Froud R, Meza T J, Ernes K O, Slowther A M
Department of Health Sciences, Kristiania University College, Oslo, Norway.
Warwick Medical School, University of Warwick, Coventry, UK.
BMC Health Serv Res. 2019 Jan 10;19(1):24. doi: 10.1186/s12913-018-3816-0.
While the development and evaluation of clinical ethics services in Norway has been recognized internationally, the country's research ethics infrastructure at times may have been less well developed. In 2016, media interest in the controversial nature of some health services research and pilot studies highlighted gaps in the system with certain types of research having no clear mechanisms through which they may be given due independent consideration. It is not clear that new legislation, implemented in 2017, will address this problem. We explore relevant law, committee scope, and the function of the system. We show that 1) Norwegian law provides for ethics assessment for all forms of health research; 2) regional RECs in Norway might not have always enforced this provision, considering some interventional health services research to be outside their remit; and 3) Norwegian law does not explicity provide for local/university RECs, meaning that, in practice, there may be no readily accessible mechanisms for the assessment of research that is excluded by regional RECs. This may include health services research, pilot studies, and undergraduate research. New 2017 legislation has no effect on this specifically but focuses on institutions regulating researcher activity. This may place researchers in the difficult situation of on one hand, needing to hold to recognized ethical standards, while on the other, not readily having access to independent committee scrutiny to facilitate consistent operation with these standards.
To support researchers in Norway and to protect the public, it may be necessary either to widen the regional RECs' remit or to make legislative alterations that permit and do not discourage the existence of local RECs.
尽管挪威临床伦理服务的发展和评估在国际上得到认可,但其国家研究伦理基础设施有时可能发展得不够完善。2016年,媒体对一些卫生服务研究和试点研究的争议性质的关注凸显了该系统的漏洞,某些类型的研究没有明确的机制来给予其应有的独立审议。尚不清楚2017年实施的新立法能否解决这一问题。我们探讨了相关法律、委员会范围和该系统的功能。我们发现:1)挪威法律规定对所有形式的卫生研究进行伦理评估;2)挪威的地区伦理审查委员会可能并非一直执行这一规定,认为一些介入性卫生服务研究不在其职权范围内;3)挪威法律没有明确规定地方/大学伦理审查委员会,这意味着在实践中,对于被地区伦理审查委员会排除的研究,可能没有现成的评估机制。这可能包括卫生服务研究、试点研究和本科研究。2017年的新立法对此没有具体影响,但侧重于规范研究人员活动的机构。这可能使研究人员陷入两难境地,一方面需要遵守公认的伦理标准,另一方面又难以获得独立委员会的审查以促进与这些标准的一致操作。
为了支持挪威的研究人员并保护公众,可能有必要扩大地区伦理审查委员会的职权范围,或者进行立法修改,允许并鼓励地方伦理审查委员会的存在。