Thursday, April 5, 2007

Anthropologist Patricia Marshall Appointed to SACHRP

The Department of Health and Human Services has announced the appointment of a new chair and three new members to the Secretary’s Advisory Committee on Human Research Protections. Among the three new members is Professor Patricia A. Marshall of Case Western University. Like Lorna Rhodes who left the committee in 2006, Marshall is a medical anthropologist, making me wonder if the department has unofficially reserved a seat for such a scholar, who is then supposed to represent all social scientists.

Marshall brings a somewhat critical perspective, having complained about her own treatment by an IRB. In the early 1990s, she wanted to interview patients in a waiting room, and—in a classic example of IRB formalism--her IRB insisted that because she was doing research in a medical setting, she had to warn her interview subjects that “emergency medical treatment for physical injuries resulting from participation would be provided.” (Patricia A. Marshall, “Research Ethics in Applied Anthropology,” IRB: Ethics and Human Research 14 [Nov. - Dec., 1992]: 1-5).

Perhaps as a result of this experience, she has maintained some skepticism about IRB review of anthropology, as expressed in her essay, “Human Subjects Protections, Institutional Review Boards, and Cultural Anthropological Research,” Anthropological Quarterly 76 (Spring 2003): 269-285. That essay shows Marshall’s familiarity with much of the critical literature on IRBs, and she repeats some of that criticism herself:


  • “IRBs may be overly zealous in their interpretation and application of federal guidelines, exacerbating the challenges faced by anthropologists and other professionals in seeking approval for studies.” (270)
  • “Although committees must include representatives from diverse scientific fields and the community, IRBs have a strong orientation to biomedical and experimental research. In fact, a significant flaw in the development of the federal guidelines for ethical research is that social scientists were not included in the process. The result is a conflation of two related problems for anthropologists: first, the Common Rule emphasizes concerns for biomedical researchers; and second, most IRBs do not have members with expertise in anthropological methods.” (272)
  • “Misapplications of the Common Rule and inappropriate requests for revisions from IRBs can have a paralyzing effect on anthropological research. Moreover, it reinforces a cynical view of institutional requirements for protection of human subjects, and it uses scarce resources that would be better spent on studies involving greater risks for participants.” (273)



Given her understanding of these problems, one might expect her to advocate, or at least consider, the exclusion of anthropological research from IRB review. Instead, she concludes, “regulatory oversight by IRBs is a fact of life for scientific researchers. Anthropologists are not and should not be exempt.” (280)

Huh?

This conclusion is so contrary to the rest of the essay that I can only guess at how it got in there. Perhaps it represents a resigned surrender after years of failed efforts to exclude some review. Perhaps it is a failure of imagination. Perhaps Marshall believes that only by embracing IRB review will anthropologists be taken seriously by the biomedical researchers she works with.

Or perhaps the key issue is that Marshall fits the pattern I mentioned earlier of some anthropologists’ embrace of the Belmont Report principles. In “Research Ethics in Applied Anthropology,” Marshall cites not the Code of Ethics of the American Anthropological Association, but the comparable Ethical Guidelines of the National Association for the Practice of Anthropology, which state that “Our primary responsibility is to respect and consider the welfare and human rights of all categories of people affected by decisions, programs or research in which we take part.”

I have no complaint with applying those guidelines to their intended subject: “a professionally trained anthropologist who is employed or retained to apply his or her specialized knowledge problem solving related to human welfare and human activities.” But they are inappropriate restrictions for scholars whose primary role is academic inquiry, not problem solving.

Thus, like Stuart Plattner, Marshall uncritically assumes that one field’s ethics can be imposed on another. She writes, “ethical principles governing applied anthropological research are not unique to this discipline. Respect for persons, beneficence, and justice are fundamental concerns for any scientist.” (“Research Ethics in Applied Anthropology,” 4) While that sounds lovely, the latter two terms, as defined by the Belmont Report, are foreign to the ethical codes of most academic research. Until she recognizes the distinction between problem-solvers whose primary goal is to do no harm and researchers whose primary goal is to seek the truth, she will be a poor advocate for most scholars in the social sciences and humanities.

Yet in previous work, Marshall herself has argued against the idea that humans share a single set of ethics, recognizing instead that “ethics and values cannot be separated from social, cultural, and historical determinants that regulate both the definition and resolution of moral quandaries.” (“Anthropology and Bioethics,” Medical Anthropology Quarterly, New Series, 6 [Mar., 1992]: 62) If she brings that insight to the committee, perhaps she will recognize the basic wrongness of forcing Belmont’s biomedical ethics on non-biomedical fields.

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