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Re: bioethics: Protocol Review Charges



Dear Diana,

I will answer some of the questions.

Ombudsman is suggested by us as a mechanism to obtain true informed consent 
and post ethical approval surveilance. We have proposed him to be appointed by 
the researcher and the ethics committee but functions independently of both 
with independent financial mechanism.

In the case of Sri Lankan Twin Registry a person from the Multiple Birth 
Association can perform as an ombudsperson.

As the mechanism of ombudsperson is not in position yet there are no examples. 
It is yet hypothetical.  In ethically sensitive trials an ombudsman will be 
there physically when the investigator takes informed consent. Especially 
valuble as the scientific literacy is low and there is no national debate on 
these issues and the level of health care is mainly preventive and inadequate 
as in developing countries.

This should be in the trial document and written and agreed before with a 
mechanism for reimbursement.

Hope to send you more details soon,

Sisira

-----Original Message-----
From: "Diana Berlinerblau" <di_berlinerblau@yahoo.com> 
Date: Saturday, December 21, 2002 13:29:28 -0500

All and Sisira Siribaddana & Nipuna Siribaddana:

I have a some questions regarding the role of "Ombudsman" in your community: 
is this person part of an independent ethics commitee, or would they work 
separately?  What specific task would he perform?  Would you be so kind as to 
describe examples?

Is there a general agreement or a definition of "ethically sensitive trials", 
for example: AIDS research, vulnerable community research (psychiatric 
patients - children)? If defined previously, would it automatically pose an 
extra burden on Ethics Commitees that would also automatically require the 
monitoring of the protections of subjects, for example, visiting patients? 
Witnessing the process of informed consent? Is this procedure writen in any 
document, before the trial begins? Is it a standard procedure?

Do you visit patients to ask in person what they feel like regarding their 
protections as subjects?

Is this a sensitive matter regarding investigators? How do they feel regarding 
this possibility?

Kind regards to all

Diana Berlinerblau
Psychiatrist
Buenos Aires
Argentina

Further elaborating on the role of Ombudsman we have said "Granting of ethical 
clearance alone is inadequate and on going monitoring of the progress, 
developments and adherence to the protocol is essential. The role of an 
ombudsman will be beyond ensuring freely given informed consent and also for 
monitoring any significant departures from the protocol for which the ethical 
clearance is granted."

This concept was also extensively discussed in this forum (discussion group) 
sometime ago. So, in ethically sensitive trials, ombudsman or an ombudsman 
agency can be separately budgeted.

-----Original Message-----
From: "Sisira Siribaddana & Nipuna Siribaddana" <nipuna@stmail.lk>

Dear Ames,

We from Sri Lankan Twin Registry has formulated guidelines on ethics titled 
"research ethics from developed world perspective" and addressed this issue of 
post-trial obligations and oversight. Our proposal is to appoint an third 
party ( ombudsman ) for ethically sensitive trials to ensure freely given 
informed consent and ongoing monitoring of research.

Further elaborating on the role of Ombudsman we have said " Granting of 
ethical clearance alone is inadequate and on going monitoring of the progress, 
developments and adherence to the protocol is essential. The role of an 
ombudsman will be beyond ensuring freely given informed consent and also for 
monitoring any significant departures from the protocol for which the ethical 
clearance is granted."

This concept was also extensively discussed in this forum (discussion group) 
sometime ago. So, in ethically sensitive trials, ombudsman or an ombudsman 
agency can be separately budgeted.

This document is in print and we will send you a copy as soon as it becomes 
available.

Hope this will help

sisira & athula

Dr. Sisira Siribaddana & Dr Athula Sumathipala
Research co-ordinator Sri Lankan Twin Registry
Registered as an Association under the Companies Act No. 17 of 1982
Staff Specialist in Medicine Sri Jayewardenepura Post-graduate Teaching
Hospital
Endocrinologist
Secretary Osteoporosis Associations of Sri Lanka
259, Temple Road
Thalapathpitiya
Nugegoda
10250
Sri Lanka
Fax-00 94 1 778661
Phone 00 94 1 779354
Mobile 94 77 326 940
http://www:infolanka.com/org/twin-registry
www.siribaddana.yourmd.com (Endocrinology web site)

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