Suchergebnisse

There is a diversity of 'ethical practices' within medicine as an institutionalised profession as well as a need for ethical specialists both in practice as well as in institutionalised roles. This Brief offers a social perspective on medical ethics education. It discusses a range of concepts relevant to educational theory and thus provides a basic illumination of the subject. Recent research in the sociology of medical education and the social theory of Pierre Bourdieu are covered. In the end, the themes of Bourdieuan Social Theory, socio-cultural apprenticeships and the 'characterological tu

This article is premised on the idea that were we able to articulate a positive vision of the social scientist's professional ethics, this would enable us to reframe social science research ethics as something internal to the profession. As such, rather than suffering under the imperialism of a research ethics constructed for the purposes of governing biomedical research, social scientists might argue for ethical self-regulation with greater force. I seek to provide the requisite basis for such an 'ethics' by, first, suggesting that the conditions which gave rise to biomedical research ethics are not replicated within the social sciences. Second, I argue that social science research can be considered as the moral equivalent of the 'true professions.' Not only does it have an ultimate end, but it is one that is – or, at least, should be – shared by the state and society as a whole. I then present a reading of confidentiality as a methodological – and not simply ethical – aspect of research, one that offers further support for the view that social scientists should attend to their professional ethics and the internal standards of their disciplines, rather than the contemporary discourse of research ethics that is rooted in the bioethical literature. Finally, and by way of a conclusion, I consider the consequences of the idea that social scientists should adopt a professional ethics and propose that the Clinical Ethics Committee might provide an alternative model for the governance of social science research.

This article outlines a theoretical and conceptual account for the analysis of contemporary ethical or "bioethical" expertise. The substantive focus is on the academic discipline of bioethics—understood as a "practical" or "applied" ethics—and its relationship to medicine and medical ethics. I draw intellectual inspiration from the sociology of science and make use of research into the idea of "expertise" per se. In so doing, I am attempting to move the debate beyond the limitations placed upon it by philosophical or meta-ethical analysis and develop a perspective than can be used to address the sociological reality of (bio)ethical expertise. To do so, I offer the terms ethos and eidos to provide a basic conceptual framework for the sociological analysis of "morality" and "ethics." I then turn to an exegesis of Collins and Evans's account of ubiquitous, contributory, and interactional expertise and situate these topics in relation to academic bioethics and medical practice. My account suggests a particular understanding of the kinds of relationships that "bioethics" should seek to foster with the social fields it endeavors to not only comment on but also influence.

For reasons that are discussed in what follows, the author of this case study prefers to remain anonymous. Autoethnography is a qualitative research method that aims to improve sociological understanding through the reconciliation of personal experience with social phenomena. Despite receiving no small degree of criticism, autoethnography has grown in popularity, especially in fields such as sexuality, immigration, and health care research. One possible reason for this is that health care, having both personal and social value, is a subjective phenomenon and, as such, can only be properly experienced and understood by the self. My own research, conducted as part of my MA dissertation, adopted an autoethnographic approach and drew upon my experiences during my fathers cancer. In this way, I sought to explore the goals of health care during the end stages of terminal illness. Currently, there is relatively little guidance for researchers using autoethnographic methodology, especially regarding data collection, the presentation of results, and, most pertinently for this case study, ethics. In this case study, I explore the novel ethical issues I encountered when conducting my autoethnographic project. Particular emphasis is placed on questions of informed consent and the anonymity of individuals involved in the research. Two key challenges with respect to the informed consent of those who might be thought of as research participants in the context of autoethnography are outlined. These are the validity of retrospective consent and whether consent given by participants known to the researcher can be considered to be genuine, freely given, and ?ouncoerced.? Subsequently, the challenges of anonymity in qualitative and authoethnographic research are discussed. This case study concludes with some suggestions for ways in which these issues might be engaged and overcome along with a discussion of the practicalities of the suggested solutions.

A recent project I was involved with sought to explore the phenomenon of dying alone. One strand of the project centered on individuals whose bodies had remained undiscovered for an extended period of time. Sociological autopsy was used, taking an ethnographic approach to the coroner's file about each death before moving on to other data sources, such as interviews with people who knew them and newspaper reports. There are always ethical issues in research on death and dying, but extra considerations were evident early in the process from the inclusion of people who had already died. It was highly unlikely that any of the deceased individuals would ever have documented an opinion about participating in research, and they were unlikely to have anyone to speak for them. It was necessary to obtain approval from a Research Ethics Committee, and committee members required assurance that the research was worthwhile and that it would cause no harm. The research adopted a pragmatic approach in which deceased individuals were treated as if they might have living relatives who could be affected by the research. In practice, this meant protecting the identity of deceased participants, but this prompted further questions. In this case study, I set out the initial ethical questions raised by this research and the ways in which I sought to resolve them. I then discuss the secondary ethical concerns that were prompted by the approach adopted and the way in which I attempted to engage with such matters.

This case describes what happened in a study of a National Health Service panel responsible for deciding whether to fund high-cost drugs when the Local Health Board asked the researchers to release audio-recorded data because of an impending judicial review case. In judicial review, the courts scrutinize the conduct of administrative decisions to determine whether they are lawful. When research access was negotiated, panel members had been told that access to audio recordings of meetings would be limited to the researchers. The Local Health Board's request raised ethical issues about whether the terms of research ethics committee approval had been respected and the position of subjects protected, and issues concerning the university's and researchers' obligations under the Data Protection Act 1998, contractual obligations relating to the requirements of the Department of Health as funder, and risks to the university and researcher arising from legal processes related to the object of study. The case describes how possible release of data was negotiated with the various stakeholders, the process via which specific subjects were asked to permit release, the stance taken by the university administration and its legal advisors, and how data were eventually passed to the Local Health Board. It discusses the dilemmas facing the researchers and, in particular, how pressures from stakeholders make it very difficult for researchers to formulate a principled position that resists release of data. Lessons for future research projects are discussed, including whether risks need to be communicated more clearly to research subjects and what steps can be taken to avoid holding data that may harm them.

This case study outlines some of the difficulties encountered in obtaining ethical approval for a study into women and pornography using participatory research methods. My research, the Living with Porn(ography) Project, explores women's experiences of pornography. It aims to develop a sociological understanding of what pornography means for women, and how they think and feel about it, by looking at their lived experiences. I have designed this project around the principles of co-research and, by working with a specially convened group of women, it is being conducted according to the methodology of participatory research. In keeping with these commitments, the study has been structured to facilitate the women's ownership of their contribution to the project. Consistent with this approach, the anonymity of those participating in the research was conceived of as an optional, as opposed to an automatic, condition. This stance was one of the key issues that led to my application to the University of Sheffield twice being subject to compulsory changes following an unfavorable opinion. This case study will discuss the application process in detail and explore the tensions that arose between the ethics of participatory research and the traditional ethical principles guiding sociological research. I will discuss the nature of this ethical friction and how it was resolved. This case will encourage critical examination of the standard ethical considerations and norms that inform the planning and review of research proposals. It will consider how those pursuing participatory research can develop good ethical practices toward all those involved in their work.

The challenges of securing ethical approval to undertake qualitative research in the English National Health Service have been previously detailed. Acknowledging these general challenges, this case study describes some further issues specific to gaining approval for ethnographic research in National Health Service settings. Ethnographers attempt to understand the world from the vantage point of those that inhabit it. As it entails a concern for the perspectives and experiences of others, ethnography is an invaluable approach to understanding the social and cultural dimensions of health and illness. Ethnographers spend time with people in their "natural habitat" or social setting, seeking to engage with people on their own terms. Ethnography can offer critical insight into the practices of healthcare, as well as the contexts within which these practices take place. Gaining access to National Health Service settings for the purpose of research that includes patients requires prior approval from a National Research Ethics Committee. The bureaucratic structure within which these committees operate is designed to weigh up the potential harms and benefits of biomedical research. It does not, therefore, fit neatly with ethnographic research. This case study describes three important questions which arose in the course of seeking approval for my doctoral research: first, how to provide an account of a research proposal that involves an inherently unpredictable process in a format designed for carefully controlled biomedical research; second, how personal perspectives affect research; and third, the difficulty of working across the complicated organizational structures found in and around the National Health Service. I provide some reflections on these issues, and my experiences, with the aim of helping other students as they prepare to undertake ethnographic research in the National Health Service.