Navigating the ethics of cross‐cultural health promotion research

Abstract

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.

Developing an Evidence-base to Guide Ethical Action in Global Challenges Research in Complex and Fragile Contexts: A Scoping Review of the Literature

“…The 4P's rubric provides a helpful training architecture. (III) Develop institutional protocols that reflect the need for flexibility in responding to ethical conflicts in the field, with particular importance placed on cultural sensitivity and less reliance on western principles and practices (Haintz, Graham, and McKenzie 2015;Sylvestre et al 2018). (IV) Prioritise informed consent process in contexts with multiple barriers such as power differentials and cultural contexts which do not recognise individual freedoms.…”

“…The most prevalent consideration was the researcher's relationship with participants. This spanned all aspects of the research process (see Table 2) and included ethical concerns regarding how to engage with participants (and potential participants) in a respectful way, whilst taking into account different culture and language and recognising resilience and potential vulnerability (Haintz, Graham, and McKenzie 2015;Molyneux et al 2016). Ethical issues in the recruitment and informed consent process also featured prominently in the papersthe main dilemma was how to avoid taking advantage of vulnerability or power differentials (Gebremariam et al 2018;Kelley et al 2016).…”

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Gurus and Griots: Revisiting the research informed consent process in rural African contexts

“…A growing number of researchers working in highly communal, low literate, rural African settings report that the research process is significantly dictated by the cultural values and traditional practices prevailing in specific local settings, and are distinct from those in highly individualistic social settings. An impressive body of evidence exists to support this assertion in sub-Saharan Africa [9][10][11][12] and in studies conducted in Western countries with minority groups [13][14][15]. Although cultural values and norms are visibly ubiquitous and explicitly expressed in more collectivistic social settings (e.g., Africa and Asia), cultural factors have also been found to strongly influence participants' understanding and awareness of the scientific research process [13], and had determined the language and communications tools appropriate for use in research for specific groups in more individualistic social settings [14,16].…”

“…The majority of existing guidelines discuss ethical issues such as confidentiality, IC, deception, privacy, and anonymity from a general, global perspective, without recourse to possible sociocultural differences in study settings. There is presently a heightened interest to re-examine the use of the universal, individual-focused ethical guidelines, which is premised on Western individualistic social orientation, in non-Western, more collectivistic social contexts, and to adapt aspects of the UEGs (e.g., the IC) to the unique cultural and socioeconomic circumstances of participants [5,[9][10][11][12]. Largely, the universal IC guidelines adopt the individual-based consent model, where the decisional authority rests entirely on the individual [2,3].…”