IRB 101: Looking to the future and the past

By: Andy Burman, PRIM&R Blog Squad member

PRIM&R is pleased to bring you blog posts from the PRIM&R Blog Squad during the 2010 Advancing Ethical Research Conference. The PRIM&R Blog Squad will be blogging every day from the conference, so continue to check back for updates.Today I had the pleasure of attending the pre-conference program Institutional Review Board (IRB) 101sm – Biomedical Research. The course explored a number of topics, including several case studies that produced compelling, thought–provoking, and interesting conversation. However, the discussion of the history of research, while interesting, brought up some disconcerting questions.“Only a fool learns from his own mistakes. The wise man learns from the mistakes of others.”
– Otto von Bismarck, First Chancellor of the German Empire
It is uncomfortable, and even disgusting, to see images of “research subjects” from the unfortunate events that occurred in Nazi Germany, Guatemala, and Tuskegee. It is tempting, as proponents of research, to hold our hand out and push away that history. After all, many of these events occurred over half a century ago. It is easy to think that such a thing “wouldn’t happen at my institution…” or “in my city…” or “…to me as a research subject.”Unfortunately, those beliefs of “it can’t happen to me” or “I wouldn’t make an unethical decision” have proven false on too many occasions. As Marcia Angell, MD, former editor-in-chief, New England Journal of Medicine said, “ethical lapses are almost never cases of bad people, bad things, for no good reason. More often they are good people, doing good things, for bad reasons.” Such a statement indicates that, in our pursuit of ethical research we are not bad folks, but from time to time we exhibit bad judgment in our pursuit of great things. For each of us, as promoters of the day-to-day execution of ethical, the keys to the question of ‘What is ethical?’ are all too often not found in government rules and regulations. Rather, the keys to what is right and ethical will more frequently lie in the past.It is difficult enough to face our past, but even that will not be enough. The only way to prevent the mistakes of the future is to examine others’ mistakes and change our behaviors.. The study of the history of research, including the dryness, possible uncomfortable results, and lack of general pleasure that accompanies its study, is not something that any research professional can afford to avoid. If we do, we are destined to be the next case in the presentation, a subsequent case of ethicism gone awry.Learn from the mistakes of others. Don’t let the past be your future.