Abstract
Hyder and colleagues’ (2014) article demonstrates that the distinctive features of health systems research give rise to nuanced ethical considerations in areas like informed consent, risk, and benefit. Yet it focuses primarily on ethical issues that fall within the purview of institutional review boards (IRBs). This gives an impression (likely not intended by the authors) that the scope of health systems research ethics principally covers the traditional range of issues that arise at the project level in international research. In doing so, the article largely fails to highlight how the ethics of health systems research in low and middle-income countries (LMICs) is fundamentally connected to a “broader bioethics agenda of equity and population health” (Daniels 2006, 22). […]