摘要：Community-based participatory research (CBPR) addresses the social justice dimensions of health disparities by engaging marginalized communities, building capacity for action, and encouraging more egalitarian relationships between researchers and communities. CBPR may challenge institutionalized academic practices and the understandings that inform institutional review board deliberations and, indirectly, prioritize particular kinds of research. We present our attempt to study, as part of a CBPR partnership, cigarette sales practices in an inner-city community. We use critical and communitarian perspectives to examine the implications of the refusal of the university institutional review board (in this case, the University of California, San Francisco) to approve the study. CBPR requires expanding ethical discourse beyond the procedural, principle-based approaches common in biomedical research settings. The current ethics culture of academia may sometimes serve to protect institutional power at the expense of community empowerment. COMMUNITY-BASED participatory research (CBPR) is a way to identify and address health disparities 1 , 2 by engaging marginalized communities, building capacity for action, and ending relationships of dominance in favor of partnerships working toward health, equality, and parity. 3 Public agencies and foundations have developed research funding mechanisms that encourage CBPR, 4 and multiple obstacles to successful CBPR have been acknowledged. 5 , 6 However, little has been written about how CBPR may fundamentally challenge institutionalized academic understandings that shape ethical deliberations, define research and research subjects, and indirectly prioritize clinical trials and other biomedically oriented studies. For this case study, we drew from communitarian ethics and critical social perspectives to analyze ethical tensions that arose when our CBPR study of single-cigarette sales was denied institutional review board (IRB) approval. We analyzed how an individual-focused, biomedically oriented approach to IRB review of CBPR may have the effect of protecting institutional power structures and perpetuating inequities while precluding research aimed at changing community environments. There is a need for expanded dialogue about the distinctions between individual behaviors and institutional practices, the practical nature of risk calculations, and the potential for institutional conflicts of interest in risk-averse academic environments.
