The Department of Health and Human Services, Office of the Secretary, along with the Office of Science and Technology Policy, has issued an advance notice of proposed rulemaking (“ANPRM”) requesting comments on how to update current regulations on the protection of human subjects who participate in research.
Existing regulations on human research have been in place for decades with little significant change. Thus some have dubbed the current initiative “historic.” The impetus to modernize the regulations is in part a result of the way human research has evolved over the years. Changes in the way human research is conducted include an increase in multi-site clinical trials and observational studies; research in the social and behavioral sciences; research using databases, the Internet, and biological specimen repositories; and perhaps most significantly the use of advanced technologies, such as genomics. Other factors motivating change include criticism of the existing regulatory scheme by government bodies (e.g., Government Accountability Office) and academics. A recent Executive Order also charges Federal agencies to review and update existing significant regulations to ensure that objectives are being met in the most efficient manner. Improving Regulation and Regulatory Review, January 18, 2001.
The ANPRM addresses a host of concerns over the “Common Rule,” which is codified at 45 C.F.R. part 46, subpart A, and has been adopted by about 15 Federal departments and agencies. The Common Rule generally requires that Federally funded investigators obtain and document the informed consent of research subjects and describes, among other things, the requirements for membership, function, operations, research review, and recordkeeping of institutional review boards (“IRBs”). Regulations to protect human subjects involved in FDA-regulated research include the provisions set forth at 21 C.F.R. parts 50 (informed consent), 56 (IRBs), 312 (investigational drugs), and 812 (investigational medical devices). FDA’s regulations on informed consent and IRBs are separate from, but largely track, the provisions of the Common Rule. The proposed rulemaking notes that other regulatory schemes, such as FDA regulations and the HIPAA Privacy Rule, will be affected and “will need to be harmonized.”
Seven primary categories of concern are highlighted in the ANPRM:
(1) Ensuring that the rules relate to the magnitude of risk to study subjects. For example, IRBs have been criticized for spending too much time reviewing studies that involve minimal risk or overestimating foreseeable risks to subjects, particularly in the context of social and behavioral research.
(2) Streamlining IRB review of multi-site studies.
(3) Improving informed consent. Particularly in biomedical research where risks can be significant, there is value in ensuring that the consent process conveys the information needed for a potential subject to make an informed decision in a manner that the subject can understand. At the same time, a rigid requirement to obtain written informed consent for certain types of research, e.g., surveys or interviews, has been questioned.
(4) Strengthening data protections to minimize information risks. For example, where genetic information is collected and stored, study subjects incur the risk of accidental or unauthorized disclosure of personal information. HIPAA requirements address such risks in part, but apply only to covered entities.
(5) Collecting information that would better allow evaluation of the system and how well human subjects are protected.
(6) Extending the scope of the Common Rule to include research studies conducted at institutions that receive any Federal funding, even if not specific to the study at issue. This responds in part to those who have called for legislation to expand the Common Rule to cover all human subjects research conducted in the United States, regardless of the source of funding.
(7) Clarifying and harmonizing regulatory requirements and guidance across Federal agencies.
The ANPRM requests public comment on these issues and asks for responses to more than 70 specific related questions. Barring an extension, comments must be submitted by 5 p.m. on September 26, 2011.