Culturally responsive research ethics: How the socio-ethical norms of Arr-nar/Kreng-jai inform research participation at the Thai-Myanmar border

Abstract

Despite advances, international research ethics guidelines still tend to consist of high-level ethical principles reflecting residual influence from North American and European traditions of ethics. Local ethics committees and community advisory boards can offer more culturally-sensitive approaches to training but most institutions lack substantive practical ethics guidance to engage rich moral understandings in day-to-day research practice in diverse cultural contexts. To address this gap, we conducted an international series of qualitative research ethics case studies, linked prospectively to active research programs in diverse settings. Here, we share findings from two case studies with a research team working on malaria and hepatitis B prevention with pregnant women in clinics serving migrants along the Thai-Myanmar border. In this sociocultural ethical analysis, we consider how core ethical requirements of voluntary participation, provision of fair benefits, and understandings of research risks and burdens are shaped, enriched, and in some instances challenged, by deep-seated and widespread Burmese, Karen and Thai cultural norms known as Arr-nar (in Burmese and Karen) or Kreng-jai (in Thai), encompassing multiple meanings including consideration for others and graciousness. We offer a model illustrating how one might map ethically significant sociocultural influences across the research practice pathway and close with lessons for developing a more culturally responsive research ethics practice in other international settings.

Migration health ethics in Southeast Asia: a scoping review

“…In recognition of the lack of practical research ethics guidance which takes into account moral perspectives in diverse cultural contexts, an empirical sociocultural analysis was performed using a qualitative approach at the Thai-Myanmar border ( Khirikoekkong et al, 2023 ). The research specifically analysed how sociocultural-moral norms pervasive in all aspects of the lives of local communities, known as Arr-nar (in Burmese and Karen) or Kreng-jai (in Thai), influence multiple aspects of research ethics, including “voluntary participation, provision of fair benefits, and understanding of research risks and burdens”.…”

“…Even within the same national territory, there may be a divergence in socio-cultural norms and values. As evidenced by the research on cultural responsiveness by Khirikoekkong et al (2023) empirical ethics research on sociocultural and ethical norms can foster a nuanced comprehension of local customs and practices, and how these cultural factors impact the realm of research ethics. Knowledge from research as such may then aid in the development of research ethics support that is more responsive to local and regional ethical norms.…”

The challenges and potential solutions of achieving meaningful consent amongst research participants in northern Thailand: a qualitative study

“…Decision making was influenced to a greater or lesser extent by family members, translators and healthcare workers. Trust in others and cultural attributes like ‘ kreng-jai’ led to some joining the research [ 12 , 40 , 41 ]. The cultural attribute of ‘ kreng-jai ’ is similar to the need to be polite and not refuse requests from outsiders seen in diverse settings including Kenya and India [ 11 ].…”