Date Published: July 28, 2009
Publisher: Public Library of Science
Author(s): Doris Schopper, Ross Upshur, Francine Matthys, Jerome Amir Singh, Sunita Sheel Bandewar, Aasim Ahmad, Els van Dongen
Abstract: Doris Schopper and colleagues describe the functioning of the Médecins Sans Frontières independent ethics review board and the framework used for ethics review, and discuss challenging ethical issues encountered by the board since its inception.
Partial Text: Médecins Sans Frontières (MSF) is an international humanitarian aid organisation that provides emergency medical assistance to populations in danger in more than 80 countries. In its work, MSF is often confronted with situations for which effective and feasible interventions are lacking. As a result, over the past few years, MSF has expanded its research activities –. But although MSF often works in close collaboration with scientific institutes and ministries of health that have their own ethical review mechanisms to oversee research, MSF as a humanitarian organisation has concerns that are distinct from those of academic institutions and wants to endorse with confidence any research that takes place under its name –. Furthermore, not all countries in which MSF works have ethics committees, some local ethics committees may not have the resources to function optimally –, and the local or national government is not always a guarantor for the well-being of its population. For these reasons, in 2001 MSF decided to institute its own ethics review board (ERB).
Since its inception, the ERB has faced several important ethical challenges. Some of these challenges have been resolved after extensive discussion at ERB meetings but others remain unresolved.
The ERB instituted by MSF has been in place for seven years, and the need for independent ERB review of MSF research in addition to local ethics approval is now well accepted within the organisation. The MSF ERB often has a different perspective from that of academic institutions. In particular, it is more oriented towards programmatic relevance (feasibility issues) and is sensitive to vulnerable populations and equity issues.