of the key values involved and the balancing approach used in the case study at the end. We use four specific values to help analysis these issues: public benefit, stewardship, transparency and engagement. We demonstrate how the Deliberative Framework can support ethical governance of PPPs involving biomedical big data.
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Personal health information in research: Perceived risk, trustworthiness and opinions from patients attending a tertiary healthcare facility. J Biomed Inform 2019; 95:103222. [PMID: 31176040 DOI: 10.1016/j.jbi.2019.103222] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Revised: 03/20/2019] [Accepted: 06/04/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Personal health information is a valuable resource to the advancement of research. In order to achieve a comprehensive reform of data infrastructure in Australia, both public engagement and building social trust is vital. In light of this, we conducted a study to explore the opinions, perceived risks and trustworthiness regarding the use of personal health information for research, in a sample of the public attending a tertiary healthcare facility. METHODS The Consumer Opinions of Research Data Sharing (CORDS) study was a questionnaire-based design with 249 participants who were attending a public tertiary healthcare facility located on the Gold Coast, Australia. The questionnaire was designed to explore opinions and evaluate trust and perceived risk in research that uses personal health information. Concept analysis was used to identify key dimensions of perceived risk. RESULTS Overall participants were supportive of research, highly likely to participate and mostly willing to share their personal health information. However, where the perceived risk of data misuse was high and trust in others was low, participants expressed hesitation to share particular types of information. Performance, physical and privacy risks were identified as key dimensions of perceived risk. CONCLUSION This study highlights that while participant views on the use of personal health information in research is mostly positive, where there is perceived risk in an environment of low trust, support for research decreases. The three key findings of this research are that willingness to share data is contingent upon: (i) data type; (ii) risk perception; and (iii) trust in who is accessing the data. Understanding which factors play a key role in a person's decision to share their personal health information for research is vital to securing a social license.
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Franco NH, Sandøe P, Olsson IAS. Researchers' attitudes to the 3Rs-An upturned hierarchy? PLoS One 2018; 13:e0200895. [PMID: 30110335 PMCID: PMC6093608 DOI: 10.1371/journal.pone.0200895] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 07/04/2018] [Indexed: 12/26/2022] Open
Abstract
Animal use in biomedical research is generally justified by its potential benefits to the health of humans, or other animals, or the environment. However, ethical acceptability also requires scientists to limit harm to animals in their research. Training in laboratory animal science (LAS) helps scientists to do this by promoting best practice and the 3Rs. This study evaluated scientists' awareness and application of the 3Rs, and their approach to other ethical issues in animal research. It was based on an online survey of participants in LAS courses held in eight venues in four European countries: Portugal (Porto, Braga), Germany (Munich, Heidelberg), Switzerland (Basel, Lausanne, Zurich), and Denmark (Copenhagen). The survey questions were designed to assess general attitudes to animal use in biomedical research, Replacement alternatives, Reduction and Refinement conflicts, and harm-benefit analysis. The survey was conducted twice: immediately before the course ('BC', N = 310) and as a follow-up six months after the course ('AC', N = 127). While courses do appear to raise awareness of the 3Rs, they had no measurable effect on the existing low level of belief that animal experimentation can be fully replaced by non-animal methods. Most researchers acknowledged ethical issues with their work and reported that they discussed these with their peers. The level of an animal's welfare, and especially the prevention of pain, was regarded as the most pressing ethical issue, and as more important than the number of animals used or the use of animals as such. Refinement was considered more feasible than Replacement, as well as more urgent, and was also favoured over Reduction. Respondents in the survey reversed the 'hierarchy' of the 3Rs proposed by their architects, Russell and Burch, prioritizing Refinement over Reduction, and Reduction over Replacement. This ordering may conflict with the expectations of the public and regulators.
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Affiliation(s)
- Nuno Henrique Franco
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- IBMC – Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
| | - Peter Sandøe
- Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Food and Resource Economics, University of Copenhagen, Copenhagen, Denmark
| | - I. Anna S. Olsson
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
- IBMC – Instituto de Biologia Molecular e Celular, Universidade do Porto, Porto, Portugal
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Gu C, Ye M, Wang X, Yang M, Wang H, Khoshnood K. Nurse researchers' perspectives on research ethics in China. Nurs Ethics 2017; 26:798-808. [PMID: 28812946 DOI: 10.1177/0969733017720848] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND In China, research ethics is a subject of increasingly formal regulation. However, little is known about how nursing researchers understand the concept of research ethics and the ways in which they can maintain ethical standards in their work. AIM The aim of this study is to examine nursing researchers' perspectives on research ethics in China. RESEARCH DESIGN We conducted a descriptive qualitative study. Qualitative research methods enabled us to gain an in-depth understanding of nursing researchers' views on research ethics. PARTICIPANTS AND RESEARCH CONTEXT We carefully selected and extensively interviewed 28 nursing researchers, nursing faculty, and clinical nurses who had been involved in research or who may undertake research in the future. We collected data between October 2014 and March 2015. ETHICAL CONSIDERATIONS This study was approved by the institutional review boards of Yale University and Central South University. FINDINGS We grouped the data into five categories based on the interviewees' responses: (1) perceptions of ethics, bioethics, and research ethics; (2) perception of the ethics review process; (3) perception of the function of institutional review boards; (4) the need for comprehensive ethical guidelines for future studies; and (5) ethical challenges faced by the interviewees. DISCUSSION AND CONCLUSION This study contributes new insights into nursing researchers' views on research ethics in China and finds considerable shortcomings in researchers' understanding and implementation of ethical principles. Intensive educational efforts are needed to provide nursing researchers, institutional review board members, and even study subjects with accurate and up-to-date information and guidance on research ethics. In addition, while Western research ethics theoretically have guided Chinese clinical research for several years, the ways in which nursing researchers have implemented these ethical standards highlight the differences between the Eastern and Western ethical paradigms. This finding suggests the need for ethical standards that are more tailored to the Chinese context.
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Dixon-Woods M, Kocman D, Brewster L, Willars J, Laurie G, Tarrant C. A qualitative study of participants' views on re-consent in a longitudinal biobank. BMC Med Ethics 2017; 18:22. [PMID: 28330487 PMCID: PMC5363013 DOI: 10.1186/s12910-017-0182-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 02/27/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Biomedical research increasingly relies on long-term studies involving use and re-use of biological samples and data stored in large repositories or "biobanks" over lengthy periods, often raising questions about whether and when a re-consenting process should be activated. We sought to investigate the views on re-consent of participants in a longitudinal biobank. METHODS We conducted a qualitative study involving interviews with 24 people who were participating in a longitudinal biobank. Their views were elicited using a semi-structured interview schedule and scenarios based on a hypothetical biobank. Data analysis was based on the constant comparative method. RESULTS What participants identified as requiring new consent was not a straightforward matter predictable by algorithms about the scope of the consent, but instead was contingent. They assessed whether proposed new research implied a fundamental alteration in the underlying character of the biobank and whether specific projects were within the scope of the original consent. What mattered most to them was that the cooperative bargain into which they had entered was maintained in good faith. They saw re-consent as one important safeguard in this bargain. In determining what required re-consent, they deployed two logics. First, they used a logic of boundaries, where they sought to detect any possible rupture with their existing framework of cooperation. Second, they used a logic of risk, where they assessed proposed research for any potential threats for them personally or the research endeavour. When they judged that a need for re-consent had been activated, participants saw the process as way of re-actualising and renewing the cooperative bargain. CONCLUSIONS Participants' perceptions of research as a process of mutual co-operation between volunteer and researcher were fundamental to their views on consent. Consenting arrangements for biobanks should respect the cooperative values that are important to participants, recognise the two logics used by research volunteers, and avoid rigidity. Agility may be favoured by tiered consent combined with strong oversight mechanisms; this approach requires evaluation.
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Affiliation(s)
- Mary Dixon-Woods
- Cambridge Centre for Health Services Research, University of Cambridge, Institute of Public Health, Forvie Site, Robinson Way, Cambridge, CB2 0SR UK
| | - David Kocman
- Department of Health Sciences, Social Science Applied to Healthcare Research (SAPPHIRE) Group, University of Leicester, Leicester, UK
| | - Liz Brewster
- Lancaster Medical School, Faculty of Health and Medicine, Lancaster University, Lancaster, LA1 4YW UK
| | - Janet Willars
- Department of Health Sciences, Social Science Applied to Healthcare Research (SAPPHIRE) Group, University of Leicester, Leicester, UK
| | - Graeme Laurie
- Department of Law, University of Edinburgh, Edinburgh, UK
| | - Carolyn Tarrant
- Department of Health Sciences, Social Science Applied to Healthcare Research (SAPPHIRE) Group, University of Leicester, Leicester, UK
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Kerasidou A. Trust me, I'm a researcher!: The role of trust in biomedical research. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2017; 20:43-50. [PMID: 27638832 PMCID: PMC5318478 DOI: 10.1007/s11019-016-9721-6] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
In biomedical research lack of trust is seen as a great threat that can severely jeopardise the whole biomedical research enterprise. Practices, such as informed consent, and also the administrative and regulatory oversight of research in the form of research ethics committees and Institutional Review Boards, are established to ensure the protection of future research subjects and, at the same time, restore public trust in biomedical research. Empirical research also testifies to the role of trust as one of the decisive factors in research participation and lack of trust as a barrier for consenting to research. However, what is often missing is a clear definition of trust. This paper seeks to address this gap. It starts with a conceptual analysis of the term trust. It compares trust with two other related terms, those of reliance and trustworthiness, and offers a defence of Baier's attribute of 'good will' a basic characteristic of trust. It, then, proceeds to consider trust in the context of biomedical research by examining two questions: First, is trust necessary in biomedical research?; and second, do increases in regulatory oversight of biomedical research also increase trust in the field? This paper argues that regulatory oversight is important for increasing reliance in biomedical research, but it does not improve trust, which remains important for biomedical research. It finishes by pointing at professional integrity as a way of promoting trust and trustworthiness in this field.
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Affiliation(s)
- Angeliki Kerasidou
- The Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
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Dixon-Woods M, Foy C, Hayden C, Al-Shahi Salman R, Tebbutt S, Schroter S. Can an ethics officer role reduce delays in research ethics approval? A mixed-method evaluation of an improvement project. BMJ Open 2016; 6:e011973. [PMID: 27580832 PMCID: PMC5013460 DOI: 10.1136/bmjopen-2016-011973] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 07/13/2016] [Accepted: 07/20/2016] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE Frustration continues to be directed at delays in gaining approvals for undertaking health research in the UK. We aimed to evaluate the impact of an ethics officer intervention on rates of favourable opinions (approval) and provisional opinions (requiring revision and resubmission) and on the time taken to reach a final opinion by research ethics committees (RECs), to characterise how the role operated in practice, and to investigate applicants' views. DESIGN Mixed-method study involving (i) a 2-group, non-randomised before-and-after intervention study of RECs assigned an ethics officer and a matched comparator group; (ii) a process evaluation involving a survey of applicants and documentary analysis. PARTICIPANTS 6 RECs and 3 associated ethics officers; 18 comparator RECs; REC applicants. RESULTS Rates of provisional and favourable opinions between ethics officer and comparator RECs did not show a statistically significant effect of the intervention (logistic regression, p=0.26 for favourable opinions and p=0.31 for provisional opinions). Mean time to reach a decision showed a non-significant reduction (ANOVA, p=0.22) from 33.3 to 32.0 days in the ethics officer RECs compared with the comparator RECs (32.6 to 32.9 days). The survey (30% response rate) indicated applicant satisfaction and also suggested that ethics officer support might be more useful before submission. Ethics officers were successful in identifying many issues with applications, but the intervention did not function exactly as designed: in 31% of applicants, no contact between the applicants and the ethics officer took place before REC review. LIMITATIONS This study was a non-randomised comparison cohort study. Some data were missing. CONCLUSIONS An ethics officer intervention, as designed and implemented in this study, did not increase the proportion of applications to RECs that were approved on first review and did not reduce the time to a committee decision.
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Affiliation(s)
- Mary Dixon-Woods
- Institute of Public Health, Forvie Site, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Chris Foy
- R&D, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK
| | | | - Rustam Al-Shahi Salman
- Centre for Clinical Brain Sciences, School of Clinical Sciences, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK
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15
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Abstract
Bioethics can be considered as a topic, an academic discipline (or combination of disciplines), a field of study, an enterprise in persuasion. The historical specificity of the forms bioethics takes is significant, and raises questions about some of these approaches. Bioethics can also be considered as a governance practice, with distinctive institutions and structures. The forms this practice takes are also to a degree country specific, as the paper illustrates by drawing on the author's UK experience. However, the UNESCO Universal Declaration on Bioethics can provide a starting point for comparisons provided that this does not exclude sensitivity to the socio-political context. Bioethics governance practices are explained by various legitimating narratives. These include response to scandal, the need to restrain irresponsible science, the accommodation of pluralist views, and the resistance to the relativist idea that all opinions count equally in bioethics. Each approach raises interesting questions and shows that bioethics should be studied as a governance practice as a complement to other approaches.
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Affiliation(s)
- Jonathan Montgomery
- University College London, ULC Laws, Bentham House, Endsleigh Gardens, London, WC1H 0EG, UK.
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Leach V, Redwood S, Lasseter G, Walther A, Reid C, Blazeby J, Martin R, Donovan J. Research participation registers can increase opportunities for patients and the public to participate in health services research. J Health Serv Res Policy 2016; 21:183-7. [PMID: 26769574 DOI: 10.1177/1355819615625699] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Members of the public and patients repeatedly indicate their willingness to take part in research, but current United Kingdom research governance involves complex rules about gaining consent. Research participation registers that seek consent from participants to be approached about future studies have several potential benefits, including: increased research participation across clinical and healthy populations; simplified recruitment to health care research; support for people's autonomy in decision making; and improved efficiency and generalizability of research. These potential benefits have to be balanced against ethical and governance considerations. With appropriate processes in place, seeking prospective consent from patients and members of the public to be approached about future studies could potentially increase public participation in health research without compromising informed consent and other ethical principles.
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Affiliation(s)
- Verity Leach
- School of Social & Community Medicine, University of Bristol, Bristol, UK NIHR CLAHRC West, Bristol, UK
| | - Sabi Redwood
- School of Social & Community Medicine, University of Bristol, Bristol, UK NIHR CLAHRC West, Bristol, UK
| | - Gemma Lasseter
- School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - Axel Walther
- School of Social & Community Medicine, University of Bristol, Bristol, UK University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Colette Reid
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Jane Blazeby
- School of Social & Community Medicine, University of Bristol, Bristol, UK University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Richard Martin
- School of Social & Community Medicine, University of Bristol, Bristol, UK
| | - Jenny Donovan
- School of Social & Community Medicine, University of Bristol, Bristol, UK NIHR CLAHRC West, Bristol, UK
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Goodyear-Smith F, Jackson C, Greenhalgh T. Co-design and implementation research: challenges and solutions for ethics committees. BMC Med Ethics 2015; 16:78. [PMID: 26573410 PMCID: PMC4647576 DOI: 10.1186/s12910-015-0072-2] [Citation(s) in RCA: 120] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Accepted: 11/12/2015] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Implementation science research, especially when using participatory and co-design approaches, raises unique challenges for research ethics committees. Such challenges may be poorly addressed by approval and governance mechanisms that were developed for more traditional research approaches such as randomised controlled trials. DISCUSSION Implementation science commonly involves the partnership of researchers and stakeholders, attempting to understand and encourage uptake of completed or piloted research. A co-creation approach involves collaboration between researchers and end users from the onset, in question framing, research design and delivery, and influencing strategy, with implementation and broader dissemination strategies part of its design from gestation. A defining feature of co-creation is its emergent and adaptive nature, making detailed pre-specification of interventions and outcome measures impossible. This methodology sits oddly with ethics committee protocols that require precise pre-definition of interventions, mode of delivery, outcome measurements, and the role of study participants. But the strict (and, some would say, inflexible) requirements of ethics committees were developed for a purpose - to protect participants from harm and help ensure the rigour and transparency of studies. We propose some guiding principles to help square this circle. First, ethics committees should acknowledge and celebrate the diversity of research approaches, both formally (through training) and informally (by promoting debate and discussion); without active support, their members may not understand or value participatory designs. Second, ground rules should be established for co-design applications (e.g. how to judge when 'consultation' or 'engagement' becomes research) and communicated to committee members and stakeholders. Third, the benefits of power-sharing should be recognised and credit given to measures likely to support this important goal, especially in research with vulnerable communities. Co-design is considered best practice, for example, in research involving indigenous peoples in New Zealand, Australia and Canada.
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Affiliation(s)
- Felicity Goodyear-Smith
- Department of General Practice & Primary Health Care, University of Auckland, PB, 920919, Auckland, New Zealand.
| | - Claire Jackson
- Centre for Primary Care Reform Research Excellence, School of Medicine, University of Queensland, Brisbane, Australia.
| | - Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
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Carter P, Laurie GT, Dixon-Woods M. The social licence for research: why care.data ran into trouble. JOURNAL OF MEDICAL ETHICS 2015; 41:404-9. [PMID: 25617016 PMCID: PMC4431337 DOI: 10.1136/medethics-2014-102374] [Citation(s) in RCA: 185] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 11/24/2014] [Accepted: 12/30/2014] [Indexed: 05/21/2023]
Abstract
In this article we draw on the concept of a social licence to explain public concern at the introduction of care.data, a recent English initiative designed to extract data from primary care medical records for commissioning and other purposes, including research. The concept of a social licence describes how the expectations of society regarding some activities may go beyond compliance with the requirements of formal regulation; those who do not fulfil the conditions for the social licence (even if formally compliant) may experience ongoing challenge and contestation. Previous work suggests that people's cooperation with specific research studies depends on their perceptions that their participation is voluntary and is governed by values of reciprocity, non-exploitation and service of the public good. When these conditions are not seen to obtain, threats to the social licence for research may emerge. We propose that care.data failed to adequately secure a social licence because of: (i) defects in the warrants of trust provided for care.data, (ii) the implied rupture in the traditional role, expectations and duties of general practitioners, and (iii) uncertainty about the status of care.data as a public good. The concept of a social licence may be useful in explaining the specifics of care.data, and also in reinforcing the more general lesson for policy-makers that legal authority does not necessarily command social legitimacy.
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Affiliation(s)
- Pam Carter
- Health Sciences, University of Leicester, Leicester, UK
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19
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Tarrant C, Jackson C, Dixon-Woods M, McNicol S, Kenyon S, Armstrong N. Consent revisited: the impact of return of results on participants' views and expectations about trial participation. Health Expect 2015; 18:2042-53. [PMID: 25929296 PMCID: PMC4737222 DOI: 10.1111/hex.12371] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Increasingly, the sharing of study results with participants is advocated as an element of good research practice. Yet little is known about how receiving the results of trials may impact on participants' perceptions of their original decision to consent. OBJECTIVE We explored participants' views of their decision to consent to a clinical trial after they received results showing adverse outcomes in some arms of the trial. METHOD Semi-structured interviews were conducted with a purposive sample of 38 women in the UK who participated in a trial of antibiotics in pregnancy. All had received results from a follow-up study that reported increased risk of adverse outcomes for children of participants in some of the trial intervention arms. Data analysis was based on the constant comparative method. RESULTS Participants' original decisions to consent to the trial had been based on hope of personal benefit and assumptions of safety. On receiving the results, most made sense of their experience in ways that enabled them to remain content with their decision to take part. But for some, the results provoked recognition that their original expectations might have been mistaken or that they had not understood the implications of their decision to participate. These participants experienced guilt, a sense of betrayal by the maternity staff and researchers involved in the trial, and damage to trust. CONCLUSIONS Sharing of study results is not a wholly benign practice, and requires careful development of suitable approaches for further evaluation before widespread adoption.
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Affiliation(s)
- Carolyn Tarrant
- SAPPHIRE, Department of Health Sciences, University of Leicester, Leicester, UK
| | - Clare Jackson
- SAPPHIRE, Department of Health Sciences, University of Leicester, Leicester, UK
| | - Mary Dixon-Woods
- SAPPHIRE, Department of Health Sciences, University of Leicester, Leicester, UK
| | - Sarah McNicol
- The Education & Social Research Institute, Manchester Metropolitan University, Manchester, UK
| | - Sara Kenyon
- School of Health and Population Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Natalie Armstrong
- SAPPHIRE, Department of Health Sciences, University of Leicester, Leicester, UK
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20
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A Critical Look at Biomedical Journals' Policies on Animal Research by Use of a Novel Tool: The EXEMPLAR Scale. Animals (Basel) 2015; 5:315-31. [PMID: 26479237 PMCID: PMC4494415 DOI: 10.3390/ani5020315] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Revised: 04/03/2015] [Accepted: 04/23/2015] [Indexed: 12/04/2022] Open
Abstract
Simple Summary Biomedical journals have the responsibility to promote humane research. To gauge and evaluate journal policies on animal research, the EXEMPLAR—For “Excellence in Mandatory Policies on Animal Research”—scale is presented and applied to evaluate a sample of 170 biomedical journals, providing an overview of the current landscape of editorial policies on the ethical treatment of animals. Abstract Animal research is not only regulated by legislation but also by self-regulatory mechanisms within the scientific community, which include biomedical journals’ policies on animal use. For editorial policies to meaningfully impact attitudes and practice, they must not only be put into effect by editors and reviewers, but also be set to high standards. We present a novel tool to classify journals’ policies on animal use—the EXEMPLAR scale—as well as an analysis by this scale of 170 journals publishing studies on animal models of three human diseases: Amyotrophic Lateral Sclerosis, Type-1 Diabetes and Tuberculosis. Results show a much greater focus of editorial policies on regulatory compliance than on other domains, suggesting a transfer of journals’ responsibilities to scientists, institutions and regulators. Scores were not found to vary with journals’ impact factor, country of origin or antiquity, but were, however, significantly higher for open access journals, which may be a result of their greater exposure and consequent higher public scrutiny.
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21
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Tiwari SS, Raman S. Governing stem cell therapy in India: regulatory vacuum or jurisdictional ambiguity? NEW GENETICS AND SOCIETY 2014; 33:413-433. [PMID: 25431534 PMCID: PMC4226321 DOI: 10.1080/14636778.2014.970269] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 09/10/2014] [Indexed: 06/04/2023]
Abstract
Stem cell treatments are being offered in Indian clinics although preclinical evidence of their efficacy and safety is lacking. This is attributed to a governance vacuum created by the lack of legally binding research guidelines. By contrast, this paper highlights jurisdictional ambiguities arising from trying to regulate stem cell therapy under the auspices of research guidelines when treatments are offered in a private market disconnected from clinical trials. While statutory laws have been strengthened in 2014, prospects for their implementation remain weak, given embedded challenges of putting healthcare laws and professional codes into practice. Finally, attending to the capacities of consumer law and civil society activism to remedy the problem of unregulated treatments, the paper finds that the very definition of a governance vacuum needs to be reframed to clarify whose rights to health care are threatened by the proliferation of commercial treatments and individualized negligence-based remedies for grievances.
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Affiliation(s)
- Shashank S. Tiwari
- Institute for Science and Society (ISS), School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
| | - Sujatha Raman
- Institute for Science and Society (ISS), School of Sociology and Social Policy, University of Nottingham, Nottingham, UK
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22
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Parker N, O'Reilly M. “We Are Alone in the House”: A Case Study Addressing Researcher Safety and Risk. QUALITATIVE RESEARCH IN PSYCHOLOGY 2013. [DOI: 10.1080/14780887.2011.647261] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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23
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Dixon-Woods M, Yeung K, Bosk CL. Why is U.K. medicine no longer a self-regulating profession? The role of scandals involving "bad apple" doctors. Soc Sci Med 2011; 73:1452-9. [PMID: 21975027 DOI: 10.1016/j.socscimed.2011.08.031] [Citation(s) in RCA: 120] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Revised: 08/21/2011] [Accepted: 08/24/2011] [Indexed: 11/16/2022]
Abstract
This article identifies the role played by a series of medical scandals in the U.K., occurring from the mid-1990s onwards, in ending a collegial model of self-regulation of the medical profession that had endured for 150 years. The state's original motive in endorsing professional self-regulation was to resolve the principal-agent problem inherent in the doctor-patient relationship. The profession, in return for its self-regulating privileges, undertook to act as a reliable guarantor for the competence and conduct of each of its members. Though sufficient to ensure that most doctors were "good", the collegial model adopted by the profession left it fatally vulnerable to the problem of "bad apples": those unwilling, incapable or indifferent to delivering on their professional commitments and who betrayed the trust of both patients and peers. Weak administrative systems in the NHS failed to compensate for the defects of the collegium in controlling these individuals. The scandals both provoked and legitimised erosion of the profession's self-regulatory power. Though its vulnerability to bad apples had been present since the founding of the 19th century profession, it was the convergence of social and political conditions at a particular historical moment that transformed the scandals into an unstoppable imperative for reform. Huge public anger, the voice permitted to a coalition of critics, shifts in social attitudes, the opportunity presented for imposing standards for accountability, and the increasing ascendancy of pro-interventionist managerialist and political agendas from the early 1990s onwards were all implicated in the response made to scandals and the shape the reforms took. Scandals need to be understood not as simple determinants of change, but as one performative element in a constellation of socially contingent forces and contexts. The new rebalancing of the "countervailing powers" has dislodged the profession as the senior partner in the regulation of doctors, but may introduce new risks.
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Affiliation(s)
- Mary Dixon-Woods
- Dept of Health Sciences, 2nd Floor, Adrian Building, University of Leicester, Leicester LE1 7RH, UK
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24
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Wilson D. Creating the 'ethics industry': Mary Warnock, in vitro fertilization and the history of bioethics in Britain. BIOSOCIETIES 2011; 6:121-141. [PMID: 22563348 PMCID: PMC3342788 DOI: 10.1057/biosoc.2010.26] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Recent decades have seen a shift in the management and discussion of biomedicine. Issues once considered by doctors and scientists are now handled by a diverse array of participants, including philosophers, lawyers, theologians and lay representatives. This new approach, known as 'bioethics', has become the norm in regulatory committees and public debate. In this article, I argue that bioethics emerged as a valued enterprise in Britain during the 1980s because it fulfilled, and linked, the concerns of several groups. My analysis centres on the moral philosopher Mary Warnock, who chaired a government inquiry into human fertilization and embryology between 1982 and 1984, and became a strong advocate of bioethics. I detail how Warnock's promotion of bioethics tallied with the Conservative government's desire for increased surveillance of hitherto autonomous professions - while fulfilling her own belief that philosophers should engage in public affairs. And I also show that Warnock simultaneously promoted bioethics to doctors and scientists as an essential safeguard against declining political and public trust. This stance, I argue, framed bioethics as a vital intermediary between politics, the public, and biomedicine, and explains the growth and endurance of what the Guardian identified as an ethics industry.
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Affiliation(s)
- Duncan Wilson
- Centre for History of Science, Technology and Medicine, University of Manchester , UK . E-mail:
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25
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Pogorzelska M, Stone PW, Cohn EG, Larson E. Changes in the institutional review board submission process for multicenter research over 6 years. Nurs Outlook 2010; 58:181-7. [PMID: 20637931 DOI: 10.1016/j.outlook.2010.04.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2010] [Indexed: 10/19/2022]
Abstract
Although collaborative research across sites is essential to increase the statistical power and generalizability of research findings, the need to undergo multiple institutional review board (IRB) reviews is a challenge. The purposes of this paper are to describe changes in the IRB submission process in 2 national multisite studies before and after the implementation of the Health Information Portability and Accountability Act (HIPAA) Privacy rule (2002 and 2008) and to discuss implications for policy and practice related to human subjects research. In the second study, there was a shorter mean approval time and reduced variability in the decision about the level of review, the mean number of pages per application doubled, and an increased proportion of IRBs required conflict of interest and data use agreements. Possible approaches to further enhance the efficiency and streamlining of the research review process are suggested.
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Affiliation(s)
- Monika Pogorzelska
- Columbia University School of Nursing, Columbia University, New York, NY 10032, USA.
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26
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Kjellström S, Fridlund B. Literature review: status and trends of research ethics in Swedish nurses' dissertations. Nurs Ethics 2010; 17:383-92. [PMID: 20444779 DOI: 10.1177/0969733009355541] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Research ethics is increasingly formally regulated, but little is known about how ethical considerations are reported in dissertations. The aim of this literature study was to describe the status and trends of ethical considerations in Swedish doctoral dissertations written by registered nurses. A total of 77 dissertations from 1987, 1997, and 2007 met the inclusion criteria and were analyzed by descriptive statistics. Ethical considerations were mostly overlooked in 1987, but almost ubiquitous by 2007. All dissertations in 2007, except one, had a section on ethical considerations; however, these were short, lacking in references, and short on content. The most common topic was informed consent and approval from research ethics review boards, followed by confidentiality and ethical aspects of methodological issues. Our results imply that the quantity and quality of ethical considerations must be improved in order to assure ethical soundness for participants, patients, researchers, and society.
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Affiliation(s)
- Sofia Kjellström
- Institute of Gerontology, School of Health Sciences, Jönköping University, Jönköping, Sweden.
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Varga O, Hansen AK, Sandøe P, Olsson IAS. Improving transparency and ethical accountability in animal studies: three ways to link ethical approvals to publications. EMBO Rep 2010; 11:500-3. [PMID: 20539309 PMCID: PMC2897124 DOI: 10.1038/embor.2010.91] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2010] [Accepted: 05/21/2010] [Indexed: 11/09/2022] Open
Abstract
More transparency and accountability could help to alleviate public opposition to the use of animals in research. The authors propose various means of achieving this goal. Three ways to link ethical approvals to publications
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Affiliation(s)
- Orsolya Varga
- Institute for Molecular and Cell Biology (IBMC) in Porto, Portugal.
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Guillemin M, Gillam L, Rosenthal D, Bolitho A. Resources Employed by Health Researchers to Ensure Ethical Research Practice. J Empir Res Hum Res Ethics 2010; 5:21-34. [DOI: 10.1525/jer.2010.5.2.21] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
There is little empirical evidence about what resources health researchers use in order to make decisions about the ethical conduct of human research. Undertaking an empirical examination of how researchers understand research ethics and how they address ethical issues in research practice can lead to a richer understanding of how researchers approach research ethics. Our findings are based on interviews with 54 Australian health researchers. We conclude that, despite the considerable time devoted to ethics review, ethics committees and research guidelines were not seen as valuable resources for researchers undertaking research in the field. Although researchers did not perceive ethics committees as a resource when faced with ethical issues in the field, they nevertheless perceived the process of ethics review as beneficial to them; this allowed them to clarify their research, make decisions about the ethical conduct of the research, as well as offering them a sense of protection when undertaking research. In the actual undertaking of research practice, it was their past professional experience and personal values that researchers considered most useful resources when encountering ethical problems.
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Thompson AGH, France EF. One stop or full stop? The continuing challenges for researchers despite the new streamlined NHS research governance process. BMC Health Serv Res 2010; 10:124. [PMID: 20465819 PMCID: PMC2882919 DOI: 10.1186/1472-6963-10-124] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Accepted: 05/13/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Obtaining the necessary approvals and permission for clinical research requires successful negotiation of the ethical and R&D layers of the NHS. Differences in structure and governance frameworks feature between the constituent nations of the UK (England, Scotland, Wales and Northern Ireland), which adds complexity to cross-national studies. Difficulties in carrying out research in the NHS in the UK due to bureaucratic and time-consuming governance processes have led to the development of a new system of application and co-ordination from 2009. This paper illustrates how this new system fails to be consistent and streamlined and is unlikely to become so unless changes are made to the implementation and management of the governance processes. METHODS We present a case study of the research governance process at the survey stage of an investigation into the use, preferences and need for information by people making choices or decisions about health care. The method involved home-based, face-to-face interviewing in a questionnaire survey in relation to decisions about lymphoma treatment, Down's syndrome screening in pregnancy, and caring for people with dementia. RESULTS Our experience of the ethics stage was very positive, noting an efficient process of application and a speedy decision, both in relation to the initial application and to subsequent substantial amendments. By contrast, the R&D stages were very slow, most with unexplained delays, but some offering contradictory advice and exhibiting a lack of clear guidance and training for NHS staff. The R&D arrangements in Scotland were far quicker and more likely to be successful than in England. Overall, the delays were so severe that substantial parts of the research could not be delivered as planned within the funding timescale. CONCLUSIONS If high-quality research in the NHS, particularly in England, is to be delivered in a timely and cost-effective way, R&D processes for gaining research governance approval need improvement. Attention is needed in process implementation and management, particularly in relation to staff training, as well as clarity in guidance and communication within and between organisations.
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Affiliation(s)
- Andrew GH Thompson
- Politics and International Relations, School of Social and Political Science, University of Edinburgh, Chrystal Macmillan Building, 15A George Square, Edinburgh EH8 9LD, UK
| | - Emma F France
- Department of Nursing & Midwifery, University of Stirling, R.G. Bomont Building, Stirling FK9 4LA, UK
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O'Reilly M, Armstrong N, Dixon-Woods M. Subject positions in research ethics committee letters: a discursive analysis. ACTA ACUST UNITED AC 2009. [DOI: 10.1258/ce.2009.009027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Ethical review of applications to conduct research projects continues to be a focus of scrutiny and controversy. We argue that attention to the actual practices of ethical review has the potential to inform debate. We explore how research ethics committees (RECs) establish their position and authority through the texts they use in their correspondence with applicants. Using a discursive analysis applied to 260 letters, we identify four positions of particular interest: RECs positioned as disinterested and responsible; as representing the interests of potential participants; as facilitating ethically sound, high-quality research; and as engaged in dialogue. These positions are used strategically to deflect criticism or complaint. This analysis has implications for reducing contestation between researchers and RECs, suggesting that more dialogic rather than hierarchical approaches to positioning might be helpful.
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Affiliation(s)
- Michelle O'Reilly
- Department of Health Sciences, University of Leicester, Adrian Building, University Road, Leicester LE1 7RH, UK
| | - Natalie Armstrong
- Department of Health Sciences, University of Leicester, Adrian Building, University Road, Leicester LE1 7RH, UK
| | - Mary Dixon-Woods
- Department of Health Sciences, University of Leicester, Adrian Building, University Road, Leicester LE1 7RH, UK
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Dixon-Woods M, Tarrant C. Why do people cooperate with medical research? Findings from three studies. Soc Sci Med 2009; 68:2215-22. [PMID: 19394741 DOI: 10.1016/j.socscimed.2009.03.034] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2008] [Indexed: 11/19/2022]
Abstract
In this paper, we distinguish decisions about cooperation with medical research from decisions about research participation. We offer an empirical and theoretical exploration of why people in three different UK-based medical research projects chose to cooperate. Data analysis of the accounts of 128 participants across the three studies was based on the constant comparative method. Participants' cooperation was engaged by a perception that they would be contributing to the 'public good', but they also wanted to justify their decision as sensible and safe. Critical to their cooperation was their belief that researchers would fulfil their side of the cooperative bargain, by not exposing participants to risks of harm or exploitation. Although participants were generally unaware of the details of the regulatory regime for research, they demonstrated a generalised reliance on regulation as a feature of everyday life that would provide a safe context for cooperation. In their assessment of particular projects, participants made judgements about whether to cooperate based on more specific cues, which acted as signs to assure them that researchers shared their cooperative intentions. These cues included organisational and professional credentials, the role identities and perceived trustworthiness of those involved in recruiting to research, and visible signs of reasonable practice mandated by regulatory systems. Thus participants drew on their understandings of an institutional field that was much broader than that of research alone. We propose that the social organisation of research is fundamental to the judgements people make about cooperation with research. Cooperation may be a more useful way of thinking about how people come to engage in collaboratively oriented actions such as research participation, rather than currently dominant individualistic models. Attention to the institutional context of research is critical to understanding what makes cooperation possible, and has important implications for the design of regulatory regimes for research.
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O'Reilly M, Dixon-Woods M, Angell E, Ashcroft R, Bryman A. Doing accountability: a discourse analysis of research ethics committee letters. SOCIOLOGY OF HEALTH & ILLNESS 2009; 31:246-261. [PMID: 18983419 DOI: 10.1111/j.1467-9566.2008.01132.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Research ethics committees (RECs) are charged with adjudicating the ethical status of research projects, and determining the conditions necessary for such projects to proceed. Both because of their position in the research process and because of the controversial nature of ethical judgements, RECs' views and decisions need to be accountable. In this paper we use techniques of discourse analysis to show how REC decision letters 'do' accountability. Using a sample of 260 letters from three datasets, we identify a range of discursive devices used in letters written by RECs. These include drawing attention to: the process behind the decision, including its collaborative nature; holding the applicants accountable, by implying that any decision made by the REC can be attributed to the performance of the applicants; referring to specialist expertise; and calling upon external authorities. These tactics 'do' accountability by showing that routines of ethical assessment have been enacted, by establishing the factuality of claims, and by managing questions of fault and blame attribution. They may, however, also risk undermining legitimacy by failing to acknowledge the inherent contestability of ethical decision making or the limited nature of the cultural authority accorded to RECs, and thus may appear as an illegitimate exercise of power.
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Affiliation(s)
- Michelle O'Reilly
- Greenwood Institute of Child Health, Department of Health Sciences, University of Leicester, Leicester, UK
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De Vries RG, Kim SYH. Bioethics and the sociology of trust: introduction to the theme. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2008; 11:377-379. [PMID: 18629608 PMCID: PMC2712295 DOI: 10.1007/s11019-008-9158-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/23/2008] [Indexed: 05/26/2023]
Affiliation(s)
- Raymond G De Vries
- Bioethics Program, University of Michigan Medical School, 300 North Ingalls Street, Ann Arbor, MI, 48109, USA.
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