'Wicked' ethics: Compliance work and the practice of ethics in HIV research

► Qualitative study of research ethics regulation in five HIV clinics in US, Thailand, South Africa, and Uganda. ► Argues that research ethics is a 'wicked' problem and regulation often has unintended consequences and creates new problems. ► Compares “official ethics” with “ethics on the ground” in HIV clinics that are engaged in both treatment and research. ► Argues that “official ethics” substitutes bureaucratic ethics for other systems of ethics and displaces personal morality. ► Argues that “official ethics” sometimes does a better job of protecting research organizations than research subjects.