Book review: Patchett offers insight into the work of IRBs

I was excited to read State of Wonder by Ann Patchett for Ampersand’s Summer Reading List. Having thoroughly enjoyed two of Patchett’s previous books (The Magician’s Assistant and Bel Canto), I looked forward to her most recent New York Times bestseller, especially as she took on several issues critical for those of us in the research ethics field, including respect, justice, beneficence, informed consent, coercion, and more. As I can find it challenging to explain the work of an institutional review board (IRB) to lay people, finding a popular novel that can do so is refreshing and helpful.

Marina Singh, the heroine of State of Wonder, is a doctor working for Vogel, a drug company, whose colleague and friend dies while on a business trip to the Amazon in Brazil. The purpose of his trip was to obtain an update on the research efforts of the elusive Annick Swenson, an investigator funded by Vogel who is seeking to develop what could be a very valuable drug. When Marina volunteers to go to the Amazon to pick up where her colleague left off, she is thrust into a world far from the safety of her laboratory, where the ethical precepts that guide research  have been left behind, and where the roles of researcher and research participant have become blurred.

From the outset, Dr. Swenson’s approach to research is revealed as troubling. No one is aware of the details of her work—not even her exact location—and she is not required to provide regular progress reports. While the secrecy of this elusive researcher is grounded in altruism, her distrust of her funders, her fellow researchers, the research oversight system, and even the subjects of her research threatens to destabilize her work. While Patchett does not provide an in-depth exploration of the research issues IRBs grapple with, she does, through Marina’s story, examine the real-life dilemma of holding tight to our ethical center in the face of the tantalizing prospect of scientific discovery. 

Patchett is a gifted and dazzling storyteller, and this book is a terrific launching pad to engage those in our field in a discussion about the questions of right and wrong, as well to help family and friends more fully understand the purpose and work of the IRB.

I recommend adding State of Wonder to your summer-quickly-becoming-autumn reading list and hope you will let us know here at Ampersand what you think of this and the other books on our Summer Reading List.