As more patients become citizen-scientists and conduct research on themselves, with peer-reviewed journals increasingly publishing the results, ethicists are considering how to tailor ethical oversight to reduce bias and increase safety. Ethical oversight needs to be flexible enough to accommodate the distinctive character and various forms of patient-led research, Institute of Biomedical Ethics research fellow Effy Vayena writes. Vayena and colleagues discuss in the journal PLoS Medicine possible models for oversight.