Sunday, December 23, 2012

Dunn and Hunter Defend Mandatory Review

The Journal of Medical Ethics has published two responses to Murray Dyck and Gary Allen's August 2012 article, “Is Mandatory Research Ethics Reviewing Ethical?” The responses do little to grapple with what I take to be the article's major's proposal.

[Michael Dunn, “Getting the Justification for Research Ethics Review Right.” Journal of Medical Ethics (October 31, 2012). doi:10.1136/medethics-2012-100943; David Hunter, “How Not to Argue Against Mandatory Ethics Review.” Journal of Medical Ethics (December 12, 2012). doi:10.1136/medethics-2012-101074.]

As I wrote in September, I understand Dyck and Allen to be arguing not for the abolition of ethics committees, but rather for a shift from compulsion to persuasion as committees' chief tool.

I am not sure that Dunn and Hunter share this understanding. While they offer challenges to some of Dyck and Allen's claims about the current workings of ethics committees, they say little about the suggestion that advisory committees might preserve the best features of mandatory ethics review while eliminating its abuses.

Dunn agrees that ethics committees can be flawed and calls, briefly, for "novel governance frameworks" to improve efficiency and accountability. If one follows his footnotes, one finds that he cites with approval Sheehan's call for enhanced due process in ethics review. Yet Dunn believes that "any such approach would be diametrically opposed to the path laid out for us by Dyck and Allen." Why? It strikes me that stripping ethics committees of the power of compulsion is--like Sheehan's vague proposals--a move toward accountability.

Hunter asks, "Why would not responsible professionals want the input of an expert panel to help guide them to an ethically defensible decision about their research?" Well, Dyck and Allen ask the same thing, and suggest that the committees' power of coercion makes them lazy, so that they become inexpert panels. Their proposal would force panels to become expert if they wanted to shape research, rather than relying on the threat of sanctions.

Whether researchers are empowered to appeal decisions or vote with their feet, ethics committees must be brought to account.

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