You may recognize the elephant story as a variant of an old joke and chuckle (or groan). It may seem like something Baghdad Bob, the Iraqi Information Minister, might have produced. You may even have used something like this in a research methods course. But you may also recognize it as a having some resemblance to the research ethics dilemma, and squirm a little. I hope, I tried to drop a few hints!
Many of the essential ingredients are there in the Research Ethics Bureaucracy (REB), such as:
II. POLICY TRUMPS SUBSTANCE - Research Ethics Bureaucracy (REB)
It is the last that I would call attention to this morning (with an able assist from the penultimate), as it seems to present potential constraints on intellectual inquiry that are "irrational" and thus nearly immune to challenge and change. This is less a criticism of local REBs and their efforts, but more a reluctant acceptance of what humanity has created: behold, The Bureaucracy! Once in place, a bureaucracy seems almost sentient in its quest to not only survive but grow, and it becomes virtually impregnable to external input. You will be assimilated -- as far as I can tell, the main difference between the Borg on Star Trek and Bureaucracy is that "Borg" is easier to spell.
I think one of my personal landmark intellectual transitions came when I realized (at a more advanced age than I like to admit): "bureaucrats do not get fired for following the rules, they get fired for doing something novel, outside the rules" -- that's the sense in which I mean "irrational," mindless. I realized that bureaucracies are a creation optimally designed for control, group think, and inertia. How did mere mortals ever devise such a construct, it truly warrants "shock and awe!"
Consider Revenue Canada. Whether the tax rule makes sense or not, they don't care and you better comply! The result is that anyone within reach of the tentacles eventually adopts the least-effort strategy of "just following orders/rules," anything else takes too much time away from one's primary interests. So, although we might grumble about federal waste and why we can't have a deduction someone else gets, we dutifully crunch the numbers and write the check on April 30th. We design our life and business to comply with rules that we barely understand, and which often lack any apparent rationale. Further, even rules that seem clearly defined are redefined as the agency requires (viz. "just a temporary war tax," and eliminating tax-exempt faculty trust accounts for research).
Neither rational argument nor ridicule have the least impact, certainly not in an individual confrontation. The only hope, and it is not a sure thing, is Kors and Silverglade's keep the sunlight shining on it. We may in principle feel citizens should pay (some) taxes, that's the hook, but we resent the unresponsive high-handedness, we grumble, then we capitulate and get on with life. To illustrate, my son filed his first return this year -- he had a lot of "why" questions, and I realized how mindless I had become. Asking "why" is not a childish question, and "because that's the rule" is not an acceptable answer (I think that too was established at Nuremberg, eh?).
There is a similar atmosphere to the "research ethics industry" as manifest in the Research Ethics Bureaucracy (REB). Rules (policies) have been established, and adherence to these rules has become more important than the substance or principles behind the rules, much less the research. Thus we have an "agenda of control" rather than an "agenda of inquiry."
The hook with research ethics was the notion of "extraordinary risk." Safety, who could oppose it? Of course, we never did have an initial casualty count, or even a count of collateral damage, and thus we will never be able to document improvement, but, not wanting to appear uncooperative, we opened the door to control, just a crack. I confess, I too have served time as a departmental ethics chairman, and reviewer. I am proud to say that no one died on my watch. But full disclosure requires me to note that no one had died previously, nor since.
Sadly the concept of "everyday risk," while still official policy, in fact has given way in practice to the utopian pursuit of zero risk. On the face of it this is preposterous, but a "zero tolerance disorder" (ZTD) permeates life today well beyond the REB. Remedial probability theory should be a prerequisite for membership as an ethics reviewer. But even that might not be sufficient: those entities in our research are no longer "subjects," not even "participants," but victims.
Example 1. As a topical case in point, WHO Director, Ms. Gro Harlem Brundtland, creator of the SARS fiasco in Toronto, met earlier this week with a "why us" pro-Toronto group. She was asked about what would constitute having SARS "under control." At first she professed not to have a definition (whoops!!), then she ventured this observation: "For the ONE person that happens to get SARS -- the outbreak is not under control" (Terence Corcoran, National Post financial editorial, April 30, 2003, FP 17). No, I am not kidding, ZERO cases is "under control." Golly, even Doctor Kildare lost a patient here and there.
What better way to perpetuate and extend control than to proclaim an impossible goal and/or an undefined goal? Now that's job security that makes tenure look anemic! Is zero-tolerance an intellectual fault, or some emotional disorder, and how do these people get taken seriously, over and over? Yes, this is a variant of the REB practice of ignoring "everyday risk" and seeking "zero risk." Apparently, from the inside of the bubble, zero tolerance does not seem insane. Neither a pie in the face nor a Singapore caning is likely to penetrate that bubble, much less "rational" debate.
In their spare time, these believers have been fine-tuning the history books of late, so that, for example, the Vikings are portrayed as invading England to sell life insurance and encyclopedias (you remember those, that's where we looked things up before Google). In truth, everyday risk meant something in Viking days! If you can continually rewrite history it doesn't matter that you didn't establish a baseline originally. I am not saying I am opposed to rules, not at all, but would you play poker or bridge with someone who could change the rules as they please? (If so, bring your life savings to lunch and we'll have a few rounds of blackjack, I'll explain the rules as we play.)
As an example of how a bureaucracy gets to make the rules on the fly, just like tax rulings, consider how the REB moved beyond safety (risk), to embrace "ethics" as its goal. At that point the hope of ever assessing the effectiveness of the review process just dropped into a black hole. The one thing left was to be sure we followed "the rules," if they would just stand still.
Example 2. There is an ethics listserv that I lurk on, that is, I listen/read and don't speak. It is peopled mostly by the REB officers at various institutions, the "pros." The details and nuances of rules that preoccupy these folks is something to behold, as is the scope of coverage that they perceive themselves as having. It's frightening to listen as they trade tips on how to increase control, and it's informative just how obsessed with rules they are. It has been an opportunity to relearn the lesson: "bureaucrats do not get fired for following the rules, they get fired for doing something novel, outside the rules" (how many times must I relearn that?). Some people have no life beyond rules, and not all of them become tax accountants.
A few weeks ago, a discussion thread emerged around "what is research," because "research" has to go to an ethics review. They posed the hypothetical (ahem) example of a solitary practicing physician (ahem) who has a patient with an untreatable condition and the doctor prescribes an unapproved treatment. Is this research, does it require REB sanction? The opinions flew back and forth, and the consensus was clear: (more or less) as long as it was an individual case and not submitted for publication, the rules said it was OK, didn't need REB processing.
I'm staring at my monitor reading these e-mails, wondering at the moral/ethical disconnect that I saw. It wasn't "is the doctor's behavior ethical," it wasn't "is the person at (unusual) risk," it was whether the rules and policies covered it. I repressed the impulse to point out that Dr. Frankenstein was a practicing physician administering an unapproved treatment to a single patient, history having shown me that audience has no sense of humor.
Example 3. This week a thread started on this ethics discussion group in regard to what to do should SARS spread sufficiently to lead to the inability to convene a "quorum for REBs during a plague." And how long can REB meetings be held with quarantined members in teleconference, for example, without violating the face-to-face rule? Talk about priorities -- again, rules trump. The irony is that maybe one thing to rival the spread of a bureaucracy is a hearty virus -- will SARS wipe out the REB? Perhaps this quandary should be turned over to WHO and Ms. Brundtland, and she can assure us that the REB will not be considered solved as long as one board remains? Maybe it's impending-Alzheimers, but I do sometimes feel like the transporter has malfunctioned and I have been thrust into the middle of a Monty Python sketch. (My favorite real-life example of how "policy trumps all" involves topaz and a nuclear reactor, I can tell you about it another time.)
There are more of these eye-openers, these ethical blindspots, but one more will suffice. It speaks volumes to the tragic preoccupation with policy.
Example 4. I would be remiss not to relate the sad case of a colleague who was called from his father's hospital bedside by the ethics officer at his university (USA). The "emergency" was that he needed to sign again the original of his grant application, in blue ink so they could tell which was the original, that was the rule. When he returned to the hospital his father had died, because someone had failed to follow proper procedure. (The federal response: That's a local problem. The local response: The feds make us do it.)
The REB is not about safety, not about ethics, just policy and rules. One wonders how far this obsession with rules can go. National accreditation is on the horizon, for no good reason other than it can be done. And I do not think it a joke that "soon" we will be required to submit research results back to the REB for re-approval before publishing. All they have to do is make the rules, and the rules are made by them for their convenience. And as the rules become more complex no one really understands them, like the tax law. People can interpret them freely for assorted purposes -- there is no umpire or referee.
III. TRADING CONTROL FOR DOLLARS
That policy discussion forum deserves to exist (I suppose), but the disturbing thing is that there is no forum for dealing with the "why"questions, no respect for the perspective of the scholar. "Consultations" by the rule-makers will be with your VP-Research, who, of course, is just like us. Once in discussing delays in processing, mine noted that he had had one approved in a day recently, so there you go, just one of us, eh?
This imbalance has happened gradually, possibly even without intent, as control over the review process has become increasingly externalized, specifically as research on campus is driven by the pursuit of grant dollars. In a "discussion" with a local ethics czar, in response to why we should do these things that did not seem necessary or effective, her reply was "Because I don't want to lose my grant." And therefore the rest of us will all have to do it too, whether we have grants or not.
Pocklington and Tupper (in "No place to learn") bemoaned the way research has overshadowed teaching on campus, as others have also noted (e.g., UniversitySecrets.Com). However, the truth is that increasingly the only research that counts is funded research. At some places, your proposal may not even get off campus if some local administrator in the VP-Research office thinks it isn't in the areas being funded, no matter what the ethics review says, much less its intellectual merit.
It's the Piper Principle. Not Martha Piper, the President at UBC, but "He who pays the piper calls the tune." Grants have become the academic's Lotto 6/49, and there may be a sense in which the designation of a "tax on the stupid" is also applicable to the pursuit of grants. If all the effort just affected those with grants it would be bad enough, but the whole campus has been rearranged.
The pool of dollars for medical research dominates all funding. The medical model does not work across campus, but it is very compatible with the "rules-first" mentality. The medical people call it the "protocol." The protocol lacks the assured solution of an algorithm, but as long as the protocol is followed the practitioner is largely above criticism, so the medical world love rules. It may not always stop a malpractice suit, but it helps.
Much of what passes as "research" in a medical setting does not need to be novel, therefore it is not cramped by rule-bound strategies. That highly structured "research," aka clinical trials, is really just product testing, and a protocol approach is warranted. However, the appropriate venue for it is Consumer Reports rather than a university setting. But because of the potential grant income and prospective profits in medical "research," that research and its issues have become a burden the rest of campus must bear as well. The ethics listserv is 99.99% about medical research policy, how to keep the drug companies happy. The rest of us are irrelevant; that may seem strong, but it is hard to escape that feeling, we just don't show up on the radar.
We do need to learn to negotiate bureaucracies, but we (and they? fat chance) need to understand that such is NOT learning to do research, just as learning to file a tax return has nothing to do with running your business. When the tax system hinders business too much, business goes underground, off-shore, or otherwise off the books. The implications of that for the REB can be left for another day, perhaps even research can move "off-shore" (hey, it works for Paul Martin). The problem with a "bad law" is that sooner or later people just ignore it and it becomes unenforceable because of the sheer number of violators (e.g., "right turn on red after a full stop."). The military would seem a great example of bureaucracy, but down where the work gets done there is always a Radar O'Reilly (MASH) who gets the job done - in spite of, rather than because of, the rules. A lifetime can be spent (wasted) trying to plug loopholes when rules define your existence, whereas there is always the exhilaration of finding a way to do an end run!
In truth, time being a fixed quantity, the more time spent learning the "rules" the less time for substantive inquiry. And the more "rules," the less latitude for creative inquiry. By definition, creative means novel and bureaucracies don't tolerate variation. Goodbye Serendipity -- Skinner would have had to undergo ethics review again, after the food pellets started coming intermittently.
Learning the rules might be more defensible if the rules were made by wise sages who had established that was the best way to do research. But the policies were not made by experienced scholars nor because they facilitate research, and they have long since ceased to be about public safety. Instead they (and grant decisions) are made by bureaucrats and politicians to control the areas in which research will be done. At this level it is about buying votes, not risk, not ethics. For example, Networks of Centres of Excellence: where is the evidence that this was the key ingredient in how research advances were made in the past? Nil, but this scheme fits the bureaucrat's idea of how things should be: bigger. New ideas always occur in one person's head, always have, always will.
In truth, young academics don't even "learn the bureaucracy" in the current atmosphere, which would be bad enough. Instead they learn deference, and don't do anything unusual. After all, if you repeatedly challenge the tax auditor, what happens -- you may well become a target for further attention, not a good thing! Formulaic research seems the likely outcome, not creative advances.
There is the prospect that the control agenda will become yet more heavy-handed, as exemplified in the recent harassment of Elizabeth Loftus through the University of Washington ethics process, because her work on recovered memories didn't satisfy someone. Except for her senior status this abuse would not be known. I would like to report that the University of Washington officials were disciplined by the feds, but you can probably write that ending if you just remember how Nancy Oliveri was "rewarded". Nothing requires the university nor the REB to be accountable or responsible for misbehavior of the REB. That is, the heavy federal hand descends if a participant is harmed (whether the incident was preventable or not), but if a researcher is abused, nothing. It's either silence, or "that's a local matter." And at the local level the meetings and decisions are secret (confidential), the atmosphere reeks of "trust us."
Added to the experiences of Sergent (more here), Rushton, and Pagliaro in this country, one wonders just how often harassment in the name of "ethics" does occur, especially at the junior level where there is no way to go public with the abuse. That's what it actually has become, workplace harassment, not improving public safety, not "ethics."
Like unpopular speech needing more protection than popular speech, it is unpopular research that most needs protection. Why does this cynic think "popular" research will be synonymous with "profitable," those being interchangeable on campus these days, so an "ethical" blessing will be found, quickly? Ah ha, so that's how you get expedited review. Can unpopular (unprofitable) research just be dismissed as "unethical," that is, "outside the rules," case closed? Why not?
More subtly, it is not uncommon to get feedback from an ethics review to the effect that the research does not seem "worthwhile." Does "worth" mean profitable to the university, or is it a matter of idiosyncratic reviewer values? A young colleague was told his proposal involving odor and memory was "silly, a waste of time." What does that feedback have to do with public safety? I thought quality control was the job of the peer-review journals (and that etiquette is Dear Abby's domain)? Or a response might be that "there are no benefits (i.e., it isn't worthwhile), so even though there are no risks I can't support it." What ever happened to the idea that worth was to be established by collecting data? Evaluations such as these show how complex rules, with no referee, functionally mean whatever the reader/review wants, and there is no appeal. Even photo radar has a better appeal process and prospect than the REB!
IV. ARE GRANTS WORTH THIS?
Fifty years ago, Watson and Crick unraveled DNA, without a Network of Centres of Excellence. Polio was conquered without federal grants. And so forth. But in recent years, we have dumped billions of taxpayer dollars into research of all kinds. Originally it was the "military-industrial complex," but now the "medical industry." All the while the rest of us, for whom the dollars are paltry at best, must play the same game. Universities have become "contractors" to the grant agencies and drug companies (actually pimps and prostitutes might be a better metaphor), the "Kept University".
And so, the
key question again, "why?" Is it worth it? The answer
is NOT obvious, and the
question is "worthwhile":
Am I as a taxpayer getting a good return? That is, have the
intellectual advances been commensurate with the increased expenditures
and attendant constraints on freedom of inquiry, compared to 50 years
ago and before? I am starting a sabbatical during which I will poke
around on this. Without either ethics approval or a grant.
Mueller is professor of Applied Psychology at the University of Calgary.