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Ethical Challenge & Solution in Social Behavioral Research Melody Lin December 2012 Objectives Apply regulation & ethical principles Develop review parameter Roles & responsibilities Do actions protect human subjects 45 CFR 46 Understand regulations’ flexibility and aplly to SBER research Ethical principles The 3 ethical principles are: Respect Beneficence Justice EP are the basis for the regulations Primary Ethical Concerns (SBER) Informed consent Confidentiality Privacy Risk category Psychological risk Social risk Economic risk Subject selection Areas of IRB Review Use regulations, ethical principles, institutional guidance and their expertise to review research for: Respect Beneficence Recruitment Informed consent Confidentiality procedures Subject compensation Background literature Investigator experience Research design Justice Risks and benefits Subject selection practices Application of the Regulation Do not provide direct guidance on each of these ethical concerns Ethical issues are briefly mentioned: Informed consent requirement (46.116) Confidentiality Privacy In relation to informed consent (46.116(a)(5) IRB approval criteria (46.111) Risk IRB approval crietria (46.111) Meeting or exceeding “minimal risk” (46.102)(i) Review Challenges Regulations do not provide ethical guidance IRBs are not experienced in application of the regulations to non-medical research A one-size fits all approach may not work Lack of guidance creates confusion and tension Regulations Allow for Flexibility Exempt status Expedited review via subcommittee Waiver of informed consent and documentation General open-mindedness in consideration of various research design choices Exempt Review Examples Use of biological samples Involvement of school children in educational research Survey gathering non-sensitive data Expedited Review: Examples Effect of stride frequency on oxygen uptake while running uphill Knowledge and attitudes on contraception and reproductive health in residents of a small Mexican town A comparison of standard vs. hearing aid processing in cell phones for the hearing impaired Full Committee: Examples Interviews with law enforcement agents, armed group leaders, drug users, and drug dealers on the drug trade in several Asian Countries Testing weight-reduction strategies for breast cancer survivors Study of social rejection and depression using deception So, We Understand IB member responsibilities are highly complex Social and behavioral sciences studies are highly complex Each study must be reviewed case by case Regulations allow for flexibility IRB members and administrative staff should be well-trained and supported by the institution What to Do? Improve understanding and relevant application Streamline process and compliance Determine whether actions actually protect subjects Where to focus? Where Do We Begin? PI creates a good protocol Produces valid, worthwhile science Responds ethically, not bureaucratically, to regulations Demonstrates sensitivity to the context, culture and needs of subjects Shows understanding of the consent process, risk & benefit privacy & confidentiality, and the consultative role fo the IRB Demonstrate Ethical Practices Conduct valid research (using accepted scientific methods) Appropriate sampling (to get valid results) Respect people and their communities Protect research participants Benefit individuals and society Create a basis for socially beneficial polices Disseminate findings effectively Facilitate the application of finding Stakeholders Regulatory Institutions Research subjects Shared Responsibilities Stakeholders have complementary and competing goals: Legal concerns Academic freedom Human rights Perception of the IRB Supportive? Controlling? Inconsistent? Fearful? Restrictive? Helpful? Powerful? Arbitrary? Facilitative? One dimensional? Mysterious? Uninformed? See JERHRE, March 2006 for results of study perceptions of iRBs Opportunities or Challenges? Collaborate – us/them or team approach? Communicate – challenge or Facilitate? Cooperate – problem or solutions? Collaboration, Communication and Cooperation Increase collaboration Minimize confrontation Improve communications Reduce barriers Value added decisions Shared visions and responsibility Opportunities to partner in research endeavors Tips for the IRB Organizational perception IRB composition/support Educate, guide and consult Streamline Meet the investigators Appropriate flexibilty Identify Challenge Protocol review/approval Appropriate consent process/documentation Appropriate risk assessment Turn around time Consent form details Knowledge of research design Use of exempt and expedited review Providing education The Review Process Does one size fit all? Consider methodology Disciplines involved Risk assessment/management Infomred consent Proactive Site Visits Create an opportunity to see the research in action Create an environment where on-site monitoring is accepted/valued Enhance IRB awareness of practical issues from the investigator’s perspective Promote communication between researchers and the IRB Increase opportunities for training of ethical/responsible research practices Tip for Investigators Take RESPONSIBILITY become EMPOWERED Knowledge is power – know the Federal regulations, institutional policy / guidance Opportunities to learn Protocol submission Communicate Ethical awareness Use resources Resources Both NIH and NSF have developed guidance specific to SBER research http://obssr.od.nih.gov http://www.nsf.gov/bfa/dias/policy/hsfaqs/jsp National listserve [email protected]