This article highlights the need to understand the deliberations of Institutional Review Board (IRB). Previous studies on the workings of IRBs have focused largely on their administrative structure, how well they meet certain performance criteria and the outcome of decision-making. The author in this article explains why there is a need to understand how IRBs make decisions and propose a model for assessing IRB decision making. It further informs that most data about the processes of IRB decision-making come from general descriptions of the various individuals who make up IRBs or small group of IRBs.