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Cengiz N, Kabanda SM, Moodley K. Cross-border data sharing through the lens of research ethics committee members in sub-Saharan Africa. PLoS One 2024; 19:e0303828. [PMID: 38781141 PMCID: PMC11115285 DOI: 10.1371/journal.pone.0303828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 05/01/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Several factors thwart successful data sharing-ambiguous or fragmented regulatory landscapes, conflicting institutional/researcher interests and varying levels of data science-related expertise are among these. Traditional ethics oversight mechanisms and practices may not be well placed to guarantee adequate research oversight given the unique challenges presented by digital technologies and artificial intelligence (AI). Data-intensive research has raised new, contextual ethics and legal challenges that are particularly relevant in an African research setting. Yet, no empirical research has been conducted to explore these challenges. MATERIALS AND METHODS We explored REC members' views and experiences on data sharing by conducting 20 semi-structured interviews online between June 2022 and February 2023. Using purposive sampling and snowballing, we recruited representatives across sub-Saharan Africa (SSA). We transcribed verbatim and thematically analysed the data with Atlas.ti V22. RESULTS Three dominant themes were identified: (i) experiences in reviewing data sharing protocols, (ii) perceptions of data transfer tools and (iii) ethical, legal and social challenges of data sharing. Several sub-themes emerged as: (i.a) frequency of and approaches used in reviewing data sharing protocols, (i.b) practical/technical challenges, (i.c) training, (ii.a) ideal structure of data transfer tools, (ii.b) key elements of data transfer tools, (ii.c) implementation level, (ii.d) key stakeholders in developing and reviewing a data transfer agreement (DTA), (iii.a) confidentiality and anonymity, (iii.b) consent, (iii.c) regulatory frameworks, and (iii.d) stigmatisation and discrimination. CONCLUSIONS Our results indicated variability in REC members' perceptions, suboptimal awareness of the existence of data protection laws and a unanimously expressed need for REC member training. To promote efficient data sharing within and across SSA, guidelines that incorporate ethical, legal and social elements need to be developed in consultation with relevant stakeholders and field experts, along with the training accreditation of REC members in the review of data-intensive protocols.
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Affiliation(s)
- Nezerith Cengiz
- Department of Medicine, Division for Medical Ethics and Law, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Siti M. Kabanda
- Department of Medicine, Division for Medical Ethics and Law, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Keymanthri Moodley
- Department of Medicine, Division for Medical Ethics and Law, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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2
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Zakout GA. Practicing equitable principles in cancer clinical research: Has the EU got it right? J Cancer Policy 2023; 37:100435. [PMID: 37507086 DOI: 10.1016/j.jcpo.2023.100435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/17/2023] [Accepted: 07/25/2023] [Indexed: 07/30/2023]
Abstract
Clinical trials are a fundamental part of cancer research as they establish the efficacy and safety of new cancer treatments for everyone. The lack of sociodemographic diversity among cancer clinical trial participants leaves a vacuum in scientific knowledge, which can distort credible evidence from being accessible and represents a major barrier to advancing cancer care for the entire patient population. It can also cause avoidable harm to the public, undermine patients trust and result in wasteful allocation of healthcare resources. It is therefore imperative that there is representation of all population groups who may use these new cancer treatments in clinical trial settings. Europeans are disproportionately affected by cancer with cancer mortality rates being substantially affected by inequities in socioeconomic education status. General and political recognition of cancer injustices in the EU have further increased given the contemptuously unequal impacts of the legal and policy responses to it. While innovative advances in cancer research have bridged much of these critical gaps particularly in the last few decades more work needs to be done to circumvent implications of cancer health disparities. To reduce cancer health disparities, systemic and individual-level barriers to cancer clinical trial participation must be addressed through effective and ethically rigorous EU health laws and policies.
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Affiliation(s)
- Ghada A Zakout
- Erasmus University Rotterdam, Erasmus School of Law, Burg. Oudlaan 50, 3062 PA Rotterdam, Netherlands.
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3
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Mariani J, Garau L, Ferrero F, Vukotich C, Roitman AJ, Serrano CM, Perelis L, Domínguez AG, González Villa Monte G. Assessment of an electronic system for research ethics committees document management: An observational study. Account Res 2023; 30:21-33. [PMID: 34314277 DOI: 10.1080/08989621.2021.1960515] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Since 1 January 2020, the Central Research Ethics Committee of the Health Ministry implemented PRIISA.BA, an in-house developed electronic system for online submission of health research applications to the 63 public and private research ethics committees (RECs) of Buenos Aires City, Argentina. This study though to compare the times to first review and the time to approval among applications submitted prior to PRIISA.BA and thereafter, across public RECs. All public RECs of the city were invited to participate. Overall, 453 applications from 10 RECs (242 pre- and 211 post-PRIISA.BA) were available for the analyses. There was a decrease in the time to first review and an increase in the time to approval after PRIISA.BA implementation. The increase in time to approval was transient and limited to the first three months. The results were consistent with analyses limited to non-COVID applications. Our results show an increase in the times to approval after the implementation of an electronic system for online submission of health research applications that, although transient, was significant. These data could be relevant to other RECs implementing this technology since it emphasizes the need of monitoring potential unnecessary delays in reviews during the critical initial period.
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Affiliation(s)
- Javier Mariani
- Coronary Unit Coordinator, Hospital De Alta Complejidad En Red "El Cruce", Florencio Varela (1888), Buenos Aires, Argentina
| | - Laura Garau
- Comité Central De Ética En Investigación, Ministerio De Salud Del Gobierno De La Ciudad De Buenos Aires, Ciudad Autónoma De Buenos Aires, Argentina. Consejo De Investigación En Salud, Ministerio De Salud Del Gobierno De La Ciudad De Buenos Aires, Ciudad Autónoma De Buenos Aires, Buenos Aires, Argentina
| | - Fernando Ferrero
- Departamento De Medicina, Hospital General De Niños "Dr Pedro De Elizalde", Ciudad Autónoma De Buenos Aires, Buenos Aires, Argentina
| | - Claudia Vukotich
- Comité Central De Ética En Investigación, Ministerio De Salud Del Gobierno De La Ciudad De Buenos Aires, Ciudad Autónoma De Buenos Aires, Argentina. Instituto De Ciencias Para La Familia, Universidad Austral, Pilar (1629), Buenos Aires, Argentina
| | - Adriel J Roitman
- Comité Central De Ética En Investigación, Ministerio De Salud Del Gobierno De La Ciudad De Buenos Aires, Ciudad Autónoma De Buenos Aires, Argentina. Comité De Ética En Investigación, Clínica Y Maternidad Suizo Argentina, Ciudad Autónoma De Buenos Aires, Argentina. Comité De Ética En Investigación Clínica Olivos, Buenos Aires, Argentina. Comité De Ética En Investigación De La Dirección De Investigación Para La Salud, Ministerio De Salud De La Nación, Ciudad Autónoma De Buenos Aires, Buenos Aires, Argentina
| | - Cecilia M Serrano
- Comité Central De Ética En Investigación, Ministerio De Salud Del Gobierno De La Ciudad De Buenos Aires, Ciudad Autónoma De Buenos Aires, Argentina. Hospital "Dr Abel Zubizarreta", Ciudad Autónoma De Buenos Aires, Argentina. Carrera Interdisciplinaria De Especialización En Neuropsicología Clínica, Facultad De Psicología, Universidad De Buenos Aires, Ciudad Autónoma De Buenos Aires, Argentina. Neurología Cognitiva Y Neuropsicología, Hospital "Dr Cesar Milstein", Ciudad Autónoma De Buenos Aires, Buenos Aires, Argentina
| | - Leonardo Perelis
- Comité De Ética En Investigación, Hospital General De Agudos "Dr José María Ramos Mejía", Ciudad Autónoma De Buenos Aires, Argentina. Comité Central De Ética En Investigación, Ministerio De Salud Del Gobierno De La Ciudad De Buenos Aires, Ciudad Autónoma De Buenos Aires, Buenos Aires, Argentina
| | - Adriana G Domínguez
- Comité De Ética En Investigación De La Dirección De Investigación Para La Salud, Ministerio De Salud De La Nación, Ciudad Autónoma De Buenos Aires, Argentina. Comité De Ética En Investigación Del Hospital General De Agudos "Dr Abel Zubizarreta", Ciudad Autónoma De Buenos Aires, Argentina. Diplomatura De Ética En Investigación, Universidad Isalud, Ciudad Autónoma De Buenos Aires, Buenos Aires, Argentina
| | - Gabriel González Villa Monte
- Comité Central De Ética En Investigación, Ministerio De Salud Del Gobierno De La Ciudad De Buenos Aires, Ciudad Autónoma De Buenos Aires, Argentina. Dirección General De Docencia, Investigación Y Desarrollo Profesional, Ministerio De Salud Del Gobierno De La Ciudad De Buenos Aires, Ciudad Autónoma De Buenos Aires, Buenos Aires, Argentina
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4
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Di Tonno D, Perlin C, Loiacono AC, Giordano L, Martena L, Lagravinese S, Rossi F, Marsigliante S, Maffia M, Falco A, Piscitelli P, Miani A, Esposito S, Distante A, Argentiero A. Trends of Phase I Clinical Trials in the Latest Ten Years across Five European Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14023. [PMID: 36360902 PMCID: PMC9658046 DOI: 10.3390/ijerph192114023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/18/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Phase 1 clinical trials represent a critical phase of drug development because new candidate therapeutic agents are tested for the first time on humans. Therefore, international guidelines and local laws have been released to mitigate and control possible risks for human health in agreement with the declaration of Helsinki and the international Good Clinical Practice principles. Despite numerous scientific works characterizing the registered clinical trials on ClinicalTrials.gov, the main features and trends of registered phase 1 clinical trials in Europe have not been investigated. This study is aimed at assessing the features and the temporal trend of distribution of phase 1 clinical studies, carried out in the five largest European countries over a ten-year period (2012-2021), and to evaluate the impact of the Italian regulatory framework on the activation of such studies. METHODS The main data and characteristics of phase 1 clinical studies registered on the ClinicalTrials.gov database for France, Germany, Italy, Spain and the United Kingdom have been investigated and subsequently compared. The above-mentioned countries were selected based on similarities in terms of demographic and Gross Domestic Product (GDP) data available on official government websites. (3) Results: A total number of 6878 phase 1 clinical trials were registered for the five selected countries in the ClinicalTrials.gov database during the ten years analyzed; the studies were predominantly randomized (39.33%) and for-profit (76.64%). The most represented area of investigations was oncology (52.15%), followed by hematology (24.99%) and immunology (12.04%). The variability observed between the analyzed countries showed that the UK, Germany and France presented the highest reduction in the number of phase 1 clinical trials, while for Spain and Italy, a stable/increased trend was observed, although with a lower number of trials registered on the ClinicalTrials.gov database. (4) Conclusions: Italy displayed the lowest number of registered phase 1 clinical trials, even though it showed a stable trend over the years. In this regard, the Italian regulatory framework must urgently be adapted to that of other European countries (Spain has been the first country to implement the new Regulation (EU) No 536/2014) and streamline the process of clinical trial application to increase the attractiveness of the country. Moreover, nonprofit phase 1 clinical trials (which represent 19.81% of the total number of phase 1 clinical trials registered in Italy vs. 80.19% of profit phase 1 clinical studies) should be promoted and supported by the institutions, even from a financial point of view, to allow independent researchers to develop new therapeutic drugs.
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Affiliation(s)
- Davide Di Tonno
- ClinOpsHub s.r.l., 72023 Mesagne, Italy
- Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, 73100 Lecce, Italy
| | - Caterina Perlin
- ClinOpsHub s.r.l., 72023 Mesagne, Italy
- Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, 73100 Lecce, Italy
| | - Anna Chiara Loiacono
- ClinOpsHub s.r.l., 72023 Mesagne, Italy
- Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, 73100 Lecce, Italy
| | - Luca Giordano
- ClinOpsHub s.r.l., 72023 Mesagne, Italy
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Loredan 18, 35121 Padova, Italy
| | | | | | | | - Santo Marsigliante
- Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, 73100 Lecce, Italy
| | - Michele Maffia
- Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, 73100 Lecce, Italy
| | - Andrea Falco
- Department of Public Health, European University of Madrid, 28670 Madrid, Spain
| | - Prisco Piscitelli
- Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, 73100 Lecce, Italy
| | - Alessandro Miani
- Department of Environmental Science and Policy, University of Milan, 10123 Milan, Italy
| | - Susanna Esposito
- Pediatric Clinic, Department of Medicine and Surgery, University of Parma, 43121 Parma, Italy
| | - Alessandro Distante
- Euro Mediterranean Scientific Biomedical Institute (ISBEM), 72023 Mesagne, Italy
| | - Alberto Argentiero
- Department of Biological and Environmental Science and Technologies (Di.S.Te.B.A.), University of Salento, 73100 Lecce, Italy
- Centro Ricerca Clinica Salentino (CERICSAL), Veris delli Ponti Hospital, 73020 Scorrano, Italy
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Rubbo P, Lievore C, Biynkievycz Dos Santos C, Picinin CT, Pilatti LA, Pedroso B. “Research exceptionalism” in the COVID-19 pandemic: an analysis of scientific retractions in Scopus. ETHICS & BEHAVIOR 2022. [DOI: 10.1080/10508422.2022.2080067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Priscila Rubbo
- Department of Accounting Sciences, Federal University of Technology – Paraná (UTFPR)
| | - Caroline Lievore
- Department of Accounting Sciences, Federal University of Technology – Paraná (UTFPR)
| | | | - Claudia Tania Picinin
- Postgraduate Program in Production Engineering, Federal University of Technology – Paraná (UTFPR)
| | - Luiz Alberto Pilatti
- Postgraduate Program in Science and Technology Teaching and Production Engineering and Postgraduate Program in Production Engineering, Federal University of Technology – Paraná (UTFPR)
| | - Bruno Pedroso
- Postgraduate Program in Health Sciences and Postgraduate Program in Inclusive Education, State University of Ponta Grossa (UEPG)
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Haaser T, Bouteloup V, Berdaï D, Saux MC. The Multidimensional Nature of Research Ethics: Letters Issued by a French Research Ethics Committee Included Similar Proportions of Ethical and Scientific Queries. J Empir Res Hum Res Ethics 2022; 17:242-253. [PMID: 35414297 DOI: 10.1177/15562646221093218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Debate is ongoing concerning the activities and functioning of Research Ethics Committees (REC), especially a possible science-or-ethics dichotomy in research ethics review. We retrospectively analyzed 145 letters issued by a French REC over 18 months. All queries were classified in three levels: qualification (definition of the problem), category (aggregation of broader topics) and finally fields (ethical, scientific, or administrative). Overall, 971 queries were identified, of which 407 (42%), 379 (39%), and 135 (14%) were deemed ethical, scientific, and administrative queries, respectively. The most frequent concern was about participants' information. The main influencing factor was the profession of the reporting readers-scientific queries were more frequently raised by a methodologist, whereas ethical queries were more frequently raised by an ethicist. These results indicate that research ethics review is a multidimensional task that should be considered a collaborative effort.
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Affiliation(s)
- Thibaud Haaser
- Service d'Oncologie Radiothérapie, Hôpital Haut Lévêque, 158435Centre Hospitalier Universitaire de Bordeaux, Pessac, France.,EA 4574 "Sciences, Philosophie, Humanités" Université de Bordeaux - Université Bordeaux Montaigne, Pessac, France.,Comité de Protection des Personnes Sud-Ouest et Outre-Mer III, Service de Pharmacologie Clinique, Hôpital Pellegrin, 158435Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Vincent Bouteloup
- Comité de Protection des Personnes Sud-Ouest et Outre-Mer III, Service de Pharmacologie Clinique, Hôpital Pellegrin, 158435Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.,Bordeaux Health Population, Inserm 1219, Institut de Santé Publique, d'Epidémiologie et de Développement (ISPED), Université de Bordeaux - CHU de Bordeaux, Bordeaux, France
| | - Driss Berdaï
- Comité de Protection des Personnes Sud-Ouest et Outre-Mer III, Service de Pharmacologie Clinique, Hôpital Pellegrin, 158435Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.,Service de Pharmacologie Clinique, Hôpital Pellegrin, 158435Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - Marie-Claude Saux
- Comité de Protection des Personnes Sud-Ouest et Outre-Mer III, Service de Pharmacologie Clinique, Hôpital Pellegrin, 158435Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France.,Faculté de Pharmacie, Université de Bordeaux, Bordeaux, France
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7
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Vinceti SR, Filippini T. Revising the legislation of Ethics Committees to ease biomedical research in humans across the world: lessons from the COVID-19 emergency. ACTA BIO-MEDICA : ATENEI PARMENSIS 2022; 93:e2021579. [PMID: 35546005 PMCID: PMC9171886 DOI: 10.23750/abm.v93i2.12582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 11/23/2022]
Abstract
As a legislative domain that considerably influences implementation of biomedical research, the need to improve the legal rules surrounding the organization and functioning of Ethics Committees in public health, toxicology, and clinical medicine is widely recognized within and outside the European Union. Given the often-heard complaints by researchers about the complexity and length of both the application and the review process by Ethics Committees in the authorization of new studies, adjustments to their legislation appears to be warranted. Within the European Union this seems also all the timelier, given the upcoming new regulation of clinical trials to become effective in early 2022. For this process, valuable lessons can be gleaned from the COVID-19 pandemic and the changes in the functioning of Ethics Committees that were adopted to cope with the exceptional circumstances imposed by the health emergency. The pandemic experience clearly indicates that a more responsive and practical system of applications' review by the Ethics Committees can be squared with acceptable levels of transparency and reliability in ethical accountability. For this reason, countries like Italy should consider undertaking a significant revision of the public law rules that govern the review processes of Ethics Committees in light of the pandemic experience. (www.actabiomedica.it).
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Affiliation(s)
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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8
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Magavern EF, Piasecki J, Cohen A, Cremers S. Ethics in clinical pharmacology: Facilitating public trust. Br J Clin Pharmacol 2021; 88:5-6. [PMID: 34773656 DOI: 10.1111/bcp.15118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 11/29/2022] Open
Affiliation(s)
- Emma F Magavern
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Department of Clinical Pharmacology, Cardiovascular Medicine, Barts Health NHS Trust, London, UK
| | - Jan Piasecki
- Department of Philosophy and Bioethics, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, Poland
| | - Adam Cohen
- Department of Clinical Pharmacology, Leiden University Medical Centre, Leiden, the Netherlands
| | - Serge Cremers
- Department of Clinical Pharmacology, Columbia University Irving Medical Center, New York, New York, USA
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9
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Tusino S, Furfaro M. Rethinking the role of Research Ethics Committees in the light of Regulation (EU) No 536/2014 on clinical trials and the COVID-19 pandemic. Br J Clin Pharmacol 2021; 88:40-46. [PMID: 33891323 PMCID: PMC8251080 DOI: 10.1111/bcp.14871] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/12/2021] [Accepted: 04/15/2021] [Indexed: 01/20/2023] Open
Abstract
Research Ethics Committees (RECs)—or Institutional Review Boards (IRBs), as they are known in the US—were created about 50 years ago to independently assess the ethical acceptability of research projects involving human subjects, their fundamental role being the protection of the dignity and rights of research participants. In this paper we develop some critical reflections about the current situation of RECs. Our starting point is the definition of the role they should ideally play, a role that should necessarily include a collaborative approach and the focus on the ethics component of the review. This ideal is unfortunately quite far from reality: inadequacies in the functioning of RECs have been discussed for decades, along with reform proposals. Both in the US and in the European Union (EU), reforms that aim at the centralization of the review process were recently approved. Even though these reforms were needed, they nonetheless raise concerns. We focus on two such concerns, related in particular to Regulation (EU) No 536/2014: the risk of narrowing the scope of the ethics review and that of disregarding the local context. We argue that the COVID‐19 pandemic paved the way for the transition towards the centralized model and that an analysis of its impact on the research review process could provide some interesting insights into possible shortcomings of this new model. We conclude by identifying three objectives that define the role of a REC, objectives that any reform should preserve.
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