American Indian and Alaska Native research ethics: The emergence of tribal review boards

American Indian and Alaska Native communities share unique cultural, historical, and political influences that continue to shape contemporary ethical research practices. Where and how AIAN communities live today has been shaped and defined by the federal history of colonial deterministic policy. Unfortunately, this history of systematic oppression has resulted in current inequalities in the overall health status of indigenous communities. Collectively, AIAN populations face significant health, mental health, and mortality disparities compared to other groups within the United States. These disparities include the highest rate of suicide in the nation, mental health problems, and physical health mortality disparities associated with Diabetes Mellitus, unintentional injury, substance abuse, and other chronic health problems. Disparities have attracted researchers interested in advancing scientific knowledge about the underlying etiology of these disparities. AIAN populations have experienced unethical research in the past that has resulted in unanticipated damage to AIAN communities and individuals. This history has resulted in institutional distrust within many AIAN communities toward health research. Community distrust can ultimately limit research within AIAN communities and have subsequent negative consequences toward public health knowledge and practice within underserved indigenous communities.   

The objective of this presentation is to review contemporary AIAN research ethical principles and practices from an indigenous perspective. Authors reviewed the extant literature regarding indigenous research ethics and will provide a discussion of examples of progressive community driven ethical research practices, suggestions for practice, policy, and challenges encountered. As an example, the Rocky Mountain Tribal IRB involved multiple tribal nations working together to extend more adequate human subject protection for AIAN communities. Tribal IRB’s aims are to promote Belmont Principles while advancing community confidentiality and social justice principles requiring research include clearly delineated potential benefits towards the improvement of tribal health. American Indian and Alaska Native ethical principles and practices will be described and defined, challenges and strengths of promoting tribal institutional review boards will be examined, and an analysis of sustainability strategies will be discussed to promote tribal ethical practices. Practical suggestions for improving tribal health disparities by advancing improved funding and indigenous targeted infrastructure capacity development will also be discussed.