Medicine, Science and Culture (MeSC): Research in the NHS: Procedural ethics and ethics in practice
Starts: 28 March 2012
Wednesday 2-4pm, 28 March 2012, Glamorgan Building (Room 0.85)
Research in the NHS: Procedural ethics and ethics in practice
This session will be dedicated to thinking through ethics in practice and the acquisition of ethical approval in social research, with a particular focus on studies conducted within the NHS. The session will proceed with two informal presentations followed by an open debate involving all attendees. The debate will concern both the presentations, related issues in the field, and what events members would like to be organised in the coming academic year.
Our speakers for this session are Prof. Adam Hedgecoe and Dr. Paul White:
Prof. Adam Hedgecoe (Cesagen Associate Director, Cardiff)
Research Ethics Committees, trust and the regulation of biomedical research
Based on an ethnographic study of RECs in the NHS, this paper explores a key aspect of REC decisions making - derived from the anticipatory nature of ethics review - that of trust. This paper presents a number of ways in which RECs decide whether an applicant is trustworthy and should be allowed to carry out a particular piece of research.
Dr. Paul White (Lecturer, Swansea University)
Judging the ethics of ethnographic work: an ethnography of ethics, organisation and legitimation in healthcare
There is much academic literature that makes explicit the tensions of qualitative health research and institutional review (e.g. Boden, et al., 2009; Hedgecoe, 2008; O’Reilly, et al., 2009), the ambivalence of who participates in ethical judgement (Dyer, 2004), whilst professional literatures have been situated within a context of opposition to such ethical review (e.g. Richards & Schwartz, 2002; While, 1995). This has been viewed pejoratively as part of a bureaucratisation of ethics (Boden, et al., 2009) and the rituals of verification (Power, 1999) demanded by ethical committee as regulator (McGuinness, 2008) which has broader implications for the conduct of organisational research examining healthcare. Consequently, we may question the ethics of institutions that act as moral guardians to research sites, particularly as ethics becomes closely aligned with the good reasons and justifications of audit, a process designed to create legitimacy (Strathern, 2000). Such issues are made more prescient as healthcare ethical review has become the template for how ‘ethics’ should be judged across academic disciplines (Boden et al., 2009; Hedgecoe, 2008) including business schools, rather than regulating clinical research.
This paper draws upon some strategic contingencies of an ethnographic investigation of the impact of organisational processes within hospital intensive care units (White, 2008; 2009). In particular, through processes of securing ethical approval for research, judgements made by committee members have effects on the research beyond the creation of ethical subjects and ethical subject matter, those issues within the domain of such committees, such as ‘improving’ the quality of research (Hedgecoe, 2008). Tracing the cultural accomplishments of transparent and closed door decision making, this paper examines the dependence and departure (Hickson, et al., 1971) of researcher and research from a line of ethnographic inquiry; a line of enquiry agreed and approved of by funding bodies, gatekeepers, collaborators and research sites. As a result, one aspect of this paper focuses upon how unanticipated research issues, such as the negotiation of ethical processes, are themselves a legitimate subject of inquiry, of how the individual researcher returns as both subject and object of ethnographic writing (Clifford & Marcus, 1986).
Ethnographic research has long been associated with a fluid and dynamic approach to understanding the social world and cultural forms (cf. Geertz, 1973); the ethnography from which this paper is based being no exception. What is significant here is how the impact of ethical reasoning by committee provided significant insights into the mechanisms of institutional control beyond post hoc rationalisations and justifications (O’Reilly, 2009; Hedgecoe, 2008; cf. Garfinkel, 1967). Rather the focus here is upon the methodological effects of such decisions and the cultural performance of control (Munro, 1999) upon individual social actors (Rapport, 1997). A play is in place here between discourses, rhetorics and concerns of ensuring patient safety and the individual (cf. Mills, 1959), where the knowledge and skills of the researcher are reconstituted as a risk (Beck, 1992) to research subjects and rituals of verification gain primacy over conduct. This representation of research aims to contextualise the ethics of the ‘ethical committee’ as a legitimation device (Muniesa, et al., 2007; Bauman, 1989; 1991; Lyotard, 1986; Arendt, 1977) and the significance of ethical reasoning for organisational researchers and the research sites. Through examining the strategic contingencies available to ethnographers and the nature of an ethnographic craft, the strength of ethnography to show what is being accomplished and what is at stake in organisational life can be brought to the fore.
Open To: Staff and Students