After a pioneering decade, Bessy Bitzas reflects on leadership of the Research Ethics Board
Her perspective on helping to keep research safe and (scientifically) sound
In spring 2023, Bessy Bitzas, Ph.D., leaves the Research Ethics Board (REB) after more than 15 years as a member, including the final 10 years as Chair. During that time, she played a significant role in guiding the Board, which helps to ensure that research in the Lady Davis Institute (LDI) at the JGH—and throughout CIUSSS West-Central Montreal—is conducted in ways that are safe and ethically sound for the participants.
Shortly before her departure Ms. Bitzas reflected on her years of service with the Board.
You joined the Research Ethics Board when you were a head nurse. What was your interest in research?
At the JGH, we’ve always championed having nurses apply evidence-based best practices in caring for patients. Nursing research, in particular, relates directly to how our nurses provide bedside care, which means being up to date on what the research tells us about providing care of the highest quality.
I was Head Nurse in Palliative Care when I joined the Research Ethics Board in 2007, because I felt it was important to have a nursing representative review the research studies at the JGH. Our hospital has a robust Nursing Research Centre, and our nursing researchers submit their protocols to the Research Ethics Board for review.
Of course, nurses also have projects on the units and in clinics. Some are student projects, others led by nurse clinicians. So we definitely benefit from having a nurse on the committee.
You led a department whose nurses interact daily with dying patients and their families. Would you say your involvement on an ethics board was a natural fit?
It’s certainly true that a palliative care setting is full of ethical dilemmas, as you might expect. Tough questions arise during what is often the most difficult time in the lives of patients and their families. Certainly, I’m interested in addressing all of the moral and ethical situations that can lead to distress, so that we can support our patients and families—as well as our staff—in the best way possible.
Research ethics, however, is different from clinical ethics. The considerations in research ethics are not always the same as those in the delivery of care outside of research. So I had to switch my mind-set and wear two different hats.
You served on the Board for over 15 years. Now, that’s devotion!
Yes! When the Research Review Office was searching for a Chair to replace my predecessor in 2013, I was approached and, thankfully, I had the full support of the Nursing Department. At that time, it was highly unusual for a nurse to be Chair, so I was—and still am—very proud of that.
When I joined the Board, I would never have imagined I would be involved all these years later.
You’ve sat on many committees during your career. How was your experience on this Board unique?
We all sit on “busy” committees, where results can take a long time to be realized. However, on the Board, the members work together to reach conclusions in a single meeting to help guide researchers. That’s really gratifying. We put in a lot of work, but the outcomes are clear and immediate.
I also found the discussions and debates during our meetings to be rich and thought-provoking. I think that has to do with the members being so multi-disciplinary. Sometimes we also pulled in specialists from our huge pool of clinicians throughout our CIUSSS to consult on projects whose subjects were, perhaps, different from the expertise of the committee.
All of the members on the Research Ethics Board—including the science members, the legal members, the ethicists, the community members and the specialists working in the Research Review Office—are so dedicated to doing the best job possible. It was a pleasure getting to know so many talented, intelligent and committed people. They made my job as Chair easier and so enjoyable.
Reviewing so many different types of research may be rewarding, but does this present challenges for the Board?
Most projects directly benefit our CIUSSS’s patients and residents, but the research has helped people well beyond the area the CIUSSS serves. For instance, Dr. Brett Thombs (Psychosocial Researcher in the LDI and Professor of Psychiatry at McGill University) and his team lead projects on a rare disease, scleroderma, often working with dozens of centres around the world. That kind of collaboration is especially vital when you’re studying a rare condition, because it gives you access to a much larger pool of study participants.
In those cases, we would have to coordinate with 50 international centres, each with its own Research Ethics Board, before the study could move forward. Every centre has its own culture and priorities on how it expects scientists to carry out research and to protect the patient-participants.
The laws and regulations are also different from country to country, and even here in Canada, there are variations among provinces. Thanks to the contributions of our core committee members, these are challenges we’ve been able to meet with considerable success.
As you look back on your term as Chair of the Board’s Medical-Biomedical Committee, what do you consider your most memorable moments?
The period that struck me as exceptional was the first wave of the COVID-19 pandemic. Most research activities were interrupted while a new type of urgent, COVID-related research was emerging. Those projects had to be reviewed thoroughly, of course, but also rapidly, given their potential impact.
For instance, during the pandemic, our committee worked closely with Dr. Thombs’s team while they created a novel mental-health intervention. In less than three weeks, with our support, they went from learning about a need, to having a plan, to launching a trial. We discovered afterwards that this research was seen as one of the best related trials out there.
It stands to reason that during a publicly declared emergency, research ethics reviews were carried out differently.
Oh yes, the Board was committed to reviewing all COVID-related protocols within three days. That’s remarkable when you consider that in normal circumstances, committee members have two weeks to review the studies. We also removed our deadlines for submissions, so that anytime a researcher was ready to submit a study for review, we accepted it—even on weekends.
I’m especially proud that the committee members and specialists came together to move that research forward. It was really amazing! It speaks to their dedication and desire to do their part in the research process.
You must have witnessed many changes in research ethics over the years. What do you see as you look ahead?
The volume of projects that we reviewed kept increasing. I think that was largely because of the CIUSSS’s reputation of supporting and valuing research, as well as attracting amazing researchers.
Also, there’s definitely been a trend lately toward projects relating to AI, to developing novel biological and immunological molecules, and to studying emerging technologies.
It’s an exciting era in research. Although I thoroughly appreciated and enjoyed my time as a member and then as Chair of the REB, I will now be focusing on different professional goals. The time is right for the Research Ethics Board to bring in a fresh perspective and new leadership.