Friday, October 31, 2008

Institutional review for student service?

My good friend Peter Luckow recently said one of the smartest things I've ever heard about the ethical implications of students engaging in global health work. He said to consider the fact that any research conducted in affiliation with a university - including social science and biomedical research - must be approved by an institutional review board to ensure ethical work. For example, anthropology research is checked to make sure that interview questions are culturally sensitive and will not in any way harm the research participants. This review process is essential to protecting research participants and insuring that the sciences are ethically sound.

His point however, was that no such attention is given to students who engage in international service, especially global health work. There are numerous student groups on the Northwestern campus which send students on "medical mission trips" where medicine and direct medical care are given. Unfortunately, no one regulates this work. No one evaluates the actual costs or benefits to the communities of the students actions. As I've mentioned before on this blog, there is a large potential to inadvertently cause harm through these short term medical volunteer trips.

I think that one could argue that the potential for harm and the ethical implications are far greater for direct medical care than they are for anthropological or other social science research. Yet, the university provides no way to regulate the actions of Northwestern student groups doing global health work.

Should there be an institutional review process for international (or perhaps even domestic) service projects? Is it the university's responsibility to regulate the service work conducted by student groups?

I'd love to hear what you think.

5 comments:

Evan Blank said...

Wow Jon. What can I say other than you nailed it. This summer in Uganda I came into contact with many other student groups conducting "global health projects". While some were well thought out and clearly beneficial, I found many of them to be ineffective and more disturbingly,unethical. At GlobeMed at Wash U, we have spent a great deal of time talking about the possible negative consequences of our plans and how we as students can make a positive and ethical impact through work with our partner. Infact, I have been so caught up in this idea that I am tentatively planing to write my senior thesis in Anthropology on this exact topic.

With regards to an IRB there are many issues to consider. Would the review board be compulsorily? What type of power would the board have over student groups? Who would comprise the board? Would it be just faculty, just students, or a mix between the two?

At the bare minimum, I believe that every university should have a forum where volunteer groups are able to come together to discuss these challenges. At Wash U the Community Service Office has recently created a Service Trip Coordinating Council where they provide logistical support and advice for both domestic and international trips. However, participation is optional and little time is taken to discuss the ethical implications of service trips. No time is taken to review each trip individually.

Does something like this exist at other Universities? If so, how do they function? In your post, you asked what role does a university have to regulate students trips? I would like to ask everyone else, what role do we as students have to advocate for such regulation?

jshaffer said...

Hey Evan,

Thanks so much for the comment! Admittedly, the IRB idea isn't mine, but Peter Luckow's. But, I thought that I'd post it because I found it so interesting.

I haven't thought much about the specifics of how the IRB should work, but I think that at a minimum, student groups using university funds or resources (basically all recognized student groups) for international volunteer trips should have a mandatory review process mediated by some type of advisory board. There should be a strong emphasis on the ethical implications of student-volunteer actions, but also hopefully the board could provide logistical support as you mentioned.

I like the idea of having the review board be comprised of a mix of students and professors. Its essential that student think hard about these issues.

I think that there is no question that universities have an ethical obligation to ensure that students working under the auspices of the university conduct themselves ethically. Universities take great measures to ensure that research is conducted in an ethical manner. However, they have been slow to react to the BOOMING student demand for international service, especially global health. Its time they got on the bus and began working with students to make the most of this groundswell of student action.

lpolepeddi said...

Hi Jon,

An IRB for volunteerism projects is a good idea, but I think it needs to be dramatically modified to suit volunteerism trips. A review board seems to work for research because they are just fine-tuning a proposal that has already been written. With a volunteerism project, the story can be written only after the trip. So a review board for volunteerism might have to be modified to a training board, where a student is paired with a mentor who teaches by example what (not) to do on such trips. That way when a student is abroad doing their project, they can draw on experience rather than paperwork.

-Lalith

lpolepeddi said...

Jon,

The Public Health and Human Rights blog (http://health-rights-faith.typepad.com/) has a good overview of essential components for a community health worker training program. These rules are helpful guidelines, and perhaps they can adapted so they apply to student trips.

Lalith

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