Who's Winning the IRB Wars? The Struggle for the Soul of Human Research

The origins and aspirations of institutional review boards (IRBs), the American oversight system for research with human subjects, are well known, and their failures have been documented and disputed for decades. Contention about IRBs is often ideological and unsatisfying, but their shortcomings are real. A new wave of attention to the promise and problems of this oversight system has coincided with the years-long effort to update the federal "Common Rule." Three very different recent books-Rebecca Dresser's Silent Partners, Robert Klitzman's Ethics Police, and Carl Schneider's The Censor's Hand-draw from a wealth of experiential, empirical, and rhetorical resources to triangulate this long-standing set of concerns and tensions at individual, institutional, and system levels. Schneider's volume exemplifies anti-government critiques of the regulation of science; Klitzman's catalogues IRB members' reflections on the ambiguities inherent in their regulatory role; and, by far the most interestingly, Dresser examines the potential contributions of experienced research subjects to the oversight process. Taken together, these books can help refocus the IRB wars on the ever-challenging relationships among goals, uncertainties, and practicalities, and move us toward understanding and addressing those relationships in their current (and rapidly changing) scientific and societal context. Some real progress might even result.