A federal law requiring National Institutes of Health-funded disease studies to show an adequate representation of women, minorities, and racial and ethnic subgroups is forcing researchers to adopt novel methods of inclusion. These methods often go far beyond incorporating minority groups into their research design plans. Means that investigators have adopted to attract and retain populations that conform to the new law include buying lunch, paying bus fare, opening satellite clinics, even going cross-country to find some groups.

But while innovative researchers and clinicians work to accommodate these NIH inclusion guidelines, as they are called, debate continues about whether institution of these rules represents good science, appropriate social policy, or simply justice.

The law, included in the NIH Revitalization Act of 1993, is an outgrowth of similar NIH regulations adopted in 1986 and 1987 and revised in 1990. All new grant proposals involving human subjects are required to include women,...

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