Prog Hum Geogr OnlineFirst, published on May 20, 2008 as doi:10.

1177/0309132508090475

Progress in Human Geography (2008) pp. 1–19

Ã
Un-ethical review? Why it is wrong to
apply the medical model of research
governance to human geography
Sarah Dyer1* and David Demeritt2
1
Oxford University Centre for the Environment, South Parks Road,
Oxford OX1 3QY, UK
2
Kings College London, Department of Geography, Strand,
London WC2R 2LS, UK

Abstract: The Economic and Social Research Council, the body which funds much social science
in the UK, recently imposed on UK social science a system of research ethics governance already
well established in other areas of research and in much of the rest of the developed world. This
system requires that research involving human subjects receive prior ethical approval from a
committee made up of, typically, multidisciplinary researchers and lay people. Our aim in this
paper is to prompt debate about the purpose and practice of such an anticipatory ethical review. We
begin by describing the rich and varied ethical and political debates ongoing in human geography.
We argue that these are, at best, ignored and, at worst, threatened by this system of ethical
review by committee. We describe the emergence of these formal mechanisms of research
governance and important differences between the ethical contexts, history, and demands of
research in the medical and social sciences. The paper draws on empirical research investigating
National Health Service (NHS) research ethics committees to propose three salutary lessons
geographers would do well to consider from experience elsewhere with ethical review. We argue
that in review by committee deliberations extend beyond the ethical to include the methodological,
that the system is a self-perpetuating and increasingly rule-bound mechanism, and that despite a
rhetoric of accountability it is a system as obscure to outsiders as professional ethics.

Key words: ethical review, informed consent, research ethics, research ethics committees,
research governance, standardization.

I Introduction universities must now satisfy if they are to re-

In July 2005, the Economic and Social ceive any funding from the UK Government’s
Research Council (ESRC) published its funding body for social science research. At
Research Ethics Framework (2005) setting the centre of these new regulations is formal
out a series of requirements that all UK ethical review by a designated Research

*Author for correspondence. Email: sarah.dyer@ouce.ox.ac.uk

© 2008 SAGE Publications DOI: 10.1177/0309132508090475

Copyright 2008 by SAGE Publications.

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2 Progress in Human Geography
Ethics Committee (REC).1 ‘[C]harged with
reviewing research involving human par-
ticipants to ensure that their dignity, rights
and welfare are protected’ (ESRC, 2005: 7),
RECs are arbiters of more than just research
ethics. In so far as their approval is required
to do any social science involving human
subjects, RECs also determine what kinds
of human geography gets done. It is some-
what surprising, then, that the introduction
of these new requirements has prompted so
little debate in the UK, particularly as there
is a growing chorus of complaints about
the appropriateness of this model of ethical
governance from social scientists in other
countries where it is operating (eg, Sieber
et al., 2002; Social Sciences and Humanities
Research Ethics Special Working Committee,
2004; Gunsalus et al., 2005; Halse and
Honey, 2005; Cohen, 2007).
Ethical review by REC is a form of ac-
countability initially developed in the USA
to regulate doctors conducting research on
their patients. Within the UK, the first RECs
developed locally within NHS hospitals
and other research institutions to regulate
clinical research and manage the risks, to
patients and institutional reputations alike,
of doctors conducing medical research on
patients. Although the ESRC now ‘hope[s]
and expect[s]’ (Diamond, 2005: 1) that all
UK universities will create RECs (or expand
existing ones) to review all human subject
research, there is still no legal requirement
for it. In keeping with the British penchant
for ‘light touch’ regulation, the only thing
that is formally required is that ESRC-funded
research be reviewed. In the USA, by con-
trast, the requirement for RECs or, as they
are called there, Institutional Review Boards
(IRBs) to give their prior ethical approval to
clinical research involving patients was set
down centrally by the federal government
in 1966. During the 1970s and 1980s a series
of US government regulations steadily ex-
panded the kinds of research for which ethical
review was legally required. This ultimately
culminated in the 1991 ‘common rule’, which
required ethical review of most research in-
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volving human subjects (apart from a few
legally exempted areas, such as research on
elected officials or about educational testing
procedures). Although the legislative and in-
stitutional histories of research governance
in Canada, New Zealand, and Australia are
different (NMHRC, 2007), the broad pat-
tern is similar to the USA. Formal procedures
of ethical review by REC, initially developed
to regulate doctors conducting research
on their patients, have been gradually ex-
tended to encompass most social science
research involving human subjects.
In this sense, then, the new ESRC de-
mand for external ethical assurance might
seem like little more than a tidying up of a
long-standing administrative anomaly. Ian
Diamond, the chief executive of the ESRC,
justifies imposing this medical model of ethical
review on UK social science by pointing to
the need to facilitate greater interaction
with medical researchers and those in other
countries already subject to similar external
oversight (Diamond, 2005). Seen in that
light, the new requirement for formal ethical
review by RECs might seem like an inevit-
able step, bringing UK social science into line
with accepted practice elsewhere.
Moreover, concern with public assurance
and accountability is hardly unique to social
science. Across a whole range of profes-
sions, from teaching and social work to
medicine and the bar, traditional forms of
self-regulation are giving way to increasingly
more formalized and governmentally man-
dated external audit procedures designed to
win public trust and assure ethical conduct
and public accountability of experts (Power,
1999). Accountability is the new mother-
hood and apple pie. The ESRC (2005) invokes
this term five times, without ever specifying
exactly who is being made accountable for
what or to whom.
RECs are part of a wider sea-change in the
governance of professional conduct. Until
recently, research ethics were treated as
matters of personal and professional
integrity. Some British learned societies pro-
duced descriptive and non-binding codes
 Sarah Dyer and David Demeritt: Un-ethical review? 3
of research practice, but many others,
including the Royal Geographical Society,
did not. The presumption was that individual
researchers were responsible for morally
interrogating their own research as an
ongoing and integrated aspect of the re-
search process. Adherence to disciplinary
norms was inculcated, judged, and enforced
through processes internal to the research
community, such as research training, peer
review, and private sanction. However, such
processes of professional self-regulation
are often informal and uncodified. As such,
they are potentially vulnerable to charges
of bias and self-interest. Ethical review is
designed to pre-empt complaint by imposing
a system of external accountability. In this
way, explains Diamond (2005), formal ethical
review is intended to ‘ensure that the public
will remain confident (as we are) in UK social
science’. Of course funding agencies have
their own reputations to think about too,
and demanding ethical review from grant
holders offers ESRC a way to assure poten-
tial critics that it too is accountable.
In this paper we take the introduction of
REC review to UK human geography as a
moment for reflection. Our aim in this paper
is to spark debate about the purposes and
practice of ethical review. Our argument,
in a nutshell, is that the prevailing medical
model of research governance is unsuited
to human geography (and by extension to
other social sciences as well) and that its
wholesale and indiscriminate application will
create more problems than it solves.
We begin by considering the recent ‘moral
turn’ within human geography. Those rich
and wide-ranging discussions of ethics and
the politics and practice of research go far
beyond the much narrower range of ethical
concerns at issue in the medical model of
ethical review, whose emergence and ex-
pansion we go on to describe in the next
section. We argue that medical research
conducted by doctors on their patients in-
volves very different aims, objects, risks, and
relationships than geographical research.
Consequently, there is an important question
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about whether the principles and practices
of ethical review, developed in the context
of medical research, should be applied to
regulate geographical research with human
subjects. Moreover, there are also important
practical problems with the operation of
this medical model of REC-based ethical
assurance, which we highlight in the final part
of the paper. Drawing on the lead author’s
empirical research into the conduct of Local
RECs operating within the UK’s NHS, we
point to three perverse and unintended con-
sequences of the institutional dynamics of
ethical review.
II Ethics, politics, and research practice
in geography’s moral turn
Ethics has long been central to debates
within human geography about the norma-
tive and political implications of different
understandings of the nature, purpose, and
practice of geographical research. Indeed,
there are even regular progress reports in
this journal on the topic of ethics and geo-
graphy (eg, Smith, 1997; 2001; Cutchin,
2002; Valentine, 2005). Here we will reflect
on these wider concerns with the ethical
and the political. Our argument is that the
ethical frameworks applied by formal ethical
review processes ignore those wider nor-
mative and political concerns at best, and
at worst actively subvert ongoing efforts to
infuse geographical practice with an ethical
sensibility (cf. Cloke, 2002; Valentine, 2005).
One of the major themes of what Smith
(1997) has called the ‘moral turn’ in geography
has been the effort to rethink traditional
questions of moral philosophy through the
geographer’s conceptual lens of space. Thus
Harvey (1996) tried to theorize justice as
involving a necessary tension between ac-
knowledging militantly particular claims to
local difference while still maintaining the
ambition towards all-encompassing global
universals that override those particular-
ities. In a somewhat similar vein, a number
of geographers have also considered the
nature and scope of our ethical obligations
to others (Corbridge, 1993; Smith, 2000;
4 Progress in Human Geography
Murdoch, 2003; Massey, 2004). Drawing
on poststructural theory, geographers have
questioned the ways in which the distinc-
tion between a personalized ethic of loving
care and universal ideals of justice has been
‘mapped onto a spatial distinction between
responsibilities to proximate others and
… to distant others’ (Barnett, 2005: 5).
In turn, that concern with the spatiality
of moral claims has led geographers to re-
consider the underlying metaphysics of moral
philosophy. For instance, feminist geog-
raphers and environmental ethicists have
both called into question the long-standing
Cartesian dualisms of self/other and human/
nature organizing Enlightenment claims
to moral standing and ethical recognition
(McDowell, 1999; Proctor, 2001; Popke,
2003). Acknowledging the relationality of
our place in a ‘more-than-human world’
unsettles the idea, absolutely central to the
liberal principlism of conventional ethical
review, of an autonomous individual subject
who might give its informed consent to
becoming the object of research by another
(Whatmore, 1997; Popke, 2003). It also chal-
lenges the anthropocentrism of prevailing
moral frameworks. Whereas Smith’s (2000)
work on moral geographies is concerned
largely with anthropocentric geographies of
community and justice, Whatmore (2002)
invokes an ontology of hybridity to raise
ethical questions about living together
with an expanded and yet also less clear-
cut sense of morally significant others
(cf. Hobson, 2007).
In parallel with those often quite abstract
debates about the relationships between
metaphysics, moral philosophy, and geog-
raphy, a second strand of the moral turn
in geography has focused attention on the
politics of geographical research and the
normative responsibilities it implies. For
instance, Dorling and Shaw (2002: 630),
among others (eg, Martin, 2001; Hamnett,
2003), slate the cultural turn for ‘turn[ing]
its back on public policy and particularly the
issues of poverty and inequality’. Despite
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a regrettable tendency to hyperbole and
posturing, the ensuing discussion about the
relevance of cultural geography raised im-
portant questions about for whom, how, and
why geography should be relevant (Castree,
2000; Massey, 2001; Dorling and Shaw,
2002; Imrie, 2004; Murphy et al., 2005;
Staeheli and Mitchell, 2005; Demeritt and
Lees, 2005). It highlighted the effect of par-
ticular theoretical and epistemological com-
mitments in facilitating or preventing en-
gagement with different audiences (Lees,
1999; Massey, 2001; Demeritt, 2005).
These concerns about the funding, control,
and dissemination of research fall outside
of the remit of RECs. They are, nevertheless,
central to professional assessments of the
ethics and politics of geographical research.
Underlying the ongoing controversy over the
political and epistemological value of the cul-
tural turn is a question about the wider role
of geographers and geographical research in
society. This too is a long-standing concern.
It is nearly 40 years now since the first radical
geographers boldly declared that the pur-
pose of geographical research was not simply
to understand the world but also to change
it. There are, of course, different ways to
change the world through our research,
ranging from liberal ideas of speaking truth to
power to more radical conceptions of ideo-
logy critique and action research that involve
much stronger challenges to the long-standing
epistemic commitments to Mertonian values
of scientific objectivity and disinterestedness
on which the scientific status of geographical
research depends.
The undoubted academic success of
critical geography has led to questions about
whether it has lost its critical edge (Castree,
2000). Some bemoan the apparent attenu-
ation of ‘activism and the academy’ (Blomley,
1994), which they regard as proof that geog-
raphy has abandoned its revolutionary re-
sponsibilities for the comforts of the ivory
tower (eg, Smith, 2005). Others strike a less
polemical tone. Cloke (2002) for instance,
argues that geography has not taken its
 Sarah Dyer and David Demeritt: Un-ethical review? 5
responsibility to represent the world in an
honest and constructive way seriously enough
over the past decade, while Lees (2003) notes
that gentrification researchers have tended
to talk among themselves rather than engage
with urban policy-makers and practitioners
whose activities they critique.
Geographers have also raised ethical and
political questions about the wider polit-
ical economy of research and publishing.
For instance, Chatterton and Featherstone
(2007) recently called for a boycott on re-
viewing and publishing for Elsevier-owned
journals to protest at the company’s involve-
ment in the arms trade. Meanwhile, other
geographers have pointed to the ways in
which what gets published in geography is
determined by the profit-making imperatives
of private corporations, such as Sage (now
owner of Progress in Human Geography,
which it bought in 2006 from the Hodder
Group). Sage are keen to push textbooks
over monographs and to squeeze value from
their intellectual property by limiting wider
public access to often publicly funded geo-
graphical research (Barnett and Low, 1996).
Others have pointed to how the changing
contexts for research, such as the UK’s Re-
search Assessment Exercise or the demand
to generate research grant income, condition
the possibilities for geographers to exercise
their critical faculties (Peck, 1999; Demeritt,
2000; Ward, 2005). In this regard there has
also been extensive discussion within the
discipline about the politics of contract re-
search and the ethical responsibilities owed
by universities and principal investigators
to contract researchers on temporary or
non-tenure track contracts (Ní Laoire and
Shelton, 2003; Purcell, 2007).
The scope for the ethical in these geo-
graphical engagements with moral philo-
sophy and critical politics is thus considerably
broader than the much more restricted
concern of ethical review with assuring the
protection of human subjects involved in
research. But a third strand of the moral
turn in contemporary human geography
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has addressed the sort of questions about
research ethics and practice considered by
RECs. For instance, there is now quite a sub-
stantial literature on the particular dilemmas
of conducting research on social elites or
in other situations where geographers hold
little power or influence over those they
study (Hughes and Cormode, 1998; Ward
and Jones, 1999; Smith, 2006). This work
highlights the importance, at once prac-
tical, ethical, and political, of questioning the
patronising assumption that our research
subjects are necessarily socially inferior or
vulnerable to us (Shea, 2000). In the con-
text, for example, of contract research for
policy-makers, the opposite is often the
case, and, as Beaumont et al. (2005) note,
there is an ethical and epistemic obligation to
maintain academic independence in the face
of demands from clients to tailor research
findings to their particular purposes.
But geographers have not ignored the
ethical issues arising from research involving
potentially vulnerable people, such as children
(McDowell, 2003; Valentine and Skelton,
2003), or those in socially or economically
precarious positions (Evans et al., 2005). The
aim of such research is usually to highlight
those precarious and unjust conditions, and
in the process it is paramount that ‘partici-
pants’ interests or well-being … not be dam-
aged as a result of their participation in the
research’ (ESRC, 2005: 25). But, whereas
ethical review is focused largely on reducing
‘potential physical or psychological harm,
discomfort, or stress’ (ESRC, 2005: 21), femi-
nist and development geographers, in par-
ticular, have also considered the wider ques-
tions of voice, representation, and power
such research involves (McDowell, 1999;
Mahtani, 2006). Speaking of something,
like the marginalization of low-paid care
workers, is simultaneously speaking for it.
Representation has that double sense. Thus,
in addition to reducing harm, academic re-
searchers also have a moral obligation to
consider the ways in which their own efforts
to speak up for the oppressed can sometimes
6 Progress in Human Geography
serve to reproduce the very powerlessness
that their research was originally designed to
highlight and thereby reduce. In that regard,
geographers have discussed the notions of
reflexivity and positionality at great length
(eg, Rose, 1997; Barker and Smith, 2001).
Another response to that dilemma
has been to develop various participatory
methods by which researchers and their
subjects work together, so as to make the
research an empowering and emancipatory
process for all participants (McDowell, 1999:
231–44; see also Pain, 2004). Such practices
break down the sharp distinction between
researcher and consenting object of research
on which informed consent and the process
of ethical review are both predicated.
In sum then, geography is alive with
healthy debate about the ethics, politics, and
practice of research. Although these pro-
cesses of ethical consideration are informal
and often go unreported in write-ups of em-
pirical research, they do provide a variety of
ways in which ethical standards in human
geography are continually examined and
maintained. What these internal processes of
self-regulation are perhaps less effective at is
communicating those standards and assuring
others that we uphold them.
It is this public assurance function that eth-
ical review is designed to provide. However,
as we go on to describe in the next section,
REC review originated in a rather different
context and in response to different needs.
III Emergence of ethical review
The model of REC-based ethical governance
was first developed in the specific context of
clinical research by doctors on their patients.
Such research is haunted by a long history of
scandal over the proper distinction ‘between
procedures undertaken as part of patient-
care which are intended to contribute to the
benefit of the individual patient … and those
procedures which are undertaken, either
on patients or on healthy subjects, solely
for the purpose of contributing to medical
knowledge’ (MRC, 1964: 178). In the wake
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of revelations about the horrific experiments
performed by Nazi doctors on concentration
camp prisoners, the 1948 Nuremberg Code
(US GPO, 1949) formally established the
‘voluntary consent of the human subject’ as
the first and ‘essential’ principle of research
ethics.
The Nuremberg Code, like the sub-
sequent 1964 Helsinki Declaration on
Ethical Principles for Medical Research
Involving Human Subjects (World Medical
Association, 1964), made compliance with
its ethical principles a ‘personal duty and re-
sponsibility’ falling upon ‘each individual who
initiates, directs or engages in the experi-
ment … which may not be delegated to
another with impunity’. Drawing expressly
on the Helsinki Declaration, the Medical
Research Councils of both Australia and
the UK developed voluntary codes to guide
individual researchers doing experimental
research on human subjects (MRC, 1964;
NMHRC, 2007).
The practice of independent ethical re-
view to ensure that doctors were actually
upholding these ethical principles was first
mandated in the USA, in response to a series
of scandals about medical research. In the
USA, the 1962 Kefauver-Harris amendments
to the 1938 Food, Drug, and Cosmetic Act
made informed consent a legal requirement
in drug testing. They followed on from
Senate investigations, chaired by Senator
Estes Kefauver, in which it emerged that
drug companies routinely provided untested
drugs to physicians who were then paid to
prescribe them and to collect data on the
responses of patients who often did not
know they were taking experimental drugs
or participating in loosely controlled research
on their safety and efficacy (ACHRE, 1995).
Writing in the shadow of both this scandal
and the Thalidomide tragedy, in which an ex-
perimental drug was prescribed to pregnant
women leading to thousands of birth de-
fects, Wolfensberger (1964: 48) predicted:
‘There is the danger that, if scientists do
not respond to the public’s concern about
 Sarah Dyer and David Demeritt: Un-ethical review? 7
research conduct, research rules will be im-
posed on science from without.’ Indeed, this
is exactly what happened.
Against the backdrop of a landmark paper
by Harvard anesthesiologist Henry Beecher
(1966) highlighting widespread abuses in
clinical trials, the US Surgeon General issued
the first federal requirement for ethical review
in 1966. To assure that appropriate ethical
standards were being observed, all clinical re-
search funded by the National Institutes of
Health or Public Health Service, the largest
federal funders of medical research, was to
be subject to some kind of peer-review style
ethical scrutiny:
This review should assure an independent
determination (1) of the rights and welfare of
the individual or individuals involved, (2) of
the appropriateness of the methods used to
secure informed consent, and (3) of the risks
and potential medical benefits of the investi-
gation. (Quoted in ACHRE, 1995: Chapter 3)
These regulations were soon made more
stringent in response to further revelations
about unethical medical research, most
notoriously the Tuskegee experiments in
which treatment was withheld from African-
American men infected with syphilis so that
doctors could observe its etiology. In 1974,
Congress passed the National Research Act,
establishing the National Commission for
the Protection of Human Subjects of Bio-
medical and Behavioral Research (1979)
whose Ethical principles and guidelines for
the protection of human subjects of research,
better known as the Belmont Report, articu-
lated the basic ethical principles of respect for
persons, beneficence, and justice that would
underwrite ethical review in the USA and
internationally.
Federal requirements for ethical review
were greatly elaborated in 1974 regulations
on the Protection of Human Subjects issued
by the US Department of Health, Education,
and Welfare (DHEW, 1974). The 1974 rule
required all institutions receiving DHEW
funding to provide written assurance that
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they were protecting the rights and welfare
of human research subjects by requiring re-
search proposals involving human subjects
to seek prior approval from a designated
REC, whose membership, mandate, and re-
view procedures were set down in the 1974
rule. Although concerns were raised at the
time about extending these requirements
to social and behavioural research, DHEW
(1974) cited the administrative need for con-
sistency in defending its decision to hold social
scientists to the same regulatory standards
as biomedical research. The 1974 rule dra-
matically expanded the remit for REC
reviews and the administrative burdens in-
volved in meeting them, particularly since
universities tended to apply it even to non-
DHEW funded research so as to protect
their ‘general assurance’ status with DHEW
and avoid a cut-off of federal funding, which
cost Johns Hopkins University some US$301
million when its general assurance status was
suspended in 2001 for procedural failings by
its RECs (Curry, 2001). With some minor
modifications in 1981 and again in 1991 when
it was adopted by 14 other federal agencies
as the so-called ‘common rule’ of human
subject protections, these 1974 DHEW
regulations provide the legal basis for federal
regulation of human subject research in the
USA (ACHRE, 1995).
The regulatory path blazed by the USA
was soon followed by other countries, if
only to ensure that their pharmaceutical
research would be admissible in drug
licensing applications to US Food and Drug
Administration, which controls access to
the world’s largest market. In Australia,
the practice of ethical review by committee
was first officially recommended in 1976, in
Supplementary Note 1 to the NMHRC’s
Statement on human experimentation. It was
not, however, formally required of all insti-
tutions receiving funding from the Medical
Research Council until 1985 when a further
amendment also extended the jurisdiction of
RECs to encompass social and behavioural
as well as clinical research involving human
8 Progress in Human Geography
subjects (NMHRC, 2007). In Canada, the
Medical Research Council of Canada and
the Social Science and Humanities Research
Council adopted separate ethical guidelines
during the 1970s, helping to spawn a com-
plex patchwork of rules and institutional
practices. Initially voluntary, requirements
for ethical review were both standardized,
along the lines set out in the US ‘common
rule’, and made compulsory in 1998 with
the publication of the Tri-Council Policy
Statement on Ethical Conduct for Research
Involving Humans (Canadian Institutes of
Health Research, Natural Sciences and
Engineering Research Council of Canada,
Social Sciences and Humanities Research
Council of Canada, 1998).
The UK has followed these same trends
towards both the expansion and standard-
ization of ethical review by REC. As in
Australia, the first RECs in the UK were
established in the late 1960s to oversee
medical research being conducted locally
in NHS hospitals. Without any central
oversight or statutory force, each REC
operated according to its own standards
and procedures. Through the 1990s, the
government made a series of reforms to the
system in response to persistent criticisms
from the medical research community about
the costs, inconvenience, and inconsistency
of this patchwork system of unregulated
local RECs. The Department of Health
(1997) created a second tier of Multi-Centre
RECs to review clinical trials taking place
over multiple sites and established a Central
Office of Research Ethics Committees to
oversee the system and provide guidance
and training to RECs in the UK. In 2001, the
Department of Health published a national
Governance Arrangements for Research
Ethics Committees, which set out standard
operating procedures for RECs (Depart-
ment of Health, 2001). For the first time the
Governance also made ethical review a legal
requirement for any research involving NHS
patients, staff, or facilities. This coincided
with the EU publishing European Directive
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2001/20/EC (European Parliament, 2001),
which required member states to institute
standard operating procedures for the ethical
review of clinical trials.
The European clinical trials directive is one
outcome of a wider effort by the pharma-
ceutical industry to press national regulators
to coordinate their requirements for develop-
ing, testing, and licensing of drugs and other
medicinal products. Through the Inter-
national Conference on Harmonization
(ICH), for example, regulators from Europe,
Japan, and the USA are working with the
pharmaceutical industry to develop inter-
national guidelines on good clinical practice
so as to ensure:
a more economical use of human, animal, and
material resources, and the elimination of un-
necessary delay in the global development
and availability of new medicines whilst main-
taining safeguards on quality, safety, and
efficacy, and regulatory obligations to protect
public health. (ICH, 2005)
Abetted by a rhetoric of universal human
rights, the ICH guidelines set out international
standards for ethical research and for REC
review to assure they are met. In this way
RECs serve, in part, as mechanisms for
creating ‘open’ worldwide markets in pharma-
ceuticals and clinical devices (Abraham and
Reed, 2002).
Repatriated to UK law in the 2004 Medi-
cine for Human Use Act, the clinical trial
directive does not require ethical review for
social and behavioural research (though it is
required under the Department of Health’s
Research Governance if the research involves
NHS staff, patients, or facilities). It is this in-
consistency that the ESRC’s new Research
Ethics Framework now seeks to eliminate by
applying the procedures of ethical review by
REC, initially developed to regulate doctors
conducting research on their patients, to all
social research involving human subjects.
This move begs the question of whether that
medical model of ethical assurance can be
appropriately applied outside of the context
of its initial development.
 Sarah Dyer and David Demeritt: Un-ethical review? 9
IV Differences between human
geography and medical research
The system of ethical governance that the
ESRC is seeking to introduce in the UK,
the system already commonplace in North
America and Australasia, takes its lead
from the medical model of ethical review.
There are obvious reasons for adapting an
established system for use in our own field.
There is no point reinventing the wheel, if
the existing medical model already provides
a good way of dealing with the ethical prob-
lems of human geography research. In this
section we reflect upon the differences in
the nature, purpose, and practice of human
geography 2 and biomedical research. Our
argument is that these differences make it
inappropriate to apply the medical model
of research governance to most research in
human geography.
As human geographers we stand in a very
different relationship to our research par-
ticipants than doctors do when undertaking
research on their patients. Unlike medical
researchers who must balance their role as
carers, charged with advancing the best
interest of the patient in their custody,
with that as researcher seeking to advance
knowledge, we typically approach our re-
search subjects as simply researchers. They
have no other expectation of us, and in turn
we bear them no special duty of benefi-
cence or care beyond those owed to anyone
in normal social intercourse. In pursuit of
our research, we have a moral duty to be
civil and to keep our promises, whether of
confidentiality, anonymity, or simply of
arriving on time for an interview. This is very
different from medical researchers, who,
whether as doctors themselves or as em-
ployees of health-care institutions, have
moral and legal responsibilities to protect the
best interests of the patients on whom they
are conducting research.
In European countries there are now
also legal requirements for data protection,
but these apply to government and private-
sector organizations, as well as university-
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based researchers, and prior ethical review
is not necessary to ensure compliance with
them. If human geography requires some
special system of ethical review to assure the
observance of ordinary good manners, then
the cure of ethical review is perhaps worse
than the disease. What then makes research
with human subjects so different from those
other forms of ordinary social interaction that
a system of prior ethical review by REC is
required to assure good conduct?
The answer to that question is twofold
and turns on the conflicting social roles and
potential harms that may be involved in
research. In both cases, these ethical dilemmas
are much more acute for medical research
than they are for social research. First, one of
the most fundamental ethical issues in clinical
and medical research is managing two con-
current but conflicting relationships, that of
‘carer-cared for’ and ‘researcher-subject’.
As we have already argued, this relationship
of ‘carer-cared for’ does not generally apply
to human geographers, apart from in special
cases, such as research on students over
whom we have a direct and professional duty
of care, or the recruitment of research par-
ticipants through an institution or individual
who has such a duty of care, though in that
case the duty is not our own. By contrast,
these dual relationships are central to medical
research. People engage with health services
with certain expectations, such as that they
will be enrolled in the most appropriate
treatment regime. Taking part in medical
research can confound these expectations
by, for example, allocating treatment regimes
randomly. REC review serves as a check that
this potential conflict between the roles of
carer and researcher is properly managed.
Managing that role conflict is particularly
important because of the physical risks that
can be involved in medical research. This is
the second reason why a system of ethical
review might be desirable. Experimental
treatments may have dangerous and un-
anticipated side-effects – discovering those
risks, after all, is often the point of the
10 Progress in Human Geography
research. As part of their reviews, RECs are
charged with assessing the balance of risk
and benefit involved in proposed research
and with ensuring that unnecessary harms to
subjects are avoided.
Applied to social research, however, that
ethical standard of beneficence towards the
individual research subject can lead to per-
verse results if applied too strictly. We argue
in the next section that it inevitably will be
given the organizational dynamics of REC
review. First, in the case of critical social
science, the aim of the research is typically
to expose wider social injustices and in that
way actually harm those who benefit from
them. But, following the injunction of the
ESRC (2005: para 3.2.5) that ‘[p]articipants’
interests or well-being should not be dam-
aged as a result of their participation in the
research’, it would be impossible to secure
permission to interview employers whose
discriminatory practices a researcher was
hoping to expose and thereby end. In this
way, the priority given to the rights of the
individual by the bioethical principle of be-
neficence and associated ethical review
standard of harm avoidance is at odds with
the ideas of academic freedom to inquiry,
public right to know, and the moral duty to
expose injustice emphasized in geography’s
moral turn.
Second, unlike medical research that may
involve physical pain or even death from ex-
posure to novel drugs or surgical techniques,
most social research does not involve any
risks beyond those encountered in everyday
life. This distinction in kind was recognized in
the old nursery rhyme about the categorical
difference between sticks and stones that
can break bones and mere names that can
never hurt you. But, with federal guidance in
the USA inviting IRBs ‘to consider the ‘stress
and feelings and guilt or embarrassment’ that
‘may arise simply from … talking about one’s
… behavior or attitudes’ to the researcher,’
IRBs can sometimes:
reject a research proposal entailing just such
a conversation, one that could be carried on
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in the ordinary course of human interaction
absent of investigative intent, when they
believe the good of what might be learned does
not justify the risk of that ‘harm.’ Yet such a
conversation is normally not at all beyond the
risks of everyday life. From anthropology to
business, history, and law, IRBs straining to
interpret and apply these regulations some-
times have taken peculiar stands. One IRB,
for example, told ‘a Caucasian Ph.D. student
seeking to study career expectations in relation
to ethnicity that African-American Ph.D.
students could not be interviewed because it
might be traumatic for them to be interviewed
by the student. (Gunsalus et al., 2005: 9)
The new ESRC (2005: para 2.1.2) has a
similarly expansive definition of harm and
fragile view of the human subject in need of
protection by a REC.
One way to manage those risks is to
ensure that participants are fully aware of
what is involved and on that basis freely
consent to participate in research. This has
been formalized in the requirement to seek
an informed consent from participants taking
part in research. Informed consent has be-
come the sine qua non for ethical approval
from RECs (Corrigan and Williams-Jones,
2003; Dyer, 2006).
In a medical context there are good reasons
for this emphasis on informed consent. In-
formed consent provides a way to distribute
responsibility for managing several tensions
inherent to medical research by doctors on
their patients. First, it is only by giving their
consent that human subjects transform
themselves into objects of scientific research.
Without such consent, the doctor has no
licence to perform experimental procedures
on the patient that may be of great scientific
significance and benefit to other patients,
but are not intended for the direct benefit
of the individual being subjected to them.
Second, medical research often involves risks
of harm or other injury. Securing informed
consent serves to enroll the patient in
managing those risks. As well as providing
concrete substantiation to the bioethical
principle of respect for persons, informed
consent ensures that research subjects
 Sarah Dyer and David Demeritt: Un-ethical review? 11
are involved in ensuring the beneficence
of the doctor by participating actively in
managing the tensions between risk and
benefits and between carer and researcher
necessarily involved in medical research.
While there is a lively philosophical debate
about whether informed consent actually ful-
fills those promises (Meisel and Kuczewski,
1996; Chalmers and Lindley, 2001; Bulletin
of Medical Ethics, 2003), it is important to
recognize that the requirement for informed
consent arises not simply from a particular
research context – of doctors performing
research on their patients – but also from
a particular history. The history of medical
research is a history of scandals involving
doctors using people as research subjects
without their knowledge. Like the emergence
of ethical review itself, the emphasis given to
securing an informed consent, typically in
certifiable written form, is driven as much
by the need to protect against scandal as it
is to protect patients from harm. Informing
research subjects of potential harms and
then formally soliciting their consent to them
frames those harms as risks the research
subject has freely chosen to assume. Should
something bad occur, informed consent
ensures that moral responsibility for it is
shared between the doctor and the patient. In
this way the bioethical imperative to respect
patient autonomy, through the requirement
for informed consent, is in part also about
blame avoidance.
In contrast to medical research, social
science involves much less potential risk to
subjects. It is also less marked by the same
history of ethical scandal. Despite these and
other important differences, RECs still hold
social scientists to the same requirement
of seeking prior approval of their plans for
obtaining informed consent from research
subjects. Informed consent is embedded in
two of the six ‘key principles of ethical re-
search’ the ESRC (2005: 1) expects UK social
scientists to uphold:
• ‘Research staff and subjects must
be informed fully about the purpose,
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methods and intended possible uses of the
research, what their participation in the
research entails and what risks, if any, are
involved.’
• ‘Research participants must participate in
a voluntary way, free from any coercion.’
It feels uncomfortable questioning the ethical
significance of informed consent, as if we are
somehow endorsing the exploitation of re-
search subjects, but there are both practical
and principled reasons why informed con-
sent is not always a relevant or appropriate
standard for ethical social research. For
instance, it would be practically impossible
to secure the prior informed consent of all
the shoppers one might observe in an ethno-
graphic study of a shopping centre, quite
apart from the question of whether it should
even be required since the research poses no
risk and in such a context there can be no pre-
sumption of privacy to publicly observable
behaviour. Nevertheless, it is very common
for RECs to insist upon informed consent as
a condition for approval of research involving
participant observation (Sieber et al., 2002;
Social Sciences and Humanities Research
Ethics Special Working Committee, 2004;
Gunsalus et al., 2005; Cohen, 2007), and
the ESRC (2005: para 3.2.2) fails to mention
ethnographic research in its page-long
enumeration of the ‘exceptional research
contexts’ in which departures from the
normal expectation of informed consent
might be permissible.
In the medical context, it has been argued
that informed consent can come to colonize
and impoverish researcher-participant com-
munication (Hochhauser, 1999). In particular,
the process of obtaining an informed con-
sent has come to serve as a mechanism for
securing access. As such, it is very useful in
both medical and social research. However,
this is a very different role than an obviously
ethical one. We need to be very careful
about blindly accepting the ethical primacy
of an informed consent from individual re-
search subjects. This is a liberal, northwest
European vision of ethics, and, as the
12 Progress in Human Geography
ESRC (2005: 24) itself notes, its ‘emphasis
on the individual can seem inappropriate or
meaningless in some cultural contexts, where
the individual may take less precedence than
broader notions of kin or community’. As
Uitermark (2006) observed in an exchange on
the Critical Geographers email list, there are
times when safety, either of the investigator
or of research subjects themselves, means
that research subjects cannot be informed
about the true nature of research. He gives
the example of an investigation of the cocaine
trade. We might add studies of human traf-
ficking, illegal workers’ gang masters, and so
on. In such cases the notion of asking par-
ticipants to sign a consent form of the sort
envisioned by the ESRC (2005) is ridiculous,
and the ill of deception balanced by the im-
portance of the research and a commitment
to protecting anonymity. Researchers do not
hold a monopoly view of whether these ten-
sions are held in the right balance, but then
neither do RECs. However, in the system
adapted from medicine, research cannot go
ahead without REC approval. It might be de-
sirable to have formal mechanisms for com-
ment and input into ethically contentious
research. However, we should be wary of a
system of ethical governance that denies re-
searchers much discretion or autonomy.
Furthermore, the requirement for re-
searchers to present prospective subjects
with a complete listing of the ‘purposes,
methods, and intended uses of the research’
tacitly imposes on the social sciences a philo-
sophical framework for research developed
for the natural sciences. In this deductive-
nomological model, empirical predictions are
deduced from universal theoretical postulates
whose validity can then tested through the
conduct of experimental research. In this
positivist, hypothesis-testing tradition of
research, it is possible to specify in advance to
potential research subjects exactly what their
participation will be testing. Moreover, there
is also the assumption that informing research
subjects will not influence the results. This
assumption holds for clinical research, where
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human tissue is what Hacking (2002) calls an
indifferent kind. By contrast, the objects of
social science research are also subjects who
respond to how we interact with them. This
ontological difference between the indif-
ferent objects of natural and physical science
and the interactive kinds of interest to the
social sciences requires an interpretative and
hermeneutic rather than experimental and
positivist epistemology. In the open-ended
and exploratory traditions of hermeneutic
social science, research purposes, methods,
and intended outcomes are fluid and evolving.
They cannot be specified in advance in a
participant information sheet that potential
research participants might sign to signify
their informed consent to participating.
The ESRC (2005) acknowledges these
philosophical differences, but its recom-
mended response is ludicrously dispro-
portionate. Whereas drugs trials involving
vast sums of money, or biomedical research
on extremely vulnerable people in enormous
pain need only gain anticipatory approval,
the ESRC argues that because ‘purposes,
methods, and intended uses’ of qualitative
research evolves as it proceeds, this kind of
research should be required to seek REC
approval on multiple occasions. Such a dis-
proportionate response is itself unethical if
it overburdens researchers such that worth-
while research does not get done. There
is already good evidence of such a chilling
effect on social science in North America
where overzealous RECs have insisted that
qualitative researchers apply research norms
and practices developed in the clinical to
their very different contexts of field research
(Sieber et al., 2002; Social Sciences and
Humanities Research Ethics Special Working
Committee, 2004; Gunsalus et al., 2005;
Cohen, 2007).
V Unintended consequences of ethical
review
We have argued that the system of ethical re-
view developed to govern medical research
is, as a matter of principle, inappropriate for
 Sarah Dyer and David Demeritt: Un-ethical review? 13
the social sciences because of fundamental
differences in their philosophies and practices
and in the risks and relationships enacted
through them. At the same time, we have
also pointed at a number of practical problems
with the operation of this medical model of
REC-based ethical assurance. In this final
section, we draw on the lead author’s em-
pirical research into the conduct of Local
RECs (LRECs) operating within the NHS
to highlight three perverse and unintended
consequences likely to follow from the insti-
tutional dynamics of requiring ethical review
of social science research.3
First, the distinction between an ethical
review of human subject protections and a
scientific review of research design and valid-
ity is both controversial and difficult in prac-
tice to uphold. The Department of Health
(2005: 4.5, 5.4) is quite clear that NHS RECs
must restrict themselves to judging the ethical
soundness of human subject protections.
Ethics review is ethics review, the logic goes,
and not a review of scientific value or valid-
ity, which are epistemological questions to be
judged by expert peer reviewers. This insti-
tutional distinction between scientific validity
and ethical governance builds upon a long-
standing, Enlightenment distinction between
facts and values.
While perhaps logically valid, demarca-
tions between the two must be constructed
through practice, and LREC members
often have a more expansive understanding
of the remit of an ethical review. As the
chair of one LREC explained in interview,
‘We do look at the science, and if that is not
right, the project is not ethical’ (C19). There
is a view among some REC members that if a
trial is unscientific and will not produce valid
and therefore useful results then resources
have been wasted and patients put at risk un-
necessarily in the course of research. From
this perspective, ethical review is neces-
sarily scientific review because bad science
is unethical (Dawson and Yentis, 2007).
The prevalence of that view is one reason
that qualitative researchers have sometimes
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found it difficult to receive approval for
proposals that do not include double blind
experimental controls and other norms of
positivist methodology that medically do-
minated RECs associate with ‘good science’
(Social Sciences and Humanities Research
Ethics Special Working Committee, 2004).
In turn, researchers complain that RECs
are neither sufficiently qualified to make such
scientific judgements nor formally author-
ized to do so. In the case of funded research,
proposals have already undergone a more
exacting peer review than an REC including
‘lay’ members, bioethicists, and a wide range
of disciplinary specialisms is able to provide.
Aside from the questions about the cost,
duplication of effort, and added delay this
involves, there is a more fundamental ques-
tion about whether these are the people we
want to see deciding what kind of human
geography gets done and by whom.
Second, in order to fend off such com-
plaints from the research community and
the pharmaceutical industry, procedures for
REC review in the NHS have become steadily
more elaborate, involved, and rule-based.
In 2001, the Department of Health intro-
duced binding Governance Arrangements
for Research Ethics Committees (GAfREC).
Faced with often angry complaints from
researchers denied permission to proceed,
LREC members often stressed the import-
ance of being able to point to the rule-bound
nature of their decision-making. As one com-
mittee member explained, ‘Problems are
more easily dealt with if GAfREC guidelines
are quoted’ (C16).
Guidelines do more, though, than provide
a defence for decisions. They also discipline
the decision-making and do so to the extent
that they can be said to colonize ethical de-
liberations (Rothstein et al., 2006; Power,
1999). A member of a different committee
described how the need to justify decisions
has, in her opinion, superseded ‘ethical’
judgments: ‘We do not make moral judg-
ments. As we have to have arguments
for our decisions you cannot do that any
14 Progress in Human Geography
more. You have to itemize your objections’
(C13). Although the ethical review of human
geography is unlikely to face the same com-
mercial pressures for standardization as
medical research, we are in no doubt that the
ethical review of social science by committee
is subject to exactly these sorts of pressure.
Over time the review of human geography
research will become increasingly rule-bound
and self-referencing.
In the case of NHS LRECs, such a cen-
trally standardized review process does not
necessarily lead to better or more ethical
decision-making. It does not even lead to
better decisions on its own terms. As one
LREC member put it:
[REC review] has become more formalized.
It used to be something that was low profile,
people doing it out of good will and in their
own time … We are still in the situation where
the accountability is not very clear. And all we
have got is more bureaucracy. (C45)
Many queries raised about applications by
LRECs concerned minor paperwork vio-
lations, such spelling and grammatical errors
on patient information sheets, rather than
substantive concerns about human subjects.
Similarly, in the USA the lapses most fre-
quently cited in federal audits of RECs are
minor record-keeping and paperwork errors.
Standard procedures create standards to be
upheld, such as signed consent forms, which
RECs sometimes require even of ethno-
graphers seeking permission to do research
with non-literate and oral cultures without
written languages (Gunsalus et al., 2005). In
this way, ethical review becomes a process
of ticking boxes and ensuring that paperwork
is in order rather than making substantive
ethical judgements.
Third, the emphasis on standards and
standardization has led to a proliferation of
paperwork, effort, and expense. Standard-
ization, as Timmermans and Berg (2003)
argue, depends on and triggers more stand-
ardization. There been exponential growth
in the number and volume of guidelines for
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REC members and researchers. The cur-
rent Manual for Research Ethics Committees
runs to 578 pages (Eckstein, 2003), while the
NHS now has a National Research Ethics
Service (superseding the old Central Office
for Research Ethics Committees), which
issues guidelines for filling in the application
form, templates of participant information
sheets, guidance on information sheets,
newsletters, and so on.
All this paperwork and guidance creates
transparency of a sort about decision-making,
but it is a technical, legalistic one that de-
mands considerable expertise to understand.
While advocates of REC-based ethical gov-
ernance insist that ethical review provides
for a more transparent and accountable form
of decision-making than traditional forms of
professional self-regulation (Kent et al., 2002;
Tinker and Coomber, 2004: 5), it is clear from
listening to REC members describe their pre-
parations how much effort and expertise is
required to make sense of all the rules and
paperwork. As one member explained, ‘I try
and read all the forms the night before to let
it sink in. I cannot read these things in a rush.
The forms are very awkward’ (C16). Ethical
review is a time-consuming activity for REC
members. Not only do they have to prepare
for and attend meetings, but they also have
to attend training sessions. The majority of
LRECs surveyed reported that their monthly
meetings lasted between two and three
hours (36%) but a sizable proportion had
meetings that lasted up to four hours (26%).
Many professional members estimated they
spent half a day a month reading applications
before meetings. This time spent on REC
duties is time away from ‘proper’ work, in
our case teaching, research, and writing. Lay
members tended to take even more time to
prepare, with many putting a couple of days
aside for this work.
If REC review is difficult and time-
consuming for REC members habituated
to its procedures, it is even more so for re-
searchers (Randerson, 2006). In the early
1990s one researcher condemned the REC
 Sarah Dyer and David Demeritt: Un-ethical review? 15
system as cumbersome, confusing, and frus-
trating to the point of being unworkable
(Meade, 1990). Despite all of the changes to
the system, similar comments are still being
made. In a recent article in the British Medical
Journal, oncologists labelled the new require-
ments labour-intensive, bureaucratic, and
expensive (Hemminki and Kellokumpu-
Lehtinen, 2006). Reporting research con-
ducted by the European Organization for
Research and Treatment of Cancer, the larg-
est independent cancer research network in
Europe, they described how a third fewer
patients were enrolled in new trials in the
year after the EU clinical trials directive was
implemented than in the year before. More-
over, they reported, the cost of trials had in-
creased by 85% and the cost of insuring trials
had doubled. This research confirms what is
clear from anecdotal evidence: the increasing
standardization of ethical review has altered
rather than eradicated the burden of making
an application for ethical review. This is par-
ticularly true for less active researchers and
research teams who do not make a sufficient
volume of applications to become experts at
filling in forms. Ethical review by REC re-
mains a complicated and laborious process
for all those involved. Standardization and
the proliferation of paperwork have made the
process more predictable and accountable for
those familiar with the system, but it would
be difficult to claim that ethical review by
committee is really ‘transparent’. Certainly,
for most of the patients it is designed to pro-
tect, the new system is just as obscure and
inaccessible as the one it replaces.
VI Conclusions
Our aim in this paper has been to spark
debate about applying the medical model of
research governance and ethical review to
human geography. Although geography’s
‘moral turn’ involves lively and wide-ranging
discussion of the normative and political im-
plications of geographical research, there
has been comparatively little discussion of
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the institutional structures governing human
geography research. In this paper we have de-
scribed the specific institutional context and
history – of scandal over doctors conducting
experiments on their patients without their
knowledge and consent or due regard to their
best interests – in which ethical review by
REC emerged and the demands, for ethical
assurance and reputational risk manage-
ment as much as human subject protection,
to which its institution responds. We have
also highlighted important differences
between such medical research and human
geography.
Our central claim is that these differences
make it inappropriate to apply indiscrimin-
ately the principles and practices of REC re-
view to regulate geographical research with
human subjects. In questioning the value
and appropriateness of ethical review, we
do not mean to deny either the existence of
ethical dilemmas in geographical research or
the need to address them. We acknowledge
that there are problems. Our concern is that
ethical review may make things worse. First,
the central focus of RECs with protecting
individual subjects represents just one of a
number of contestable normative and polit-
ical issues arising from geographical research.
At best, formal ethical review disregards
most of the concerns raised by geography’s
moral turn, when it does not actually subvert
them by giving priority to protecting the rights
of the individual research subject over the
wider ideas of academic freedom to inquiry,
public right to know, and the moral duty to
expose injustice emphasized in geography’s
moral turn. Moreover, in so far as the purpose
of such mechanisms of audit and assurance is
precisely to assure against the need for further
thought, there is the danger that ethical
review can dull researchers’ ethical sens-
ibilities and effectively make ethics someone
else’s problem (Valentine, 2005). As Power
notes: ‘the fact of being audited deters public
curiosity and inquiry and the users of audit
are often just a mythical reference point
16 Progress in Human Geography
within expert discourses. Audit is in this re-
spect a substitute for democracy rather than
an aid to it.’
Second, the costs – in terms of time,
money, effort, and delay – of requiring formal
ethical review for all research involving
human subjects are substantial, but in the
case of social research involving competent
human subjects there is little or no benefit;
there are few real risks and none that require
external oversight or intervention to assure
their proper management. Despite the bio-
ethical principle of respect for persons, there
is more than a little paternalism in the idea
that RECs are required to protect competent
adults perfectly capable of protecting them-
selves from nosy human geographers by
hanging up the phone, refusing to fill in a
survey, and telling off an impertinent inter-
viewer. Requiring ethical review by REC is
a disproportionate response to a poorly for-
mulated problem.
In the science-fiction comedy A hitchhikers
guide to the galaxy the characters discover
that the answer to the meaning of life, the
universe, and everything is 42, only to realize
they must now uncover what the question
is. It seems like we might be at a similar
juncture in research ethics. While there are
problems with the current system in the UK,
such as the disconnect between the treat-
ment of ethical questions by researchers
and the reporting of them in publication, we
have argued that mandatory ethics review of
human geography is a solution in search of a
problem. History shows that ethical review is
no guarantee of ethical research (Dyer, 2004).
Those involved in ethical review recognize it
is a check on but not a guarantee of ethical
research. As one paediatrician serving on an
LREC explained:
If someone is hell bent on doing some poor
quality research and not doing it ethically they
are going to do it irrespective of what they
have written down on paper and I don’t think
you can judge that. (C40)
Research approved by an ethics committee is
not the same as ethical research (Hay, 1998).
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One reason why British social scientists have
remained quiet about the introduction of
ethical review, no doubt, is that they see
it as innocuous. However, we believe that
this is just not the case. Even if the principles
applied by REC review were appropriate to
the governance of human geography, we
have argued that the institutional dynamics
of ethical review are such that the medical
model of ethical governance is more likely, as
Halse and Honey (2005: 2142) bemoan, to
‘cultivat[e] cultures of counterfeit practice’
than ‘foster genuinely moral behaviour and
ethical research’.
Acknowledgements
We would like to thank the referees of this
paper for their insightful comments. The
empirical research discussed in this paper
was funded by the University of London,
Triangle Trust and the AHRB (as was) ref.
2003/102692.
Notes
1. Such Research Ethics Committees (RECs) are
also known as Institutional Review Boards (USA),
Research Ethics Boards (Canada), Human and
Health Research Ethics Committees (Australia),
Health and Disability Research Ethics Committees
(New Zealand). In the interests of simplicity, we
use the term REC throughout this paper to refer to
all such committees.
2. We do not seek to homogenize important diversity
in human geography, but the following argument
recognizes a difference between clinical research
and human geography generally.
3. The research was conducted in May 2002 and
February 2004. It involved a survey of all 218
Local RECs operating in the NHS at the time, and
a subsequent in-depth phase of observing the
deliberations of 19 different committees, followed
by 49 interviews with committee members to
discuss the ethical review process and substance
of committee deliberations. Quotations from
interviewees are referred to using the code ‘C’
and then a number. Further details are available in
Dyer (2006).
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