Fletcher points to streamlined ethics review processes introduced in New Zealand and the United Kingdom. There is also a Canadian solution. Public Health Ontario has developed a process wherein all studies involving human participants receive an initial risk screening to determine the required level of ethical scrutiny.2 Similar to the New Zealand protocol with 24 questions,3 the Public Health Ontario process involves a 20-item risk-screening tool, which sorts projects into one of four review levels: full ethics board review, a conventional delegated review process, an expedited delegated review process or no further review with periodic audit (manuscript currently under review).