Research ethics committees: what is their contribution?

22 Waldenstrom U, Silsson C. A randomized controlled study of birth center care versus standard maternity care: effects on women's health. Perhaps a week of intensive training in critical thinking would be the best preparation for members of research ethics committees n a recent lecture at Monash University, the philosopher Raimond Gaita, Professor of Moral Philosophy at King' s College , University of London, and Professor of Philosophy at the Australian Catholic University, told the story of a woman facing a significant turning point in her life. It was a Friday, and a decision was needed by Monday, but she had unavoidable obligations over the weekend. She had a dear friend, a psychoanalyst and philosopher who had known her all her life. He knew her circumstances, her preferences and even her secret wishes. She contacted him and prevailed upon him to make the decision for her. In our private lives most of us would find it at least odd, and probably uncomfortable, to hand over responsibility for significant decisions to others. Yet, the prevailing paradigm for human research ethics committees has institutionalised this approach. Researchers themselves often do not consider the ethical implications of their work until it is time to fill out the various forms required by committees. Even then, the main concern is " getting through ethics " with minimal scarring of their proposal. The Nuremberg Code, 1 the Helsinki Declaration, 2 and even the National Health and Medical Research Council's National statement on ethical conduct in research involving humans (the Statement), 3 are not documents with which many researchers can claim significant familiarity. The reasons for their existence are faintly recalled, and current debates are only of interest if they impede research with which the researcher has a personal concern. Once an ethics committee has made its decision, there is no need to consider " ethics " again unless there is a significant adverse event. Although they undoubtedly provide a " safety net " to detect and prevent grossly unethical research, ethics committees must not and cannot be seen as the repositories for moral decision-making. Consider an imaginary (but highly plausible) ethics committee. It meets the Statement' s requirements for membership. Some members have attended the occasional seminar sponsored by the Australian Health Ethics Committee (AHEC), and some diligently read the AHEC Bulletin sent to registered committees. Some, though not all, of the members have actually read …