Consent as Conversation: Lean research in vulnerable settings
If you’re a researcher who has spent any time in a developing country, this scene might be familiar: You have arrived at your research site, far from home. You are here to conduct a study and your bag is heavy with consent forms. You have imagined who your research participants will be and you have prepared your thoughtful questions. Halfway through the second day, you notice research participants’ answers seem pat, as though they are recited from memory. You realize: You are not the first “you” they have met. Those same people have been asked similar questions about their lives numerous times, often by people who look like you.
We know this, because we have struggled with this issue ourselves, in studies that range from inquiries into agricultural practices to banking activities, and experiences of violence in conflict to inequality closer to home. Our collective experiences across fields and disciplines prompted us to devise the lean research approach towards more rigorous, relevant, right-sized and respectful field research.
Where is the field? A note on vulnerability and power
The lean research approach applies in diverse contexts, across a variety of research designs, from ethnographic oral histories to quantitative experiments. We recognize that not all settings are equal, and much has been written on research methods in conflict settings or with marginalized populations. Some have described this as research in “‘difficult places.” At the same time, and without discounting difference or difficulty, we note that one person’s “difficult place” is another person’s home. Further, power inequalities and assumptions about vulnerability underpin research across contexts. Whether research unfolds in Harvard Square or a remote village, in our home communities or in a context with which we are newly familiar, we hope to question our assumptions on agency, power, risk and vulnerability. In this post, we focus on making informed consent a truly meaningful process, particularly when conducting research in vulnerable settings.
Making informed consent meaningful
True consent is a continual process. When our institutions require us to implement the procedures of informed consent – the process by which we inform research participants of the benefits and risks involved in a study and request their participation – the process often looks like this:
The researcher faces the participant, reads aloud a one- to two-page document, and then asks him or her to sign the document or verbally agree to its terms. From the point of view of the participant, this process is a lot like hearing one’s Miranda rights while being whisked into police custody. The participant, dazed by so much information and feeling powerless, agrees to the least risky course of action. They say “yes.”
We know this because both of us have participated in studies as research subjects. We use the term “subjects” here because we felt more like subjects than participants. Subjects often cannot summon the courage to reject or stop a study. Neighbors may be watching, silently pressuring them to do the study because future benefits might follow. From a subject’s point of view, researchers are often difficult to distinguish from aid workers. A subject in an agricultural village in Assam, India, once said: “I will say yes to the interview because the headman told me to.” When we asked the leader why he was encouraging other subjects to participate, he replied: “Because the study will show that we need help and you will bring us that help.”
This approach to informed consent, which we call “listen and sign,” misses two golden opportunities. The first is one of helping the participant feel relaxed and comfortable, key to engendering trust and gathering complete information. The second is one of truly conveying the risks a participant might experience in the research process. Because so much of our research is in developing contexts, we believe that research is a development activity, whether we intend it to be or not. Minimizing negative consequences, then, is part of our job.
We have observed, happily, many creative researchers tackle the consent process with unstinting resourcefulness. Their approach, which we call just-in-time (JIT) consent, differs from listen and sign in this important way: like just-in-time learning, JIT consent metes out information as the participant needs it. The participant needs information at the beginning of the interview (enough for her to refuse the interview), part way through the interview (enough for him to stop the interview, express discomfort or change tacks) and then at the end of the interview (enough for her to review and reject information gathered, whether verbally or through photos and video).
Two JIT researchers in a South African township recently adopted a JIT consent approach. As an example, one participant had revealed in an extensive interview enough about himself, his loss of work and his financial struggle, to make him easily identifiable to others – including a disgruntled bank. The researchers explained the bank could target him with unsavory collection practices. The participant thanked the interviewers for their warning, but wanted his story to appear in their report, nonetheless. “It’s important for the banks to hear us,” he said. “I want to be seen.” Others, though, did ask for all identifiers to be removed and were grateful the researchers had highlighted the risks after the formal interview.
Meaningful consent requires acknowledging power – power of the researcher over research participants, often unwitting but nonetheless real. We view consent as a process and a conversation, not as an obligation the researcher passes on to the participant. Reckoning with power at every step of the research process is an essential component of making research rigorous, relevant, right-sized and respectful, whether in a remote village or in our office closer to home.
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