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From Oversight to Overkill

Inside the Broken System That Blocks Medical Breakthroughs—And How We Can Fix It

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1 of 1 copy available
1 of 1 copy available

Medical research saves lives-yet all too often, it is thwarted by a review system supposed to safeguard patients that instead creates needless delays and expense. Institutional Review Boards, which exist at every hospital and medical school that conducts medical research, have ended up imposing such complex, draconian conditions that research is frequently damaged, delayed, and distorted. This is why medical miracles like the COVID-19 vaccines, which were developed at warp speed, are far too rare. Instead, medical research in countless areas is kept at a horse-and-buggy pace. The result: unnecessary suffering and avoidable deaths.


From Oversight to Overkill vividly recounts the story behind this crisis, one that remains unknown to the general public. Family physician and ethicist Simon Whitney shows how the IRB system was launched in response to scandals like the notorious Tuskegee syphilis study-and how, in recent decades, this well-intentioned program has become increasingly bureaucratic, convoluted, and stifling.


Readers will learn how vital breakthroughs in treating conditions from kidney stones to heart attacks and premature birth have been delayed by IRB red tape, forcing doctors and patients to settle for less-effective treatments. They'll see how ill-informed demands from Congressional leaders that regulators "get tough" on scientists have caused respected research institutions to be shut down-with no benefit to the public. And they'll learn about a balanced, common-sense approach to reforming the system that can free scientists from pointless wheel-spinning while still protecting the public from the risks of unethical or careless experimentation.


Until now, the debate about the IRB system's failures has been confined to specialty journals in medicine, law, and ethics. From Oversight to Overkill will finally alert citizens about this little-known crisis with America's medical research system-and what can be done about it.

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    • Publisher's Weekly

      March 13, 2023
      Making the urgent case that oversight done wrong limits crucial, sometimes life-saving options for patients and doctors, Whitney calls for a new approach to how institutional review operates for medical research involving human subjects in the U.S. He explores how Institutional Review Boards (IRBs), which provide oversight to this research, have historically developed, how their contemporary operation too often restricts the development of medical science (and traumatizes patients and their families), and offers a clear-eyed roadmap pointing to what can be done about the problem. He sees the current operation of IRBs as “unworkable” and in need of substantial overhaul to better serve research subjects and the broader needs of society, which both suffer when research is left undone.
      Whitney is a doctor himself who has served on an IRB, and also has studied the law and medical ethics, all of which gives him a unique, persuasive perspective on the necessity of external review and the problems with our current system. He takes seriously the historic harms that medical research has inflicted on test subjects (with a substantial discussion of the Tuskegee Public Health Service study, as well as other injustices) and the need for outside review of scientists’ research. However, he remains scathing in his criticisms of the current system, including the actions of the Office for Human Research Protections.
      The role of IRBs is contentious—controversy over IRB oversight has raged for years—and Whitney, a cogent stylist and persuasive constructor of arguments, recognizes that many scientists support the current system because of the need for transparency and regulation. He’s adamant in pressing for change, but also humble in the scope of his concrete suggestions, which amount to a relatively modest overhaul in policy that would help streamline and balance the current review system. Still, this look into the need, development, and problems of Institutional Review Boards is a convincing argument for reform to better serve patients and society.
      Takeaway: A persuasive case for reforming the Institutional Review Boards that oversee medical research.
      Great for fans of: David J. Rothman’s Strangers At The Bedside, Sarah Babb’s Regulating Human Research.
      Production grades
      Cover: A-
      Design and typography: A
      Illustrations: N/A
      Editing: A
      Marketing copy: A

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  • English

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