Today the BMJ publishes a clutch of papers on the regulation of clinical research by ethics committees.1^–5 All describe, in one way or another, how ethics committee review may impede and delay research, sometimes even to distort the methods so much that the conclusions are flawed and patients damaged—an unintended unethical consequence.

Although this is not just a problem in the United Kingdom, to know exactly what is going on in other countries is difficult. If the situation is anything like that in the United Kingdom it will be confusing, changing all the time (just last month the UK government notably altered its human tissue bill), and made even more confusing by varying guidance from official bodies such as the General Medical Council and the BMA. Clearly, international differences are a particular problem for multicentre research across national boundaries. For example, unlike in the United Kingdom, …