Improving the conditions under which incarcerated populations give "informed consent" is a desirable goal given prisoners' lack of autonomy; part of the Institutional Review Board's (IRB) procedures is the inclusion of representative voices from the prisoner population as a mechanism to reduce harms. The most recent review of the ethics of research on prisoners by the Institute of Medicine recommends an expanded role for prisoner involvement, outlining a collaborative research approach involving prisoners as active participants in "all" aspects of the research, including design, planning and implementation, not just at the IRB stage. In this paper, we briefly outline the existing state of IRB protections for prisoners selected for research, and focus on the effectiveness of prisoner representatives in this process. We suggest that there are weaknesses within the existing system such that representation may provide little more than ideological legitimation for the process. Moreover, we argue that while the Institute of Medicine's recommendations mark a major improvement in protection vis-a-vis prisoner representation, it does not go far enough in articulating the process whereby the voices of prisoners, their advocates or their representatives are included in the different stages of the process. In short, we question whether "being heard" is enough. We suggest that research needs to be conducted to more extensively map the scope of this issue and to raise some critical questions in order to improve the effectiveness of the ethical considerations for research on prisoners, as well as the IRB process and any post-IRB oversight, in protecting this vulnerable population.