Medical Dominance within Research Ethics Committees

Abstract

Qualitative research is reported which explores the perceptions of members of the U.K.'s independent Phase I ethics committees (IECs) about key issues identified following a literature review. Audio-recorded interviews were conducted with ten expert and ten lay members from all IECs except the one to which the lead author was attached. Transcripts were thematically analyzed following a broadly hermeneutical approach. The findings-dealing with such matters as recruitment strategies and length of service; attitudes towards member categories, published ethics guidelines, and the adequacy of insurance; levels of training and views on achieving a recognised level of competence-have an intrinsic interest, but it is when the findings are considered collectively using Freidson's theory of professional dominance that they reveal the influence the medical profession can have in shaping ethics review.

Emotions in human research ethics guidelines: Beyond risk, harm and pathology

“…Medical and legal conceptualisations of emotions, which are notoriously dualistic in their treatment of emotion (Bergman Blix and Wettergren, 2015; McNaughton, 2013; Shaw et al, 2020), can be inferred within HREGs, reflecting the disciplinary traditions of the authors and the overarching medical dominance that persists within ethical review processes (Humphreys et al, 2014). For instance, of the 11 named authors of the US Belmont Report, three have medical doctorates, two have PhDs in related fields and three have legal qualifications.…”

“…On the whole, included HREGs neglected the importance of emotions to human experiences, including research and ethical decision-making (Briggs, 2013; Humphreys et al, 2014; Romocea, 2014). They were uncritical in their conceptualisation of positively valanced prosocial emotions (e.g.…”

“…Conceptualisations of emotions matter; emotions discourses have been implicated in reinforcing the status quo to the exclusion of marginalised bodies in medicine and other settings (Ahmed, 2015; McNaughton, 2013). Though HREGs are but one source of advice on how to do research ethically, along with textbooks, international and professional guidelines, these national guidelines are arguably the most influential, with university- and hospital-HRECs instructed to base their decisions on these guidelines (Humphreys et al, 2014; Liamputong, 2007; Pickersgill, 2012). Based in a discursive analysis of HREGs from four countries, revealing the gendered and pathologised treatment of emotions, in this article, I call for critical attention to and revision in the way emotions are conceptualised and operationalised in HREGs.…”

'Text-work' in Research Ethics Review: The significance of documents in and beyond committee meetings

“…Despite acknowledging some of the (historic) limitations of RECs, commentators have identified the potential educative value of engaging with review systems (Wiles et al, 2011; Guillemin and Gillam 2004;Israel and Hay 2006) where ethical considerations become integral to the whole research process 13 from design to completion and review procedures as potentially helpful in assisting researchers to reflect on the ethical elements in a project. Even so, it is clear that in some aspects of review, broad ethical guidance and frameworks are superfluous with reviewers instead responding instinctively to research applications (Humphreys et al 2014). Current systems discourage reflective approaches for researchers and reviewers so that what is of primary importance and what ultimately shapes ethics review is the institutional need for transparency and an attempt at consistency providing the illusion of objectivity.…”

‘It Shouldn’t Be This Hard’: Exploring the Challenges of Rural Health Research

“…Our study has identified some of the circumstances where ethics and governance overload is counterproductive to achieving research outcomes, and that this may particularly affect disempowered, disenfranchised populations [24]. We argue that this is an outcome of extending a medical model of research ethics to non-medical research without considering what might really be needed [25], and that ‘this trend portends a form of colonization by the medical sciences at the expense of the culture of the social sciences’ [26].…”