Conclusion

This chapter summarizes the arguments and conclusions developed in the book and discusses proposed reforms to the system of overseeing research with human subjects including mandating that sponsors of institutions provide fair compensation to subjects for research-related injuries; creating a national registry for healthy volunteers to protect them from harm and promote data integrity; harmonizing regulations from different federal agencies, including DHHS, FDA, and EPA; closing loopholes in the federal regulations; simplifying and streamlining the process for adopting reliance agreements between institutions that are collaborating on a research project; developing federal regulations or policies for participation of adults with impaired decision-making in research; providing additional logistical, financial, and educational support for IRBs; enhancing support for local participation on IRBs; enhancing public and community engagement with human subjects research; promoting evidence-based IRB decisions-making in research with subjects; and controlling IRB mission-creep. The chapter also discusses some areas for future research, such as the ethics of testing emerging technologies on human beings, such as human gene editing (germline and somatic); nanomedicine; stem cell therapy and regenerative medicine, robotics, bionics, neural implants, wearable devices, and machine-human interfaces; microbiome interventions; and artificial intelligence.