Ethics overload: Impact of excessive ethical review on comorbidity research

There are circumstances where ethics overload may be counterproductive to the successful achievement of research outcomes, especially for disempowered client groups. This paper describes and questions the complex time-consuming nature of seeking ethical approval from multiple Human Research Ethics Committees (HRECs) for a comorbidity research project in South Australia. Applications for ethical approval of a major research project involving surveys and interviews of managers and clinicians from mental health and alcohol and other drug services, community advocates and other relevant services were submitted to three major HRECs. Collectively, it took a duration of 10 months to receive full approvals from these HRECs. In addition, a number of Site-Specific Assessments were needed and further approvals were required from multiple Non-Government Organisations (NGOs). Each review process required a detailed application, sometimes followed by lengthy negotiation periods and amendments. These cumbersome, often duplicated processes took a considerable amount of researcher and committee time from a three-year project funding period, thereby delaying the project by almost a year. We discuss the impact of these delays on the timing, progress and potential quality of the research, and on the research team, employed staff, doctoral students involved, and the research budget. We also discuss the additional complexities and inconsistencies of involving two vulnerable populations, Aboriginal Australians and people from refugee backgrounds. This paper informs researchers and funding bodies about this major issue, and offers some suggestions for more effective ethical review processes.