This week I spent an afternoon in the company of a lively and engaged group of pre-registration mental health nursing students, talking about processes for the ethics review of human participant research studies conducted both in, and out, of the NHS. We discussed the purpose of ethics review and the organisation of research ethics committees (RECs) across the UK, before I invited the group to become a REC and to consider an application placed before it.
As it happens, over the last ten or so days I’ve also been helping prepare a new application for NHS REC and R&D approval, and in my capacity as chair of the Cardiff School of Nursing and Midwifery Studies REC I’ve been steering another proposal through our committee. So all in all I’ve been having something of a personal research ethics-fest.
One of the first papers from my PhD was a piece, written with Davina Allen, rehearsing our experiences of seeking REC and research governance approval for two studies sharing the same design. There’s a version of the full paper available here, via the Cardiff University research repository.
In this article we started by writing about the rise of institutionalised ethics and governance review processes in the UK and globally. We then shared our experiences of ethics committee inconsistency, and of the limited understanding RECs sometimes have of qualitative research.
I now realise that some of the things which happened to my proposal are not as unusual as I thought at the time this paper was written. Not uncommonly projects will be described as ‘research’ in one context (for example, for funding purposes or for progression towards academic awards) but not in others (for example, in the context of NHS research governance and ethics review where they might be classified as ‘service evaluation’ or similar). I also realise, then as now, that ‘[e]thical decision-making is a complex process, and one that is not amenable to the application of formulaic guidelines’. This is a direct quote from our 2003 paper, and it reminds me that we should not expect absolute consistency in decision-making across different committees. But there is something to be said for committees paying attention to precedent. It is also important that RECs are clear in setting out their reasons why studies need to be amended (or indeed, refused). My recent experiences of applying for NHS REC approval have been positive, in that committee members have been open to in-the-round discussions of the issues raised. I’d like to think that researchers who have submitted their proposals to the university REC I chair have felt similarly well-treated.