Can research ethics be guided? How can ethical research practices be stimulated? Questions like these are discussed by the Mini-Committee on Ethics and Politics, a multidisciplinary group of researchers in La Paz, Bolivia. Our activities grew out of the ten-year experience of the Committee for Research, Evaluation and Population and Development Policy (CIEPP), one of several committees now affiliated to the National Forum for Sexual and Reproductive Health. 

Since 1999, the Mini-Committee has worked on the design of an instrument to assist researchers in applying ethical principles. Check-list of elements to consider? List of recommendations? Dossier of articles? First-person accounts of field dilemmas? Eventually we decided on a combined approach. As commissioned authors, we prepared a series of essays on ethical issues incorporating references from the international literature. To complement the text, several researchers contributed narratives analysing ethical problems they had personally encountered.

Ethical guidelines carry the historical burden of abuses already perpetrated. International codes were developed after World War II atrocities committed in the name of medical research. Cases such as the Tuskegee Syphilis Study (1932-1972) and the studies of Milgram (1963) and Humphreys (1970, 1972) came to signify negative examples of what ethical research seeks to avoid (1).

As Daphne Patai stresses, ‘ethics is a matter not of abstractly correct behavior, but of relations between people’ (2). These relations are not horizontal, and researchers have responsibility for their initiative in approaching those they wish to study. Reflexivity becomes a necessity in ethical research, to acknowledge our own values; to signal the partiality of our representations of others; and to consider others’ perceptions of our presence in the field.

Researcher self-presentation can help subjects evaluate the pros and cons of their involvement, but it cannot ensure ‘informed consent’. Kathleen Slobin found that people in the rural Mali villages where she did fieldwork often assumed that she was a doctor: “My claims to the contrary, accompanied by explanations that I was merely a research sociologist interested in family health care, were generally met with responses ranging from confused acceptance to disbelief” (3). Rather than a one-off declaration of acceptance giving the researchercarte blancheto intervene at will, informed decision-making is a process requiring repeated negotiation.

Applying the principle of distributive justice opens up complex issues of material and symbolic risks, costs and benefits. In our research endeavours, who gains, who loses and who pays? One Bolivian researcher told of her discussion with sex workers about cash payment for their participation in an encounter: “They said: ‘Time costs! You’d have to pay us.’ We paid them. It was their time they valued. It was a very special population. It’s not the same with other groups like adolescents. I wouldn’t agree to pay them. The benefit is more for them!” We concluded that in the situation described, the sex workers’ ‘specialness’ lay in their experience in asserting the monetary value of their time. Through their negotiation, they laid bare the fact that the primary benefit of the encounter was for the researchers.

In this dialogue between literature on ethics and researchers’ narratives, our methodological proposal started to take shape. The final chapter of our publication (4) sets out a way of working on ethics as part of research practice. We attempt to bridge the gulf between principled intentions declared at the outset, andpost hoclamentations of failure to act ethically.

In our proposed method – Ethical Mapping with repeated cycles of Anticipation, Decision/Action and Retrospective Reflection – the research process is drawn as a road with forks. The forks represent ethical dilemmas confronted and different options identified in each case. Researchers are taken to be active and reflexive subjects. They are encouraged to analyse the pros and cons of each alternative, to decide and act in consequence. Since the road is not linear, opting for a solution offers no guarantee that old dilemmas will not re-emerge and negotiation again be needed.

Ethical Mapping also takes researchers to be strategists and planners who can anticipate certain ethical problems. Although we agree with Badiou on the situational character of ethics (5), we also consider that some ethical dilemmas can be foreseen, and steps taken to prevent or minimise potential harm.

We adopt the idea of map construction developed by Schatzman and Strauss (6) as a useful anticipatory method. Mapping is a process of information gathering, organisation and analysis that allows an overall perspective of the imagined field. A map can be graphic, visual or narrative. Regardless of its particular medium of expression, a map is a strategic, analytical and planning tool.

Schatzman and Strauss identify three types of maps: social, spatial and temporal (7). We adapt the concept and propose the development of ethical maps. An ethical map can incorporate social, temporal, spatial, political, economic and other components considered relevant for each context. It is an analytical tool that facilitates the comprehension of particular research situations and relationships. It also serves as a starting point to define strategic measures to pre-empt or minimise ethical conflicts.

Ethical dilemmas actually encountered may or may not have been foreseen. In any case, they imply the consideration of a range of possible alternatives from political, ethical and methodological angles. Researchers will have particular analytic perspectives and priorities, and their decisions will also respond to specific situations. 

From our point of view, the issue is not whether researchers are ‘ethical enough’ in their decisions.  We concentrate, rather, on the quality and transparency of the decision-making process. Our emphasis is also epistemological, since decisions made simultaneously reflect and influence the process of knowledge construction.

As part of our methodological proposal, we developed a ‘Sheet to guide decision and action’ (8), where researchers can register the dilemma confronted, the different alternatives analysed and the decision made. To illustrate the use of this tool, we here present a hypothetical example concerning issues of confidentiality, anonymity and identification of participants in the publication of a research report. 

Our researcher has studied topics relating to adolescents’ lives in two schools. She has doubts about how to refer to the schools in the publication of the research findings, which include sensitive data that could negatively affect the institutions and/or individual subjects. 

Her first alternative is to name only the general locations, without describing precise characteristics of the schools. This would allow her to contextualise the findings without explicitly violating confidentiality and anonymity. However, it could ultimately allow readers to identify the schools and persons cited.

Her second alternative is to describe both the areas and schools in general terms without giving any names. This option guarantees subjects’ confidentiality and anonymity, but does not allow for the possible desire of institutions and/or individuals to appear in the publication.

The third option is discussing with the subjects of the study how they would like to be identified. This process would enable individuals and institutions to express their interests and preferences. However, it could also expose them to risks and consequences that cannot be foreseen at present. The researcher’s decision is left as a question mark.

The third moment in our model is retrospective reflection, which gives researchers an opportunity to formulate an overall analysis of ethical issues encountered to date in a project. There is no specific format for this purpose. The only requirement is the will of researchers and other influential actors (e.g. funding institutions) to look back on their actions in a self-critical manner.

Wrote one Bolivian researcher, analysing a past field experience: “I think I shouldn’t have given her my opinion about her life. I didn’t do too badly as a counsellor, but this was not what I was supposed to do at that moment. It is difficult for me not to get involved with the woman I interviewed, since I sometimes feel that I have a commitment to her; it’s the gratitude I feel for the help she gave me by telling me about her experience (...).” As authors, we consider that analytical reflection carries the potential to stimulate research practices that are more democratic and respectful of the identities, knowledge and rights of others.

We have usefully applied ‘Ethical mapping’ to our own research experiences, past and present. In an international workshop in India on abortion research (9), colleagues presenting a study done in West Kenya (10) used the method to critically reflect on issues of confidentiality that they had anticipated, encountered and addressed to varying degrees. Bolivian colleagues have been stimulated to incorporate ethical reflections in their theses and research reports. We shall present the model to the National Committee for Bio-ethics, founded in September 2000 with support from the Panamerican Health Organisation (PAHO/WHO).

Our proposal offers no recipes or solutions, no guarantee of success. We offer it as a methodological contribution to those seeking to carry out ethical work, understood as a process in which researchers bear the fundamental responsibility for their material and virtual relations with others.  

DIAGRAM 

References:

1.See Punch M: ‘Politics and ethics in qualitative research’, in Denzin NK andLincoln YS (eds.) Handbook of aualitative research. Thousand Oaks, London, New Delhi, Sage Publications 1994.

2. Patai D: ‘US Academics and third world women: is ethical research possible?’, in Gluck SB and Patai D (eds.) Women’s words: the feminist practice of oral jistory, New York and London, Routledge 1991.

3. Slobin K: ‘Fieldwork and subjectivity: on the ritualization of Seeing a Burned Child’, Symbolic Interaction 18(4):487-504.

4. Rance S, Salinas S: Investigando con ética: Aportes para la reflexión-acción, CIEPP, La Paz 2001.

5. See Abraham T: ‘Batallas éticas’, in Abraham T, Badiou A and Rorty R Batallas Éticas. Buenos Aires, Ediciones Nueva Visión 1997.

6. Schatzman L, Strauss AL: Field research: Strategies for a natural sociology. Englewood Cliffs, NJ, Prentice-Hall 1973.

7. Ibid.

8. Rance S, Salinas S op. cit.

9. ‘Lessons learned from abortion research: International perspectives’, Ipas, Manesar, New Delhi, 14-16 March 2001.

10. Rogo K, Bohmer L, Ombaka C: Community level dynamics of unsafe abortion in western Kenya and opportunities for prevention: summary of findings and recommendations from pre-intervention research. Los Angeles, Pacific Institute for Women’s Health and Nairobi, Center for the Study of Adolescence, 1999.