I was having a conversation with GPET Aboriginal Health Training team yesterday, as we prepared our session on Thursday for research week. In our discussions about ethics, we revisited the appalling human rights violations that have occurred in the name of medical research. It reminded me of the difference between procedural research ethics and “ethics in practice”, well described by Guillemin and Gillam from the University of Melbourne in their 2004 article.
Procedural research refers to the ethical approval we all seek from relevant ethics committees before we commence our research. There is usually also background ethical codes of conduct, which underpin the design and implementation of our research practice. For those of us working with Aboriginal and Torres Strait Islander communities, this includes the NH&MRC Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research. Although ethical approval is often seen as a formality, as a hurdle to overcome before we “get on with it”, the ethics form does trigger us to consider important ethical issues that protect our participants from obvious forms of abuse. But it doesn’t help us a lot with the everyday ethical dilemmas we face, particularly in qualitative research.
The second type of ethics we encounter occurs during the research. What happens if a participant discloses that she feels unsafe because of domestic violence during a qualitative interview? How distressed does a participant need to be to abandon an interview? Guillemin and Gillam describe these dilemmas as “ethically important moments”: “the ethical obligations a research has toward a research participant in terms of interacting with him or her in a human, nonexploitative way while at the same time being mindful of one’s role as a researcher.” p 264
The national statement on ethical conduct in human research says that the key principle is respect: “respect for the dignity and well-being of persons takes precedence over the expected benefits to knowledge.” There is obviously a tension here: most research does not result in a direct benefit to participants. However, the tension is resolved when the researched become true participants in the study rather than the subjects of the study. Treating people as participants means considering what informed consent, respect for autonomy and the avoidance of harm really means interview by interview, moment by moment.
This is a type of reflexivity, the commitment to step back and take a critical look in your own role in your research. It requires you to examine whether you are really respecting the autonomy, dignity and privacy of the participants moment by moment throughout the research process.
We’ll have a look at this in our session on Thursday, looking at what it really means to do research with Aboriginal communities, rather than on them. We’ll look at how research practice needs to embody ethical principles. And we’ll discuss what happens when you need to respond to or address ethical concerns that arise during research.
Reflexive ethical practice requires us to consider what we want to be as researchers, not just what we wish to do.