Research ethics in the Brazilian CEP-CONEP system: necessary reflections.

Brazil counts with a well-known human research ethics evaluation system - the CEP-CONEP System, which has been in operation for 20 years. However, its efficacy and effectiveness have been questioned, criticized and put in check, especially in recent years. This work is based on the author's experiences as faculty member in the field of bioethics, researcher and former coordinator of a CEP and aims to critically reflect on the role of ethics as a driving force of all the steps of the research process, and discuss some deadlocks, gaps, and challenging issues which must be urgently considered and addressed by the CEP-CONEP System. Issues that deserve to be permanently and critically reevaluated are discussed to cope with several challenges, providing a real scientific advance, linked to the social and ethical advance of science, such as the issue of social relevance of the study and its yield/contribution to society; the ethical and political aspects involved in research priorities; the advance of the basic initial appreciation and of the simple normative evaluation; the need for the valorization and recognition of the Ethics Committees' work; the System's discredit due to poor infrastructure, post-study care, among others.