Research methods unit III Scholarly Activity
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4 NURSERESEARCHER 2010, 18, 1
commentary
The three themed papers in this edition identify particular issues in the ethi-
cal conduct of qualitative research. Some concerns are common to all three
papers and other concerns raise queries related to the conduct of the authors’
own research. This commentary will focus on three of these issues: gaining
access and recruitment, informed consent and the relationship between the
researcher and participant.
Ethical challenges in the conduct of qualitative research Desley Hegney and Tuck Wai Chan highlight the issues of particular relevance to qualitative studies
NURSERESEARCHER 2010, 18, 1 5
Accessing the research site and recruiting participants raise many ethical
questions that researchers need to take into consideration before starting
their research. Although the focus of the research might differ, the issues are
much the same for research by qualitative researchers as they are for those
involved in quantitative research. Houghton et al (2010) and Walls et al
(2010) describe how they required assistance from clinical staff to distribute
information about their research as part of their recruitment processes. Three
distinct steps are suggested:
Clinical staff can ask patients if they are interested in participating in research,
and if they are they are given written information. If, after reading this informa-
tion, the patients are still interested in participating in the research they contact
someone from the research team. Potential participants can then choose to opt
in or opt out and are also able to withdraw at any time.
Removing the researcher from the consent process until the potential par-
ticipant is willing to meet them helps to ensure that individuals do not feel
coerced into taking part in the research. In some instances, however, it is not
possible to use this process to recruit participants. For example, Houghton et al’s
(2010) research involved the observation of students who were providing care
to patients and, therefore, involved healthcare staff, patients and visitors to the
research area. The authors discuss their process for obtaining informed consent
to collect data in a public space. They note that visitors to the clinical area can
also become part of the research and that there can be difficulty in ‘deciding
from whom to obtain informed consent and by what means’. The strategy used
to overcome this was to place posters in public spaces to inform visitors and to
provide information sheets for the ward staff. What the authors do not consider
is what might happen if a visitor does not consent to participate in the research.
Does this mean they are unable to visit their relative or does it mean that the
research must be suspended?
A controversial alternative might be for research participants to opt out rather
than to opt in to some forms of research. That is, if people do not indicate their
desire not to be involved in the research then they are considered to have con-
sented to be in the research. How participants had received sufficient informa-
tion would, of course, need to be demonstrated to and then approved by the
relevant research ethics committee (REC). Houghton et al (2010) consider how
6 NURSERESEARCHER 2010, 18, 1
commentary
a ‘potentially exploitative relationship’ can arise between the researcher and the
research participant and link this to the ethical principles of ‘autonomy, benefi-
cence and justice’. In the conduct of their research, and in all human research, the
principle of justice is the most important. Are the students being treated as mere
objects of the researcher or as a resource with little or no consideration of their
wellbeing? A similar question could be asked when conducting sensitive research
as described by McGarry (2010). Given the sensitive nature of the research, are
the participants the right ones to be recruited or are they simply a group that is
easy to access?
Houghton et al (2010) also discuss the principles of beneficence and non-
maleficence, noting that the researchers have to ‘calculate the risk-benefit
ratio’. They state that the ‘benefit of the interview does not outweigh the
harm of distress’. This statement acknowledges that all research carries the
risk of some harm; it is just the degree of harm that has to be balanced. They
note that if the interviewee becomes distressed then the researcher ‘may
(our emphasis) refer participants to appropriate professional intervention’. It
could, however, be argued that researchers have an obligation to take action.
Consideration should also be given to the fact that the distress constitutes an
adverse event which must be reported to the REC. In any research protocol,
harm should be anticipated and processes put in place to manage it.
Houghton et al (2010) also highlight the complex ‘dual role of the clinician
and researcher’. They use the example of a ‘potentially dangerous’ situation
where the researcher observes poor care. They argue that here the researcher,
as a nurse, should intervene. There are arguments in some research disci-
plines that interfering in this way might not be appropriate, but when the
researcher is a nurse, with a professional obligation that takes precedence
over their role as a researcher, they have no choice but to always consider the
care of the patient first. Houghton et al (2010) demonstrate the complexity
of this relationship by describing research in which a nurse researcher was
observing a nursing student delivering care to a patient. They say that if
researchers observe harm they are obliged to intervene. It could be argued
that the obligation not to cause harm in this situation rests with the student.
Further, the nurse-researcher has no obligation beyond reporting the situation
to another member of staff. Researchers need to be aware of which role they
NURSERESEARCHER 2010, 18, 1 7
are working in and that they have multiple roles (nurse, teacher, researcher)
and must consider how these roles might clash with or affect their research.
These three papers have examined some interesting ethical considerations
but they also suggest that the ethical conduct of qualitative research (in the
social behavioural research ethics paradigm) is somehow different to that of
quantitative research. While many RECs may believe that there is a greater
risk of harm from poorly designed social science research, this is not neces-
sarily so. Ethical principles should equally apply to all research regardless of
the paradigm being used. Many of the issues considered apply as equally to
quantitative research as they do to qualitative research n
Desley Hegney is director of research, Alice Lee Centre for Nursing Studies,
National University of Singapore and Faculty of Health Sciences, the
University of Queensland
Tuck Wai Chan is associate director, Institutional Review Board,
National University of Singapore
Houghton CE, Casey D, Shaw D, Murphy K (2010) Ethical challenges in qualitative research: examples from practice. Nurse Researcher. 18, 1, 15-25.
McGarry J (2010) Exploring the effect of conducting sensitive research. Nurse Researcher. 18, 1, 8-14.
Walls P, Parahoo K, Fleming P, McCaughan E (2010) Issues and considerations when researching sensitive issues with men: examples from a study of men and sexual health. Nurse Researcher. 18, 1, 26-34.
references
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