When Scientific Validity Overshadows Justice: An Analysis of a Liberian Institutional Review Board's Minutes...

Post-Ebola Liberia experienced rapid growth in internationally sponsored health research, increasing demands on institutional review boards (IRBs) amid constrained oversight capacity. This qualitative single-case study analyzed meeting minutes from 2018-2019 from one Liberian IRB, coding 124 documented ethical concerns using Emanuel et al.'s eight-principle framework. Scientific validity accounted for nearly half of concerns, while fair participant selection and informed consent formed a second tier, and collaborative partnership and social value were rarely mentioned. These findings suggest that concerns tied to study design, risk-benefit assessment, and consent are raised more frequently than concerns that explicitly address partnership and social value. We interpret this pattern as a profile of documented deficiencies rather than a hierarchy of the committee's ethical commitments, since minutes capture objections and requests for change. The results highlight opportunities to strengthen attention to collaborative partnership, social value, and equity-oriented capacity-building in IRB procedures, and training in Liberia and aid-dependent settings.