Before research with human subjects can commence in the Netherlands the research file must first be approved by an independent committee of experts. This is laid down in the Medical Research Involving Human Subjects Act (WMO).

The review system is a decentral one, whereby accredited reviewing committees spread throughout the country are responsible for the review. The legislator made the conscious decision not to appoint this task solely to the central government. This was to prevent the central government having too much influence on the medical/ethical review of medical research resulting in a form of state ethics.