Many ethnographic researchers have raised concerns over the potential impacts that the institutionalization of ethics review boards can have on social science research, especially within healthcare settings. However, few articles to-date have documented how these norms and practices play out in actuality. This paper, therefore, uses autoethnography to provide an account of three ethical challenges that arose during my process of seeking ethics approval through institutional review boards to conduct ethnographic fieldwork in a healthcare setting. In doing so, I demonstrate how bureaucratic accountability took precedence over my research expertise, making the research that I initially set out to do inaccessible, questionable, and 'unethical', despite being carried out in accordance with the current standards governing research involving human participants and their data. I conclude with ways to move beyond this existing ethics structure towards a more collaborative approach between ethics boards, researchers, and research participants grounded within the realities of the field.