Righting Research Wrongs: An Empirical Study of How U.S. Institutions Resolve Grievances Involving Human Subjects

K. Underhill
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Abstract

Tens of millions of people enroll in research studies in the United States every year, making research a multi-billion-dollar industry in the U.S. alone. Research carries risks: although many harms are inevitable, some also arise from errors or mistreatment by researchers, and the history of research ethics is in many ways a history of scandal. Despite regulatory efforts to remedy these abuses, injured subjects nonetheless have little recourse to U.S. courts. In the absence of tort remedies for research-related injuries, the only venue for resolving such disputes is through alternative dispute resolution (ADR)—or more commonly, internal dispute resolution (IDR) through a process offered by the research institution. The federal regulations on human subjects are silent on resolving subject grievances, and to date, little is known about how institutions handle these disputes. This Article is the first empirical study of how U.S. universities and hospitals resolve subjects’ claims of physical injury, dignitary harm, non-compensation, deviations from research protocols, and maltreatment by research staff. I have conducted in-depth interviews with personnel from 30 hospitals and universities to understand how institutions respond to grievances involving research subjects. These interviews reveal highly flexible dispute resolution processes managed by institutional review boards (IRBs), the institutional authorities mandated by federal law to protect human subjects. Although many interviewees spoke intuitively of procedural justice—including elements such as voice, neutrality, and courtesy—these interviews also indicated problems with neutrality, expertise, representation of participants, one-sided appeals, and access to the dispute resolution process itself. This Article takes a close look at current practices, and then suggests strategies for improvement, addressing both the federal regulations and options for institution-led reforms.
纠正研究错误:美国机构如何解决涉及人类受试者的不满的实证研究
在美国,每年有数千万人参加研究,仅在美国,研究就成为数十亿美元的产业。研究有风险:尽管许多伤害是不可避免的,但也有一些是由研究人员的错误或虐待引起的,研究伦理的历史在许多方面是丑闻的历史。尽管监管机构努力纠正这些滥用行为,但受害主体很少诉诸美国法院。在缺乏针对研究相关损害的侵权救济的情况下,解决此类争议的唯一途径是通过替代性争议解决(ADR)——或者更常见的是,通过研究机构提供的程序进行内部争议解决(IDR)。关于人类受试者的联邦法规对解决受试者的不满保持沉默,迄今为止,人们对机构如何处理这些争议知之甚少。本文是关于美国大学和医院如何解决受试者关于身体伤害、尊严伤害、不赔偿、偏离研究方案和研究人员虐待的索赔的第一项实证研究。我对30家医院和大学的工作人员进行了深入访谈,以了解机构如何应对涉及研究对象的不满。这些访谈揭示了由机构审查委员会(irb)管理的高度灵活的争议解决过程,机构审查委员会是联邦法律授权的机构当局,旨在保护人类受试者。尽管许多受访者直观地谈到了程序正义——包括发言权、中立性和礼貌等要素——但这些访谈也表明了中立性、专业知识、参与者的代表性、片面上诉和争议解决过程本身的准入方面的问题。本文将仔细研究当前的做法,然后提出改进策略,解决联邦法规和机构主导改革的选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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