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by rocqua 3220 days ago
> make sure any ethical issues have been externally vetted, so on and so forth.

Sure, but the complaints of the IRB mentioned (and the auditor) seem to be far beyond ensuring practice is ethical. Instead, they seem to focus on following process only for the sake of process.

Why should the consent form have the title of the study? Why should the consent form contain a list of risks when there are none? What is wrong with having consent forms signed with pencil when pens aren't allowed. Why should the data integrity plan require periodic review (i.e. why should we have a data integrity plan - integrity plan). These are all indicative of a bureaucratic system that places too much emphasis on 'process', losing sight of 'outcome' in the end.

2 comments

> These are all indicative of a bureaucratic system that places too much emphasis on 'process', losing sight of 'outcome' in the end.

Reminds me of something that Jeff Bezos (of Amazon.com) wrote in his 2016 Letter to Shareholders:

> Resist Proxies

> As companies get larger and more complex, there’s a tendency to manage to proxies. This comes in many shapes and sizes, and it’s dangerous, subtle, and very Day 2.

> A common example is process as proxy. Good process serves you so you can serve customers. But if you’re not watchful, the process can become the thing. This can happen very easily in large organizations. The process becomes the proxy for the result you want. You stop looking at outcomes and just make sure you’re doing the process right. Gulp. It’s not that rare to hear a junior leader defend a bad outcome with something like, “Well, we followed the process.” A more experienced leader will use it as an opportunity to investigate and improve the process. The process is not the thing. It’s always worth asking, do we own the process or does the process own us? In a Day 2 company, you might find it’s the second.

https://www.amazon.com/p/feature/z6o9g6sysxur57t

Ethics committees are there to protect both the institution and the subjects of the study. One of those protections is avoiding misleading the subjects, unless absolutely necessary and beneficial. How many times have you seen people here on HN bitch about Company X's misleading marketing? It's exactly the same with human studies - people feel used and abused when they find out they were lied to. Similarly, jancsika below points out that the author is working on a patient population with literal paranoid people in it; they're not likely to respond well if they find out a questionnaire was for a different purpose than stated.

Sticking to a common set of rules and only deviating when there's very good reason is one way to help protect subjects. What's the 'outcome' here? A doctor wants to do a study. Why is that more important than the rights of the subjects? Yes, everyone who does a study thinks it's going to cure cancer and solve the national debt. They'll promise the moon in order to get their way. These processes are put in place to protect people against poorly-planned studies. And there's no way to know ahead of time that a study is 'trivial' - if you're working on humans, you need to be vetted. "But we already do this to patients anyway" is besides the point; if you let doctors bypass vetting because of that argument, you'd see all sorts of horrific stuff happening. Ethics committees didn't come about because bureaucracy invented them for the sake of it, they came about because people were being unknowingly tested on by medicos who promised that the study was 'beneficial for the common good'.

And what you find distressing is not what other people find distressing. Search for mncharity's comment elsewhere on this page, where people are distressed simply by being asked about viruses. Yeah, sure, that's not typical, but the counterpoint is: is the research beneficial enough to warrant causing distress to people who would otherwise have been left alone?

In short, this 'needless bureaucracy' is there to protect both the institutions and innocent people from researchers going 'rogue'.

No one is saying the vetting process should be done away with. They are saying it should be reformed to not be so god damn stupid.

There's like 50 wall of text posts in here that don't seem to be understanding that