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AJPH First Look, published online ahead of print Oct 3, 2006
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November 2006, Vol 96, No. 11 | American Journal of Public Health 1914-1919
© 2006 American Public Health Association
DOI: 10.2105/AJPH.2005.082172

HEALTH POLICY AND ETHICS

"It’s Like Tuskegee in Reverse": A Case Study of Ethical Tensions in Institutional Review Board Review of Community-Based Participatory Research

Ruth E. Malone, RN, PhD, FAAN, Valerie B. Yerger, ND, Carol McGruder, BA and Erika Froelicher, RN, PhD, FAAN

Ruth E. Malone and Valerie B. Yerger are with the Department of Social and Behavioral Sciences, School of Nursing, University of California, San Francisco. Carol McGruder is with Polaris Research and Development and the San Francisco African American Tobacco-Free Project, San Francisco. Erika Froelicher is with the Department of Physiological Nursing, University of California, San Francisco.

Correspondence: Requests for reprints should be sent to Ruth Malone, RN, PhD, FAAN, UCSF, Box 0612, San Francisco, CA 94143–0612 (e-mail: ruth.malone{at}ucsf.edu).

Community-based participatory research (CBPR) addresses the social justice dimensions of health disparities by engaging marginalized communities, building capacity for action, and encouraging more egalitarian relationships between researchers and communities. CBPR may challenge institutionalized academic practices and the understandings that inform institutional review board deliberations and, indirectly, prioritize particular kinds of research.

We present our attempt to study, as part of a CBPR partnership, cigarette sales practices in an inner-city community. We use critical and communitarian perspectives to examine the implications of the refusal of the university institutional review board (in this case, the University of California, San Francisco) to approve the study.

CBPR requires expanding ethical discourse beyond the procedural, principle-based approaches common in biomedical research settings. The current ethics culture of academia may sometimes serve to protect institutional power at the expense of community empowerment.






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