An evaluation of the ethical concerns raised by a Liberian Research Ethics Committee using the principles and benchmarks proposed by Emanuel et al. (2008)

Abstract

BACKGROUND The 2014 Ebola outbreak in Liberia attracted researchers from the Global North and organizations to undertake research involving human participants. Research projects, including collaborations between those in the global north and those in the global south, have a longstanding history of exploiting underprivileged and vulnerable populations. This increase in research activities raises a lot of ethical concerns, given the vulnerable nature (poverty, illiteracy, and weak health systems) of the majority of Liberians. There, the critical role of research ethics committees (RECs) in protecting the rights and welfare of research participants became evident. One useful approach to help understand whether RECs are effectively evaluating the ethical risks and benefits of a research protocol and ensuring that the rights of research participants are protected is through the use of the Emanuel et al. framework. The framework developed by Emanuel et al. encompasses a comprehensive set of eight ethical principles and provides a systematic approach for evaluating the ethical aspects of research at various stages, ranging from the initial planning and design through the implementation and dissemination stages. This study aims to identify the ethical concerns raised by a Liberian REC using the benchmarks proposed by the Emanuel et al. framework. METHODOLOGY A qualitative case study design was used to collect the data from the meeting minutes of 17 protocols reviewed by the Liberian REC from 2018 to 2019. The data was examined using content analysis and mapped onto the eight principles of the Emanuel et al. (2008) framework. RESULTS The findings revealed that 94% of the concerns raised by the Liberian REC could be matched to the framework. Of these, the three most frequently raised ethical concerns, ranked in descending order, were related to the principles of scientific validity, fair participant selection, and informed consent. The least raised concerns were related to social value and collaborative partnerships. The study also identified other concerns, such as inconsistency in completing the application forms and the absence of section sub-headings and references. CONCLUSION Overall, the selected REC is focused on ensuring that the rights and welfare of research participants are protected. Based on the findings of this research, there is a need to strengthen the capacity and performance of the REC for conducting ethical reviews of research protocols in Liberia, especially in the context of emerging infectious diseases and global health emergencies. Thus, the Emanuel et al. (2008) framework provides a valuable tool for evaluating the ethical conduct of research in Liberia. It is adaptable and takes into account the country’s unique social and cultural context while at the same time emphasising the importance of informed consent. In addition, collaborative partnerships which are emphasised in the framework, need to be taken heed of, particularly in Liberia, where many people have limited experience in research. It also helps identify potential gaps in the review process and promotes sustainability in capacity building for researchers and REC members to protect the rights and welfare of research participants and infrastructure in the research setting.