There has been ongoing discussion in the nursing literature regarding the ethical variances that have arisen in qualitative investigations. Clearly, guidelines established for quantitative research investigations require an expanded scope of discussion when applied to qualitative research en- deavors (Cutliffe & Ramcharan, 2002; Demi & Warren, 1995; Forbat &
Henderson, 2003; Haggman-Laitila, 1999; Karnieli-Miller et al., 2009; Orb, Eisenhauer, & Wynaden, 2001; Robley, 1995). Standards for ethical con- duct in the qualitative realm will continue to require in-depth examina- tion. Although qualitative designs have improved guidelines regarding the unique concerns that emerge in this type of research, what has become in- creasingly clear is that the ethical aspects of the research process will always require ongoing critique and evaluation. Given this understanding, this chapter addresses ethical issues that require critical consideration in any qualitative research endeavor. Table 4-1 provides qualitative researchers with an “ethics checklist” to use as a guide when critiquing the ethical aspects of a research study.
Table 4-1 • The “Ethics Checklist”: A Guide for Critiquing the Ethical Aspects of a Qualitative Research Study
Topic Guiding Questions
Phenomenon of 1. Is the research study relevant, important, and most interest appropriately investigated through a qualitative design?
Explain.
2. Are there any aspects of the research or phenomenon of interest that appear to be misleading either in terms of the true purpose or misleading to participants? Explain.
3. Is the research primarily being conducted for personal gain on the part of the researcher, or is there evidence that the research will somehow contribute to the greater good? What are the benefits to the participants or society as a whole?
Review of the 1. Has all the available literature been reviewed?
literature 2. Are all citations accurate in terms of referencing and quoting?
3. Is the basis for inclusion of the articles referred to explicit?
Research design 1. How did the researcher protect the physical and participants psychological well-being of the participants?
2. Is there evidence that informed or process consent was obtained and freely given?
3. How were vulnerable populations recruited and protected from physical or emotional harm?
4. Did an Institutional Review Board approve the research?
Sampling 1. How was the confidentiality of participants protected?
2. Is there any evidence of coercion or deception?
Data generation 1. If more than one researcher collected data, were they adequately prepared?
2. Is there evidence of falsified or fabricated data?
3. Is there intentional use of data collection methods to obtain biased data?
4. Was data collection covert? If so, does the researcher explain why?
5. Have the participants been misled with regard to the nature of the research?
6. What mechanisms did the researcher employ to ensure authenticity and trustworthiness of data? (e.g., audit trail, reflexive journaling)
Data analysis 1. Was data analysis conducted by more than one person?
2. Is there evidence of data manipulation to achieve intended findings?
3. Is there evidence of missing data that may have been lost or destroyed?
Conclusions and 1. Is there evidence of intentional false or misleading recommen- conclusions and recommendations?
dations 2. Is confidentiality violated given the presentation of the findings?
Adapted from Firby, P. (1995). Critiquing the ethical aspects of a study. Nurse Researcher, 3(1), 35–41.
injected with live cancer cells. The project was conducted without informed consent and without institutional review (Levine, 1986).
• The Willowbrook Study (1950s–1970s) deliberately infected mentally handicapped children with the hepatitis B virus. Admission to the hospital was contingent on parental consent for the children to par- ticipate in the study. However, the consent was not informed, and parents were never told of the dangerous consequences of the study (Levine, 1986).
• The Johns Hopkins Crisis (2001) is one of the most recent examples leading to concerns regarding research. This study involved the use of healthy volunteers to study the pathophysiology of asthma. The third subject to receive the drug hexamethonium as part of the research protocol died as a result of progressive hypotension and multiorgan failure. The study was criticized because the consent document did not indicate that the inhaled hexamethonium was experimental and did not have U.S. Food and Drug Administration (FDA) approval (Steinbrook, 2002).
Although these examples emerged from quantitative studies that em- ployed a specific intervention, the message is clear. Guidelines are essential, but they do not always answer all the ethical or moral questions that may arise in any research study, whether the design is quantitative or qualitative.
It is the responsibility of the researcher to constantly examine and question the ethical components of their work. Participants must be protected, and the researcher must remain sensitive to emerging actual or potential ethical concerns.
Early quantitative investigations paved the way for ethical codes and guidelines. Qualitative researchers are bound by the same codes and must maintain an ongoing dialogue regarding ethical dilemmas encountered dur- ing their investigations so that all researchers can benefit from the experience of others. Despite the most vigilant attempts to ensure ethical conduct dur- ing a qualitative investigation, new and important considerations are always emerging. Researchers must be willing to share their experiences. For exam- ple, Boman and Jevne (2000) report on an experience of being charged with an ethical violation in the conduct of a qualitative investigation. The article centers on a frank discussion of a qualitative research endeavor in which the identity of a study participant was disclosed (Boman & Jevne, 2000). There is much to be learned from this open and honest sharing of the researchers’
experience. Similarly, Lawton (2001) discusses ethical concerns related to in- formed consent and role conflict that emerged during a participant observa- tion study of dying patients. Lawton (2001) and Boman and Jevne (2000) provide relevant examples from personal experience that will serve to enhance the ethical integrity of future studies. Their open and frank discus- sions leave all researchers in a better position to address ethical issues that present during the conduct of a qualitative investigation.