TABLE 4.

UGC-Vilnius and CWRU Alumni Perceptions of Key Barriers to Building Research Ethics Capacity in Post-Communist Countries.

Component Model Category	Perceived Barrier
Enabling and Developmental Conditions	Decision making driven by economics
	Legal nihilism
	Lack of public transparency
	Medical paternalism
	Political, judicial, and institutional corruption
	Lack of human rights for stigmatized and vulnerable populations
National and Institutional Commitment	Lack of research ethics legislation and policies
	Lack of regulatory enforcement
	Lack of institutional support for RECs
	Lack of an organized structure to collect information on REC effectiveness
Clinical Researcher Conduct	Inadequate knowledge and training
	Lack of funding for research ethics training programs
	Uncontrolled conflicts of interest
REC Expertise and Commitment	Lack of transparency in appointments and review
	Lack of procedural and regulatory clarity
	Lack of training of REC members