I was saddened to read about the death of Professor Paul Meehl [Observer, July 2003]. As an undergraduate at the University of Minnesota in the mid 1960s, I took his clinical psychology class. Even though it has been almost 40 years, I still remember a lot about that class. Like most other professors he wore a sport coat, but he didn’t wear a tie. He usually wore a black turtleneck with some kind of medallion on a gold chain around his neck. He had a goatee and a crew cut. He was partial to suede loafers. He said his father was a streetcar conductor. That was good for some of us to know.
Early on he told us that about half of what he was going to say to us was wrong. The trouble was he didn’t know which half. I remember when he personally demonstrated the schizophrenic walk. I’m not even going to try to describe it. He said it was usually pretty easy to spot the new sociopaths on the ward, because within a couple of hours they would be playing ping-pong with the other sociopaths. He said it was a favorable prognosis when a person who was hearing voices said the voices came from inside her head rather than “out there.” He said a healthy adult male would never cry, no matter what the tragedy. I had to tell him after class I disagreed.
One spring day I made an appointment to talk with Meehl. I didn’t actually get inside his office – we spoke in the hallway. I explained I had applied for admission into graduate school the previous year, but wasn’t admitted because I didn’t have any letters of recommendation. So I asked him, based on the merit of my ‘A’ in his course, to write me a letter of recommendation. I thought his voice sounded slightly incredulous when his response was, “You got an ‘A’ in my course?” I told him I had. He said, “Give me the forms.” Two weeks later I got a telephone call from a psychology department chairperson telling me I was definitely admitted and had an assistantship.
In addition to his work in statistics, philosophy of science, testing, personality and clinical psychology, Meehl made important contributions to learning theory. His papers on the circularity of the law of effect, the distinction between intervening variables and hypothetical constructs, and his expectancy theory were darn good. Almost as good as my recommendation.
‘Overkill’ by IRBs
University of Calgary
The APS workshop on IRBs [Observer, August 2003] admirably tried to deal with the complex regulatory web that has developed, ostensibly to protect human subjects. We have noted before that there seems to be no evidence that any of this is effective in that respect, but there is another concern here.
The regulatory representative, George Pospisil, notes “The Common Rule provides sufficient flexibility for IRBs to efficiently and effectively review non-biomedical research.” In particular, Pospisil cites the provisions in the rule for exempted research, expedited review, and waiver of consent or waiver of documentation of consent.
This sounds reasonable, yet Pospisil then notes 1) “If you’re reaching for the floor, you’re not gonna make it” (“reach for the ceiling”), and 2) “expedited review does not mean review lite.” The take-home message for local IRBs thus seems to contradict the alleged flexibility, being instead something more like “Don’t dare miss anything!” as opposed to “Exercise good judgment.” Contradictory conclusions may or may not be bothersome in a regulatory sense, but researchers definitely find them untenable.
The concept of “everyday risk” receives due mention as well, but with the caution: “Risk can range from simple embarrassment, to some serious risks, such as emotional distress, psychological trauma, invasion of privacy, loss of social status.” The implication here also seems clear: go for “zero risk.” Whether zero risk is a floor or a ceiling is not clear, but utopia is definitely a hypothetical, even fictional, condition.
The regulations may seem clear to those who spend full-time in the bioethics industry, but in fact the interpretations are as varied as some aspects of the Constitution. Given mixed messages, it is not difficult to see why local IRBs prefer to engage in overkill rather than to exercise flexibility.