Human Participants

Learning Objectives

 

Review three basic principles for treatment of human participants.

Describe the jurisdiction, mission, composition, and functions of an IRB.

Given descriptions of projects involving use of human participants in research, the learner will indicate: a) when and b) why consent for participation is required.

If oversight is required, the learner will indicate: a) when and b) how institutional oversight is applied.

Develop consent forms that meet the basic criteria for IRB approval.

 

Relevant University of Memphis Policies and Procedures

 

University of Memphis IRB (http://irb.memphis.edu)

University of Memphis Guidelines for Use of Human Subjects (http://irb.memphis.edu/process.html)

Code of Conduct (http://www.memphis.edu/facultyhandbook/2007FHB_Chapter5.htm#Academic%20Misconduct)

Academic Misconduct (http://www.memphis.edu/facultyhandbook/2007FHB_Chapter5.htm#Academic%20Misconduct)

 

Relevant Federal Guidelines and Procedures

 

Office for Human Research Protections (http://ohrp.osophs.dhhs.gov)

Human Subject Regulation Decision Charts (http://ohrp.osophs.dhhs.gov/humansubjects/guidance/decisioncharts.htm)

Office of Research Integrity (ORI) (http://ori.dhhs.gov/)

 

Brief History of the Problem

 

Previous abuses of human participants, such as Nazi research on concentration camp inmates and arbitrary use of medical patients in research hospitals, has dramatized the need for a structure to protect human participants from abuse and to protect their rights to self-determination, safety, and dignity. Building on the Nuremberg Code (http://ohsr.od.nih.gov/nuremberg.php3) which was established in response to Nazi atrocities, research institutions and funding agencies have developed an ethical framework to protect human participants.

 

Principles of Protection of Human Participants

 

In 1978, the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research issued the Belmont Report (http://ohrp.osophs.dhhs.gov/humansubjects/guidance/belmont.htm) which identified three basic principles for the treatment of human participants: respect for persons, beneficence, and justice.  These principles led to procedures to mandate informed consent of participants, reasonable ratios of benefits to risks, and equitable selection and treatment procedures.  Particularly vulnerable populations, such as children or the mentally retarded, must receive special attention.

 

What is the Institutional Review Board (IRB)?

 

The Institutional Review Board (IRB)

Jurisdiction

 

Federal law requires institutions that accept federal funds for research with human participants formalize means for protecting them.  The administrative unit is the IRB.  The mission of an IRB extends to all research using human participants as subjects.  Although some activities, such as educational testing for research purposes, may be legally exempted from its review, the IRB is responsible for all research with human participants.  IRB’s are empowered to review and approve, reject, postpone, or modify all proposals for research with human participants. No such research may proceed without IRB approval.

 

All research projects with human participants conducted by faculty, staff, or students associated with The University of Memphis must receive approval of the project before the research is begun.  If you are collecting non-public information from other people, you are conducting research with human participants, and this includes the collection of qualitative data such as interviews and stories.  It also includes observation of public behavior and phone or mail surveys.  Use of people’s records, blood or tissues samples is research even if those records were not originally collected for research purposes.   Do not assume that your activity is exempt from review.  Always assume that you need IRB approval and check with the Office of Research Support Services before proceeding. 

 

You must comply with UM’s Multiple Project Assurance (MPA) if you have responsibility for the design and conduct of a research study, even if the principal investigator is at another university.  A project approved at another university IRB will still need UM IRB review and approval. 

 

One operational definition of whether or not you have responsibility for the design and conduct of a research study is whether or not you would expect to be a co-author of publications stemming from the research.  If the answer to that question is yes, the research project must receive approval from the UM IRB.  In addition, research with human participants that is sponsored by UM, uses any property or facility of UM, or uses UM non-public information to contact or identify prospective participants must also receive IRB approval. 

 

Instructors using human participants for class projects must get UM IRB approval for all projects on a blanket basis for each class. 

 

Mission

 

The mission of the IRB is to protect the rights and welfare of human research participants.  The University of Memphis IRB statement of mission is found at this site http://academics.memphis.edu/irb/policy.php.

 

Composition

 

An IRB must consist of at least five properly qualified members, of whom at least one must be a scientist, at least one must be a nonscientist, and at least one must be unaffiliated with the institution, including not having an immediate family member affiliated with it.  The current University of Memphis IRB membership is listed at this site http://academics.memphis.edu/irb/members.php

 

Accountability and Enforcement

 

            Who reports to whom?

The Office for Human Research Protections (OHRP) of the Department of Health and Human Services approves the composition of IRB’s and monitors their activities.  Within their institutions, IRB’s report to the Institutional Official, who reports to OHRP.  All principal investigators who use human participants report to the IRB.

 

            Federal Oversight

All oversight agencies perform at least occasional on-site inspections and/or audits.  The FDA conducts these on a regular schedule, whereas other agencies tend to conduct them sporadically.  For federal agencies governed by OHRP, institutions commit themselves to OHRP oversight, via either a single project assurance (SPA) or multiple project assurance (MPA).  These assurances are agreements to oversee and perform research on human participants according to federal requirements specified in the Common Rule and all relevant subparts of Title 45, Part 46, of the Code of Federal Regulations, Protection of Human Subjects (45 CFR 46 for the Department of Health and Human Services) and/or other applicable regulations as listed in the Federal Register ( /humansubjects/guidance/ documents).  These assurances are the institution's responsibility, with OHRP acting periodically to audit institutions (usually for cause) to assure compliance.  See http://academics.memphis.edu/irb/assurance.doc for the University of Memphis assurance compliance.

 

            Sanctions

Agencies may respond to noncompliance by suspending or terminating support of projects and refusing future funding to noncompliant investigators or institutions.

Examples: Suspension of NIH-supported research at Duke University and at Johns Hopkins University.

 

Procedures of the IRB

 

Responsibilities of Principal Investigators

 

Principal investigators must possess skills adequate to their proposed research, design research that meets quality assurance standards and whose benefit to participants or society justifies the risks to participants, submit fully detailed research plans, ensure that no human participant be enlisted without prior informed consent, take all necessary safeguards to minimize risks and to protect the interests of vulnerable populations, assure the adequate training of their personnel, adhere to high ethical standards, and comply with all institutional and governmental regulations.  See this site for information about the University of Memphis IRB http://academics.memphis.edu/irb/process.php.

 

Risk/Benefit Analysis

 

The IRB is charged with estimating the risks of harm to participants from participation in research in comparison with the risks of everyday normal life or of standard alternative treatments of disorders and the likely benefits to participants or to society, excluding remuneration and subjective benefits.  It will refuse to approve research designs that fail to minimize risks or in which the risks outweigh the likely benefits.

 

Initial Review

 

There are three levels of review.  (1) All experimental investigations or others deemed to pose nontrivial risk are subjected to full review at a meeting of the IRB.  (2) Some investigations that entail minimal risks, such as anonymous surveys or surveys involving innocuous material, may be considered exempt from federal regulations for the protection of human subjects.  Nevertheless, these require the submission of a request for the research to be classified as exempt (Request for Exemption Form) . Classification as exempt is made by the chair of the IRB.  (3) Some investigations using certain closely defined categories of research operation may be reviewed through an expedited process in which review and approval is based on an evaluation by a subset of IRB members.  Forms to request review are available at this location http://academics.memphis.edu/irb/newforms.php.

 

Continuing Review

 

Approved research projects remain under IRB oversight until completion.  Principal investigators file an application for continuing review at least every 12 months or more often if required by the IRB.  In addition, principal investigators are required to file special reports of unforeseen mishaps involving human participants as they occur..  Information and procedures for reporting adverse events is located at http://academics.memphis.edu/irb/adverse.php.

 

Informed Consent: Form and Process

 

All human participants in research (or their parent/guardian) are required to indicate their consent by signing a consent form indicating their understanding of the purpose of the research, of the proposed procedures, risks, and benefits, and of their rights in the situation, and registering their consent.  Consent must be informed, in that participants must be given full disclosure of the nature of their participation (except in rare instances in which deception is scientifically necessary and justifiable) and must indicate comprehension of the information.  Consent given by participants may be withdrawn at any time without adverse effects on their relationship to the research institution.

 

Participant Control over Data

 

Participants retain the right to withhold or withdraw the data they contribute.

 

Recruitment Issues

 

Participation must be purely voluntary. There must be no elements of coercion in securing participants involvement.

Incentives for participation must avoid undue inducement that may serve as a subtle form of coercion or at least undue influence.

Participant selection criteria must avoid discriminating against classes of humans on the basis of sex, age, ethnicity, or other major characteristics, except as required for scientific reasons.

If incentives are extended to some members of a group, these must not disadvantage other, non-selected members. 

Deception must be justified by scientific necessity and benefit.  Deceived participants must subsequently be debriefed.  Deception is assumed to be rarely necessary.

 

Privacy and Confidentiality

 

All research investigations must protect the privacy of their participants.  Data regarding individuals must be stored in a form that prevents the individuals’ identification.  Participants’ contributions to the research must be kept confidential except for aggregate reporting or description that removes or alters identifying information to make it unrecognizable by the participant and by individuals acquainted with the participant.

 

Risk Minimization

 

Research procedures must minimize risks to participants consistent with adequately justifiable scientific necessity.  All risks must be fully and comprehensibly disclosed to participants and receive their consent.

 

Monitoring and Observation

 

From the beginning of research operations, principal investigators are responsible for monitoring operations through periodic analysis of data to assure that the investigation continues to promote the goals of the research.  Principal investigators must also monitor through observations designed to assure the continuing integrity of research operations, especially as these may impact research participants.

 

Reporting Requirements

 

Deviations from approved protocols and unforeseen mishaps involving human participants must be reported by principal investigators to their IRB’s and by IRB’s (or, in the case of the FDA, by principal investigators) to their institutional officials and on to the respective funding agencies.

 

Record-keeping

 

The IRB is required to keep detailed records of its deliberations and of all research proposals that come before it and of their disposition.

 

Supervision and Training of Personnel

 

Principal investigators are responsible for assuring that their research personnel are adequately trained for the research operations they perform and for the ethical conduct of research.  They are also responsible for continuing supervision of the research operations under their purview.

 

References for Further Reading

 

Arboleda-Florez, J. & Weisstub, D. N. (1997). Ethical research with the mentally ordered. Canadian Journal of Psychiatry, 42, 485-491.

 

Batchelor, J. A., & Briggs, C. M. (1994). Subject, Project or Self? Thoughts on Ethical Dilemmas for Social and Medical Researchers. Social Science and Medicine, 39, 949-954.

 

Committee on Science, Engineering, and Public Policy (1995). On being a scientist: Responsible conduct in research. Washington, D.C.: National Academy Press.

 

Mirvis, P. H., & Seashore, S. E. (1979). Being ethical in organizational research. American Psychologist, 34, 766-780.

 

Office for Protection from Research Risks, National Institutes of Health (1993). Protecting human research subjects: Institutional Review Board Guidebook. Washington, DC: United States Government Printing Office.

 

Ortmann, A., & Hertwig, R. (1997). Is deception acceptable? American Psychologist, 52,

746-747.

 

Sieber, J. E. (1992). Planning ethically responsible research: A guide for students and internal review boards. Newbury Park, CA: Sage.

 

Sigmon, S. T. (1995). Ethical practices and beliefs of psychopathology researchers. Ethics & Behavior, 5, 295-309.

 

Swazey, J. P., Anderson, M. S., & Lewis, K. S. (1993). Ethical problems in academic research. American Scientist, 81, 542-553.

 

Taube, D. O., & Burkhardt, S. (1997). Ethical and legal risks associated with archival research. Ethics & Behavior, 7, 59-67.

 

 

 

 

 

 


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