Disquiet on the research front : surveying the battle ground between researchers and human research ethics committees

In this paper, I play with the metaphors of war and peace (with apologies to Leo Tolstoy) as a strategy for describing the relations between (some) social science researchers and human research ethics committees. Even a cursory survey of recent literature reveals a raft of grievances and grumblings amongst researchers about the operation and decisions of research ethics committees. This paper presents a partial survey from both sides of some of the claims that have triggered this unofficial declaration of war, and discusses the implications for ethical research. My central argument is that the truly ethical moment lies in mutual and constructive conversations and critique between ethics committees and researchers.

Navigating the ethics of cross-cultural health promotion research

Health promotion researchers must consider the ethics of their research, and are usually required to abide by a set of ethical requirements stipulated by governing bodies (such as the Australian National Health and Medical Research Council) and human research ethics committees (HRECs). These requirements address both deontological (rule-based) and consequence-based issues. However, at times there can be a disconnect between the requirements of deontological issues and the cultural sensitivity required when research is set in cultural contexts and settings etic to the HREC. This poses a challenge for health promotion researchers who must negotiate between meeting both the requirements of the HREC and the needs of the community with whom the research is being conducted. Drawing on two case studies, this paper discusses examples from cross-cultural health promotion research in Australian and international settings where disconnect arose and negotiation was required to appropriately meet the needs of all parties. The examples relate to issues of participant recruitment and informed consent, participants under the Australian legal age of consent, participant withdrawal when this seemingly occurs in an ad hoc rather than a formal manner and reciprocity. Although these approaches are context specific, they highlight issues for consideration to advance more culturally appropriate practice in research ethics and suggest ways a stronger anthropological lens can be applied to research ethics to overcome these challenges.

Codes of ethics in corporate Sweden

Purpose – The purpose of the study is to examine and describe the use of codes of ethics in the top 100 companies operating in the Swedish corporate sector. This paper reports on the responses of those companies that possessed a code of ethics.

Design/methodology/approach – A three-stage research procedure was used. First, a questionnaire was sent to the public relations managers of the top 100 companies operating in the Swedish corporate sector (based on revenue). Companies were asked to answer up to 29 questions and to supply a copy of their code of ethics. The second stage involved content analysis of the codes of ethics supplied by survey respondents. The third stage involved a more detailed follow-up of a smaller group of firms that appeared to be close to best practice. Findings for Stage 1 of the research are reported in this paper. The areas of questioning were: how common are codes of ethics? Who was involved in the development of these codes? What are the reasons for the codes? How are they implemented? Do companies inform internal and external publics of the codes? What are the prescribed benefits of the codes?

Findings – It would appear that business ethics has only recently become a topic of interest in corporate Sweden and that many companies are in the early stages of code development and assimilation into company policies. The incidence of codes in the population (of 100) suggested by this survey (56 per cent) is lower than a US study finding (in 1995) that over 84 per cent of comparable US companies had codes of ethics. It would appear that Sweden today lags behind the US situation of 1995. When one investigates the special measures to support the inculcation of ethical values at the organizational level, there appears to be some shortfall. The supporting measures of ethics committees, ethics training committees, ethics training, ombudsman, an ethical audit and procedures to protect whistleblowers appear to be under-utilized in companies that possess codes. This lack of utilization tends to suggest that companies in Sweden, as yet, either have not developed a high commitment to supporting business ethics in their corporations, or they may have developed other methods to support their codes in their organizations that they view are as beneficial as the traditional methods practised in other western industrial democracies.

Research limitations/implications – This research was limited to internal ethical expectations. The commitment to business ethics is usually explored in terms of internal ethical expectations, but the simultaneous consideration of the external ethical expectations in the marketplace (e.g. among suppliers and customers or other publics) is desirable. A dyadic approach considering a company's internal ethical expectations and the external ethical expectations of a company's business activities may give a more balanced and in-depth approach.

Practical implications – Evidence is now available to show that codes of ethics are well developed in many of Sweden's largest corporations: organizations that, from their responses, appear to see a diverse range of benefits in developing the area of business ethics. Companies are beginning to implement not only a code of ethics, but other complementary initiatives that reinforce the need for the culture of the organization to be ethical. Codes of ethics are perceived by organizations to have assisted them in their dealings in the marketplace and many companies use their ethical values to underpin their strategic planning process. It appears that many companies now see the formalisation of business ethics as an integral part of their commercial practices.

Originality/value – This study is the first one of its kind on codes of ethics in corporate Sweden. It will enable all sectors of Swedish business to benchmark their efforts against the major companies in the Swedish corporate sector.

Creating collaborative spaces : the pleasures and perils of doing multi-disciplinary, multi-partner qualitative research

This paper describes our experience of managing a two-year research project that involved University staff from two different disciplines and three industry partners. It describes the benefits we gained from the involvement of multiple parties, such as the ability to call upon diverse expertise, the capacity to study a complex issue and the ability to make a direct contribution to industry practice. It also describes some of the difficulties such as managing across University structures, maintaining the collaborators' interest in the project, gaining approval from multiple ethics committees and managing the expectations of various stakeholders. The paper concludes with a number of recommendations for senior University staff and for researchers and points to ways universities could better facilitate involvement in these types of complex research projects.

The regulation of research by funding bodies : an emerging ethical issue for the alcohol and other drug sector?

The degree to which funding bodies can and do control the content and dissemination of research products raises important issues which need to be openly debated by the alcohol and other drug (AOD) sector. Current policies relating to censorship and other means of controlling research topics or output are explored alongside an examination of how some institutions, particularly some academic journals, deal with such issues. We argue that regulation of research by funding bodies clearly contravenes the scientific ideal of freedom of information and open access to knowledge. Using international ethical guidelines, we also demonstrate that regulation raises concerns in relation to the ethical concept of beneficence. A number of examples specific to harm reduction strategies are presented in order to demonstrate how censorship might conceivably increase the harms associated with drug use. The commentary closes with recommendations concerning the establishment the prevalence of censorship and other forms of control over research in the AOD sector, and the role that ethics committees, journal editorial boards and professional societies might play in resisting the imposition of unacceptable conditions on publication of findings.

Doing research with teachers, parents and students : the ethics and politics of collaborative research

Truly collaborative research partnerships between universities and schools are seldom commonplace (Potter, 2001). Many schools – particularly those in disadvantaged communities – have long histories of being involved in research yet few see themselves with real investment in, ownership of and/or benefiting from the experience. In this chapter we discuss research conceived with more mutually beneficial researcher-researched relations, cognisant of the ‘importance of respecting and ultimately giving more than we take to the communities we research’ (Schultz, 2001, p. 1). The research involved teachers’, parents’ and students’ engagement with schooling in a secondary school in regional Australia. Rather than conducting the research on others, we attempted to craft our project with them. Michelle Fine (1994) argues that a decision to work with those we once might have written about or for, necessarily changes our work, making it both more ethical and more explicitly connected to struggles for social justice. This chapter draws on the voices of the teachers, parents and students we worked with and alongside during the research to explore the ethics and politics of such an approach.

Space, place and race: Ethics in practice for educational research in ethnically diverse rural Australia

Research in Australia’s ethnically diverse rural and regional communities requires an approach that is informed by notions of space, place and culture, and which recognises race as a relational social construct mediated by social and political discourse and context, and prone to change overtime. This critical review examines how teacher education researchers connect culturally competent research and rural ethics with the view to improving education systems, addressing rural teacher workforce issues, informing the preparation of pre-service teachers, and, most importantly, ensuring that rural students have access to educational opportunities that are engaging and meet their needs. It focuses specifically on researcher positionality on the insider-outsider continuum and how this informs ethical research in diverse rural communities, particularly those in which visible new migrants reside. Peer-reviewed journal articles that discuss how education researchers negotiate working in rural space are examined and considered in relation to discourse about ethics in practice and the insider/outsider continuum. Scholarship reflected in the literature spanned the fields of rural/research ethics, inclusive education, education research methodology and research with new migrants, minority and marginalised groups.

The moral imperative of designating patient safety and quality care as a national nursing research priority

Since the early 1990s, research studies conducted respectively in the USA, UK and Australia have found that between 4 and 16.6 per cent of patients suffer from some kind of harm (including permanent disability and death) as a result of human errors and adverse events while in hospital. It has been further estimated that approximately 50 per cent of these human errors/adverse events resulting in harm could have been prevented. In response to the significant financial, social, and political implications of these figures, a range of processes have been put in place in an attempt to improve patient safety and quality care in Australia. Nonetheless, it is evident that more can be done to improve the status quo. One process that warrants consideration is that of peak health professional groups and organisations providing active leadership in the promotion of patient safety, such as by making a visible and recognisable commitment to patient safety as a strategic research priority area. In this paper it is contended that, given the moral importance of patient safety and quality care in nursing and related health care domains, the inseparable link between nursing practice and patient safety, and the central role that research has to play in driving safety improvements in these domains, it is morally imperative that the nursing profession gives sustained and focussed public attention to patient safety and quality care as a national research priority.

Women clinical nurses' constructions of collegiality : an ethnomethodological study

This research is about a shared journey of being together. It involved thirteen women nurses (including myself) in a process approach to working with data collected through audio transcriptions of conversations during group get-togethers, field notes and journalling over twelve months. The project was conducted in a large acute care metropolitan hospital where the ward staff interests lie in a practice history of the medical specialty of gynaecology and women's health. Prior to commencement ethical approval was gained from both the University and hospital ethics committees. Accessing the group was complicated by the political climate of the hospital, possibly exaggerated further by the health politics across the state of Victoria, at a time of major upheaval characterised by regionalism, rationalisation and debt servicing. In order to ascertain women clinical nurses' constructions of collegiality I adopted an ethnomethodological approach informed by a critical feminist lens to enable the participants to engage in a process of openly ideological inquiry, in critiquing and transforming practice. I felt the choice of methodology had to be consistent with my own ideological position to enable me to be myself (as much as I could) during the project. I wanted to work with women to illuminate the ways in which dominant ideologies had come to be apprehended, inscribed, embodied and/or resisted in the everyday intersubjective realities of participants. The research itself became a site of resistance as the group became aware of how and in what ways their lives had become distorted, while at the same time it collaboratively transformed their individual and collective practice understandings, enabling them to see the self and other anew. Set against the background of dominant discourses on collegiality, women's understandings of collegiality have remained a submerged discourse. Revealed in this work are complex inter-relationships that might be described by some as collegial!, but for others relations amongst these women depict alternative meanings in a rich picture of the fabric of ward life. The participants understand these relations through a connectedness that has empathy as its starting point. In keeping with my commitment to engage with these women I endeavoured to remain faithful to the dialogical approach to this inquiry. Moreover I have brought the voices of the women to the foreground, peeling away the rhizomatic interconnections in and between understandings. What this has meant in terms of the thesis is that the work has become artificially distanced for the purposes of academic requirements. Nevertheless it speaks to the understandings the participants have of their relationships; of the various locations of the visible and invisible voices; of the many landscapes and images, genealogies, subjectivities and multiple selves that inform the selves with(in) others and being-in-relation. Throughout the journey meanings are revealed, revisited and reconstructed. Many nuances comprise the subtexts illuminating the depths of various moral locations underpinning the ways these women engage with one another in practice. The process of the research weaves through multiple positions, conveying the centrality of shared goals, multiple identities, resistances and differences which contribute to a holding environment, a location in which women value one another in their being-in-relation and in which they stand separately yet together.

Ethical issues in forensic and correctional research

It is surprising that while the literature on ethical issues associated with social science research is burgeoning and becoming increasingly sophisticated very few papers have been written on the ethics of forensic or correctional research. The literature that exists is disappointingly narrow and superficial, and relies on professional ethical codes to a considerable degree. In this paper we present an ethical framework developed by Ward and Syversen to help with ethical decision making in research contexts. We then discuss some of the specific ethical challenges for researchers working in forensic and correctional domains, and consider how best to deal with ethical problems drawing from this framework. Our aim will be to provide researchers with some general ideas of how to proceed in certain situations rather than come up with a final set of answers to every conceivable problem.

A parallel-group, randomised controlled trial of a multimedia, self-directed, coping skills training intervention for patients with cancer and their partners: design and rationale

Introduction:

Positioning research and new knowledge systems

Debates into the positioning of research and aligning them with new knowledge systems has received mixed reactions. Many argue that research needs to follow discrete silos of disciplinary knowledge where knowledge needs to remain within a particular and defined construct. However, in the global world that we now embrace, there is a burgeoning of new knowledge systems that have disrupted ‘traditional’ processes of carrying out research and foregrounded the encompassing of new knowledge systems that follow research pathways and methodologies that are all encompassing of the multifaceted educational and social systems that embrace specific postcolonial and indigenous societies. Much of this corollary has stemmed from historical and political factors that have seen the rise of some disciplines of knowledge and the non-awareness’s and non-recognition of others. This paper articulates from an auto-ethnographic perspective the discussion surrounding the positioning of research, new knowledge systems and interdisciplinary learning in the areas of International and Aboriginal students. Focusing on postcolonial theory and Aboriginal approaches to research, the author foregrounds the tensions of historiography, hybridity, subjectivities, collaborative sharing and voice through what she terms a ‘strands of knowledge’ approach in these two areas. In the process, the author conceptualises two definitions. These are: intra-paradigm shifts and the irreducibility of the ethics of research and discusses how they are integral concepts when researching in or around particular cultural communities and groups.

The relevance to international mergers of the ethical perspectives of participants

International mergers are becoming more widespread among medium-sized companies that for decades have held a prime position in their home country market, but who now feel threatened that they may not be of a significant size to continue to be viable in the international marketplace. The purpose of this paper is to examine the merger of one Australian company and one of its former competitors in the international marketplace from the perspective of the congruence between their espoused ethical cultures in business prior to the merger. A questionnaire comprising 46 questions was sent to the public relations manager of each organization prior to the merger. These managers were asked to fill in the questionnaire and to provide a copy of their code of ethics. The research found that organizations need to not only have a code of ethics, but also need to focus especially on the area of code augmentation to ensure that they communicate the ethos of their code to their employees.

Developing a placebo-controlled trial in surgery : issues of design, acceptability and feasibility

Background: Surgical placebos are controversial. This in-depth study explored the design, acceptability, and feasibility issues relevant to designing a surgical placebo-controlled trial for the evaluation of the clinical and cost effectiveness of arthroscopic lavage for the management of people with osteoarthritis of the knee in the UK.
Methods: Two surgeon focus groups at a UK national meeting for orthopaedic surgeons and one regional surgeon focus group (41 surgeons); plenary discussion at a UK national meeting for orthopaedic anaesthetists (130 anaesthetists); three focus groups with anaesthetists (one national, two regional; 58 anaesthetists); two focus groups with members of the patient organisation Arthritis Care (7 participants); telephone interviews with people on consultant waiting lists from two UK regional centres (15 participants); interviews with Chairs of UK ethics committees (6 individuals); postal surveys of members of the British Association of Surgeons of the Knee (382 surgeons) and members of the British Society of Orthopaedic Anaesthetists (398 anaesthetists); two centre pilot (49 patients assessed).
Results: There was widespread acceptance that evaluation of arthroscopic lavage had to be conducted with a placebo control if scientific rigour was not to be compromised. The choice of placebo surgical procedure (three small incisions) proved easier than the method of anaesthesia (general anaesthesia). General anaesthesia, while an excellent mimic, was more intrusive and raised concerns among some stakeholders and caused extensive discussion with local decision-makers when seeking formal approval for the pilot. Patients were willing to participate in a pilot with a placebo arm; although some patients when allocated to surgery became apprehensive about the possibility of receiving placebo, and withdrew. Placebo surgery was undertaken successfully.
Conclusions: Our study illustrated the opposing and often strongly held opinions about surgical placebos, the ethical issues underpinning this controversy, and the challenges that exist even when ethics committee approval has been granted. It showed that a placebo-controlled trial could be conducted in principle, albeit with difficulty. It also highlighted that not only does a placebo-controlled trial in surgery have to be ethically and scientifically acceptable but that it also must be a feasible course of action. The place of placebo-controlled surgical trials more generally is likely to be limited and require specific circumstances to be met. Suggested criteria are presented.