Hostname: page-component-848d4c4894-sjtt6 Total loading time: 0 Render date: 2024-06-16T01:51:22.532Z Has data issue: false hasContentIssue false

Protection of Research Subjects: Do Special Rules Apply in Epidemiology?

Published online by Cambridge University Press:  29 April 2021

Extract

Imagine, if you will, a place where health, hospitalization, education, military, employment, law enforcement, housing, tax and financial records, as well as disease registries and the data sources for the census, vital statistics, and all aspects of people's private activities, are meticulously kept, fully linked together, and easily accessible to qualified researchers. What is that place? Epidemiologists’ heaven.

Of course, formidable problems face epidemiologists trying to reach heaven. The data sources on many aspects of our lives are incomplete and the means of linking them are typically nonexistent or partial at best. But even if the data all existed, there would be a further “catch”: epidemiologists would probably find themselves facing great obstacles in gaining access to the data.

Epidemiologists sometimes think of “ethics” as the source of those obstacles, which are believed to be embodied in the federal rules for the protection of research subjects—colloquially called 45 CFR Part 46—especially as they are interpreted by some institutional review boards (IRBs).

Type
Article
Copyright
Copyright © American Society of Law, Medicine and Ethics 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Reprinted by permission of the author and Journal of Clinical Epidemiology, Vol. 44, 1991, Pergamon Press PLC.

References

Rothman, K.J., “The Rise and Fall of Epidemiology, 1950–2000 A.D”. N Engl J Med 1981; 304: 600–02.CrossRefGoogle Scholar
Cann, C.I. Rothman, K.J., “IRBs and Epidemiologic Research: How Inappropriate Restrictions Hamper Studies”. IRB: A Journal of Human Subjects Research 1984; 6(4):57; Hershey, N., “IRB Jurisdiction and Limits in IRB Actions”. IRB: A Journal of Human Subjects Research 1985; 7(2): 7-9; Cann, C.I. Rothman, K.J., “Reply: Overcoming Hurdles to Epidemiologic Research”. IRB: A Journal of Human Subjects Research 1985; 7(2); 9.CrossRefGoogle Scholar
Jonas, H., “Philosophical Reflections on Experimenting with Human Subjects”. Daedalus 1969; 98: 219–45.Google Scholar
I. de Sola Pool, “The New Censorship of Social Research”. Public Interest 1980; 59: 5688; Patullo, E.L., “Who Risks What in Social Research”. IRB: A Journal of Human Subjects Research 1980; 2(3): 1-3, 12; Robertson, J., “The Scientist's Right to Research: A Constitutional Analysis”. So Cal L Rev 1979; 51: 1203–81.Google Scholar
Gibbs, R.A. Caskey, C.T., “The Application of Recombinant DNA Technology for Genetic Probing in Epidemiology”. Ann Rev Pub Health 1989; 10: 2748.CrossRefGoogle Scholar
MacIntyre, A., “Risk, Harm, and Benefit Assessments as Instruments of Moral Evaluation”. In: Beauchamp, et al, Eds. Ethical Issues in Social Science Research. Baltimore, MD: Johns Hopkins University Press; 1982: P. 175.Google Scholar
Id. at 177.Google Scholar
Dworkin, G., “Must Subjects be Objects?” In Beauchamp, et al., Eds. Ethical Issues in Social Science Research. Baltimore, MD: Johns Hopkins University Press; 1982: Pp. 246, 247-48.Google Scholar
Capron, A.M., “Is Consent Always Necessary in Social Science Research?” In: Beauchamp, et al., Eds. Ethical Issues in Social Science Research. Baltimore, MD: Johns Hopkins University Press; 1982: Pp. 215, 220229.Google Scholar
Berlin, I., Two Concepts of Liberty. Oxford: Clarendon Press; 1958: p. 16.Google Scholar
Faden, R.R. Beauchamp, T.L., A History and Theory of Informed Consent. New York: Oxford University Press; 1986.Google Scholar
Katz, J., The Silent World of Doctor and Patient. New Haven: Yale University Press; 1983; President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research. Making Health Care Decisions. Washington, D.C.: Government Printing Office; 1982.Google Scholar
Freund, P., “Legal Frameworks for Human Experimentation”. Daedalus 1969; 98: 323.Google Scholar
Capron, , supra note 9.Google Scholar
Fried, C., “Privacy.” Yale L J 1968; 77: 482.Google Scholar
Baumrind, D., “Nature and Definition of Informed Consent in Research Involving Deception.” In: National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research DHEW Publication no. (OS) 78–0014. Washington, D.C.: Government Printing Office; 1978: Appendix, vol. 2, pp. 2342.Google Scholar
I am indebted to West, Kathleen M., MPH, for this point.Google Scholar
Farnsworth v. Procter & Gamble, Co., 758 F.2d 1545 (11th Cir. 1985); Curran, W.J., “Protecting Confidentiality in Epidemiologic Investigations by the Centers for Disease Control”. N Eng J Med 1986; 314: 1027–28.CrossRefGoogle Scholar
Hughes, E.C., “Who Studies Whom? Human Organization 1974; 33: 327-334 (threats inhere in studying people in institutions); Geller, J.L. Lidz, C.W., “When the Subjects are Hospital Staff, Is It Ethical (or Possible) to Get Informed Consent?”: IRB: A Journal of Human Subjects Research 1987; 9(5): 45 (problems with obtaining informed consent from employees); Pattullo, E.L., “Exemption from Review, Not Informed Consent”. IRB: A Journal of Human Subjects Research 1987; 9(5) 6-8 (consent to observe employees’ work can be given by employer).Google Scholar
Capron, A.M., “The Law of Genetic Therapy”. In: Hamilton, M., Ed. The New Genetics and the Future of Man. Grand Rapids, MI: Eerdmans Publishing Co.; 1972: Pp. 133, 150152.Google Scholar
Tancredi, L., “The New Technology of Psychiatry: Ethics, Epidemiology, and Technology Assessment”. In Tancredi, L., Ed. Ethical Issues in Epidemiologic Research. New Brunswick, NJ: Rutgers University Press; 1986: Pp. 1, 16.Google Scholar