Françoise Baylis and Jocelyn Downie challenge the recent reply from Minister Ambrose to a question on the Order Paper about ethics at CIHR.

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On March 27, 2014, Ms Davies, Official Opposition Spokesperson for Health and Vice-Chair of the Standing Committee on Health, submitted the following question on the Order Paper about ethics at CIHR to the Ms. Rona Ambrose, the Minister of Health:

“With regard to the February 2014 Canadian Institutes for Health Research (CIHR) Management Response to the recommendations of the Final Report of the Task Force on Ethics Reform, approved by the Governing Council of the CIHR:  (a) precisely what information was gathered through ‘the international environmental scan’; and (b) what specific recommendations, in support of the recent appointment of Dr. Jane Aubin as the ‘Ethics Champion,’ and Dr. Paul Garfinkel as Chair of the Standing Committee on Ethics, were given to CIHR Management and CIHR Governing Council by each of (i) the CIHR Science Council, (ii) the CIHR Standing Committee on Ethics, (iii) the CIHR Institute Advisory Board Ethics Designates?”

Cape Blomaden, Eliot Clark, Smithsonian American Art Museum

As required by law, the Minister provided a written reply to the question on the Order paper in a timely fashion. For the most part, however, the Minister’s reply ducked the question.

The Minister was asked “what specific recommendations… were given… by each of (ii) the CIHR Standing Committee on Ethics, (iii) the CIHR Institute Advisory Board Ethics Designates” in support of the recent appointment of Drs. Aubin and Garfinkel.

With respect to the CIHR Standing Committee on Ethics, Minister Ambrose replied: “[t]he CIHR Standing Committee on Ethics… has been consulted on the ethics action plan and the co-chair of the CIHR Standing Committee on Ethics actively participated in the discussion that took place at a GC’s meeting on this matter.”  The Minister was not asked about whether the Standing Committee on Ethics was consulted or whether the Standing Committee on Ethics’s co-chair participated in discussions, but rather what the Standing Committee on Ethics specifically recommended to CIHR Management and Governing Council.  On this, she gave no reply.

With respect to the Institute Advisory Board Ethics Designates, Minister Ambrose replied: “[a]ll CIHR’s Institute Advisory Board (IAB) Ethics Designates (IABEDs) had the opportunity to comment on the ethics action plan and to address ethics issues at IAB’s meetings.”  The Minister was not asked about whether the IAB Ethics Designates had an opportunity to comment on or to address the ethics action plan or ethics issues, but rather what specific recommendations they provided to CIHR Management and Governing Council. On this, she gave no reply.

In fact, the Ethics Action Plan was developed with no input from the IAB Ethics Designates.  The IAB Ethics Designates objected to the plan and the process, and asked for a face-to-face joint meeting with the Standing Committee on Ethics.  CIHR refused to allow a joint meeting. Instead, with approximately two weeks’ notice, CIHR arranged a teleconference call in which, not surprisingly, only half of the IAB Ethics Designates were able to participate.  The conference call lasted approximately an hour. At the end of the teleconference the request for a face-to-face meeting was reiterated. This request was never granted.

Furthermore, on March 25, 2014, the IAB Ethics Designates sent a letter to the President and Chief Scientific Officer/Vice-President of Research at CIHR and Members of Governing Council expressing support for the recommendations in the Final Report of the Task Force on Ethics Reform, specifically the need for ethics leadership to be “assumed by a reputable expert in the field… national and internationally recognized as a leading scholar and research in ethics, parallel to the level of scientific expertise required in a specific area of health research for an individual to be appointed as a Scientific Director of a CIHR Institute.”

Thus, Minister Ambrose’s reply with respect to the IAB Ethics Designates is both false and non-responsive.  To be true and responsive, Minister Ambrose should have stated that CIHR Management and Governing Council were advised to appoint an individual to provide ethics leadership at CIHR who is nationally and internationally recognized as a leading scholar and researcher in ethics.  She should also have stated that, contrary to the recommendations received, CIHR Governing Council appointed an individual as “ethics champion” who, by her own admission, has no expertise in ethics whatsoever.

Minister Ambrose’s reply also fails to acknowledge the fact that key groups and individuals (in addition to IAB Ethics Designates) have spoken out against the CIHR Governing Council’s response to the identified problems with ethics at CIHR.

The Task Force on Ethics Reform wrote to the President and the Chief Scientific Officer/Vice-President of Research: “To speak plainly, we do not see the plan proposed as a significant advance beyond the current situation at CIHR – one in which ethics has been pushed to [the] periphery.”

Fifty members of the bioethics and health law community in Canada wrote to Minister Ambrose and other Parliamentarians: “Given the failure of CIHR Governing Council to respond appropriately to the Task Force on Ethics Reform findings and recommendations and the concerns expressed by its own internal ethics advisors, it is imperative that Parliament make it clear to the CIHR President and Governing Council that the mandate set out for CIHR in the Canadian Institutes of Health Research Act [with respect to ethics] must be met.”

Although Minister Ambrose could not have known it at the time she drafted her response to the question on the Order Paper, it is worth noting here that the President of the Canadian Bioethics Society recently wrote to Dr. Jane Aubin, Chief Scientific Officer/Vice President, Research and Knowledge Translation, CIHR: “having a champion for ethics does not imply strong leadership in ethics.  Non expert champions and external advisors may be important but they do not preclude the need for in-house scientific experts providing leadership.  On this point, it is interesting to note that none of the other principal areas in CIHR’s mandate rely exclusively on non-expert champions or advisors.”

Ethics scholars and practitioners have spoken in one voice.  Unfortunately, it is clear that the CIHR Governing Council, CIHR Management, and Minister Ambrose are not listening.

For more on the problems with ethics at CIHR (here).  There is also more to read at Impact Ethics (here), (here), (here), (here) and (here).
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Françoise Baylis is a Professor and Canada Research Chair in Bioethics and Philosophy at Dalhousie University, Halifax, Canada. @francoisebaylis

Jocelyn Downie is a Professor of Law and Medicine at Dalhousie University, Halifax, Canada. @jgdownie