How ethics committees and requirements are structuring health research in the Philippines: a qualitative study

• Published in: BMC medical ethics 2021-07, Vol.22 (1), p.1-85, Article 85
• Main Authors: Lasco, Gideon, Yu, Vincen Gregory, Palileo-Villanueva, Lia
• Format: Article
• Language: English
• Subjects: Analysis; Bioethics; Coronaviruses; COVID-19; Ethical aspects; Ethics; Health research; Hospitals; Institutional review boards; Institutional review boards (Research ethics); International organizations; Interviews; Medical research; Medicine, Experimental; Methods; Pandemics; Philippines; Qualitative research; Research ethics; Research ethics committees; Research inequity; Researchers; Review boards; Services; Social sciences
• ISSN: 1472-6939; 1472-6939
• DOI: 10.1186/s12910-021-00653-z

The last few decades have seen the rising global acknowledgment of the importance of ethics in the conduct of health research. But research ethics committees or institutional review boards (IRBs) have also been criticized for being barriers to research. This article examines the case of the Philippines, where little has been done to interrogate the health research and IRB culture, and whose circumstances can serve as reflection points for other low- and middle-income countries. Semi-structured interviews were conducted from July to October 2020 to elicit health researchers' perspectives and experiences regarding IRBs and the ethics approval process in the country, as well as counterpoint narratives from researchers who have also worked for IRBs. Across the fields of clinical, public health, and social science research, the issue of ethics review revealed itself to be foremost an issue of inequity. IRB processes serve as a barrier for those outside the academe; those belonging to institutions, cities, or entire regions without their own accredited IRBs; and researchers working independently, without ample budget, or on highly specialized topics--more so for non-clinical researchers who must grapple with the primarily biomedical framework of most IRBs. Consequently, the research landscape invariably favors those with the resources to do research, and researches that tend to attract funding. The broader challenge of equity in health research will entail more fundamental reforms, but proximal interventions can be done to make the ethics approval process more equitable, such as enhancing institutional oversight, regulating IRB fees, and enabling a more supportive and welcoming environment for early-career, student, independent, and non-clinical health researchers. This article ends by reflecting on the implications of our findings toward the larger research culture.