Towards a Better Fitting Ethical Framework around Qualitative Social-Health Research

每       My case summarises as there are some not entirely helpful traditions within research degree ethical assessment, which, coupled with some myopia and process navigational issues, leaves something of a vacuum to the detriment of potential value-add:-

LET ME START WITH A BIBLE READING, from the Letter of James:

※What good is it, my brothers and sisters, if you say you have Faith but no not have Works? Can Faith save you? If a brother or a sister is naked and lacks daily food, and one of you says, 'Go in peace, keep warm and eat your fill', and yet you do not supply their bodily needs, what is the good of that? So Faith by itself, if it has no Works, is dead.§

These are long-standing debates.

Is faith, the creation of new knowledge, a sterile quest without pressing straight ahead with fresh remedies, works, our gleaming shield of academic faith in one hand and our magic sword of instant betterment in the other?

My purpose today, albeit in the briefest overview, is to give a flavour of how, at least for me, unpacking the Ethical process, which I initially found deeply puzzling, is adding greatly to my work, which is on long term yo-yo dieting.

To the core issues:

The  Helsinki Declaration, after the Nuremberg Code post-death camp experiment atrocities - and evolving thereafter, lays explicit research rights, enshrining the notion of a risk-to-benefit evaluation.

This ideology concretised during the 1970's with such as the Belmont Report, with its active obligation to seek to do good. Beauchamp & Childress, of the famous ※balancing principles§ Autonomy, Nonmalfeasance, Beneficence and Justice have reworked it down to the present day.

The notion of actively ※doing good§ through research 每 beneficence - permeates much ethical commentary. We see the primacy of the enduring risk/benefit measure in the very latest ESRC Research Ethics Framework.

We see the ※do-goodery§ in one of the latest textbooks........in the Ethics chapter of the MMU-well-represented Research Methods in Social Science, we are told that ※Ethical practice is often defined as 'doing no harm'.........we should also aspire to do 'good', in other words to conduct research that benefits participants in positive ways.§ but this stated notion of ※good§ remains undeveloped.

The emerging disciplines of non-clinical qualitative 每 social health 每 research through the 70's & 80's sat largely subsumed within the doctor-patient-centered tradition 每 and they sit shadowed there still, problematically, I contend, with the risks of:

♂      Diffusing the focus of research in terms of knowledge generation by encouraging ※quick fixes§

♂      Exposing the collaborant to significant psychological or even physical risk, conflating therapy and research above the inevitable existing power imbalance

♂      And, related, putting the researcher potentially out of depth with regard to therapeutic competence

The problem summarises that by basing the Social-Health Research ethical debate on the primacy of the misfitting Bioemedical tradition, the procedural rationality of mechanically ※not doing harm§ is pushed too far onwards to a mirror-image imperative to ※doing good§ .

It is surely a dangerous step of vanity to assume that we are players as soon as we step out as researchers.

Currently suggested improvements summarise as Social research being better served by more iterative, intuitive and process-driven ethical perspectives - ※stop, look and listen§ - focusing on context and on the humane.........certainly a major advance on the early Ethnographer stereotype of ※Don Pith Helmet, will blunder forth and Patronise§!

But this recognition, though necessary, is hardly sufficient 每 I do not wish my own ethical performance to be judged primarily on the basis of simply not having been insensitive.

每       On to the third main issue 每 ※an overly narrow academe-centric focus of much of the current ethical debate§, diverting focus from more pressing issues. It subdivides into two areas 每 general academic freedom and specific methodology prescription.

每       Firstly on accusations of ※managerialism§ -  I have no issues with being judged by an institution whose degree badge I wish to earn not being damaged by my crass recklessness! There is a raw freedom, ultimately, to research how you like within the strictures of the criminal law 每 it just doesn't happen to exist within institutions responsible for their broader reputation and budget.

Methodology prescription is more awkward. I am not sold on purist Grounded Theory, believing that a quest for an empty mind is an overstatement of the need for an open mind. However, the requirement for a richly fleshed-out pre-research Proposal presses a deductive format over the more inductive. This vexed me.

There is the danger of letting oneself be frogmarched through an emerging and fascinating field, wearing the blinkers and straitjacket of excessive pre-emption.

Maybe one must rationalise the initial Proposal as a necessary, provisional predictive quality threshold. As such this may be an enabler to good research; the academic game may have its merits!

This leads us straight on to a quick run over my own inevitable list 每 with apologies to Steven Covey's bestsellers:

 

THE SEVEN HABITS OF SUCCESSFUL SOCIAL HEALTH ETHICS:

1.Take personal responsibility on a permanent basis for the ethical dimension.

Form-filling can be a numbing abnegation of personal responsibility. ※Doing ethics§ is not a passport to a moral-free holiday

 

 2. Do not become hidebound by a slavish search for beneficence.

Do not be backed into a false doctor-patient corner, or be suckered into an instant save-the-world mode. 

We don't have to try to be saints overnight 每  not to forget that we can become sinners in an instant.

None of this is to deny the quest for good 每 it is rather that good comes from different angles and in different shapes. Mine is a call to value in all its forms.

 

3. Be honest and all-embracing on the big questions concerning value.

Within Social-Health, this current sense of not taking without giving needs to be recast as not taking without creating. It introduces a much broader concept of Value, one which I am working through as ※Negotiated Stakeholder Value§.

It is an attempt to move the ethical debate on from limitations of the HOW, which has become stalled both on Helsinki et al, and on the new process-focussed models, into the WHAT & WHY 每 a search for purpose and values.

Ask the big questions:

Look yourself and your collaborants full square in the face and ask ※is this valuable§

And just as ※good§ is a conveniently vague catch-all, so with ※relevant§ we need to ask as May does: ※Relevant for whom and why?§

Another - ※Who's winning in this?

What am I trying to achieve?§

 

With acknowledgements to others' balancing acts, it seeks to sharpen it up further from often unnamed abstract principles to direct questions and named actors.

每       We hypothesise all value for all players into a full and frank Value Statement, including the oft ignored issues such as social science as art, curiosity, non-abusive self-advancement. We include the exchange value of our research, avoiding the sanctimony of exclusively focusing on possible use value.

每       We postulate a negotiation across all actors' interests in the project, focusing on the tension points.

每        As Marshall says - ※sociologists should make the underlying debates explicit§

 

4. If engaged with an academic institution work through the process as project enhancement.

- I have not once seen the ethical process expressed as a framework for enjoyment, satisfaction, excelllence, passion

 

5. Be as solicitous of early and ongoing peer critique as you may later be of peer approbation.

Ethics is not a one time bureaucratic obligation and neither is it in isolation of colleagues and traditions. Engage with them and co-create a living ethics.

 

6. If it feels more of a chore than a vocation then you probably shouldn't be doing it.

On the internal ethical debates within live projects, oft-quoted is House:  ※Some of the most intractable ethical problems arise from conflicts among principles and the necessity of trading one against the other. The balancing of such principles in concrete situations is the ultimate ethical act.§

The concept of Negotiated Stakeholder Value takes it a stage further 每 if the negotiations are going badly, then the ultimate ethical act is simply not to do it. 

7. Avoid beguilement within the ethical ※must-do§ lists of others 每 develop and listen to your instincts as Ethics are the lived values of your project; live your project to the full.

Trust in your Faith......hope it Works in its own time. Thank you.