KōtuituiNew Zealand Journal of Social Sciences OnlineEthical guidelines for research with children: a review of current research ethics documentation in New Zealand
Mary Ann Powell
|
|
Consent |
Protection |
Information |
Confidentiality/ anonymity |
Financial inducement |
|---|---|---|---|---|---|
Number of institutions addressing issues |
9 |
5 |
5 (2 provide examples) |
3 |
3 |
The ethical issue that dominates the documentation with regard to child participants is that of obtaining consent to participate. It is a key issue and is raised in all the policies and guidelines accessed that make reference to children.7
Two of the institutions (Canterbury, Lincoln) have the issue of consent as the sole mention in ethical guidelines relating to children. Both of these institutions require that for projects involving children written consent must be obtained from a legal representative, parents, or those acting in loco parentis. Both institutions also state that children must not be required to participate against their will. One university (Canterbury) says that consent of dependent persons (children) must be obtained as far as possible, and that “children are seen as having rights and that age appropriate consent is required”. However, what constitutes “age appropriate consent” is not detailed, and the statement that “children are seen as having rights” is not clarified or elaborated on. Three institutions (Auckland, Massey, Waikato) explicitly indicate that it may not always be in the child’s best interest to obtain consent from a parent or guardian. For example, one university (Massey) states that consent will normally be gained from a parent or guardian unless there is the potential for harm in doing so.
The age at which it is considered necessary to obtain consent from an adult varies between institutions, as does the flexibility around this issue. Three institutions (Canterbury, Lincoln, Unitec) require consent from a parent or caregiver for all child participants. One of these and three other institutions (AUT, Auckland, Massey, Unitec) consider a participant a child if under the age of 16 years. However, the guidelines appear somewhat more flexible with the latter three, and parental consent is not always required.
All of the documentation reviewed includes recognition in the general ethical provisions that participants have the right to decline to participate in the research. However, this is only mentioned specifically with regard to child participants by five of the institutions (AUT, Auckland, Canterbury, Lincoln, Otago). One other institution (Massey) makes reference to protecting the anonymity of children who do not wish to participate, which implies that children are not compelled to participate.
Thus, ethics documentation about the child’s consent, a parent or guardian’s consent, and the age or understanding of the child at which it is deemed appropriate to obtain consent, varies considerably. Most institutions require consent from a parent or guardian if the child is under 16 years. However, some institutions have flexibility around the obtaining of parental consent, dependent on the nature and features of the research project (Auckland, Otago) and the understanding of the child (AUT, Massey). The guidelines of two institutions (AUT, Auckland) include obtaining informed assent if children are considered unable to give informed consent.
The ethics documentation of five universities (AUT, Auckland, Massey, Otago, Victoria) refers to the vulnerability of children and the need for special care or protection. Again, the extent of guidance provided in the documentation varies widely between these institutions. One of them (Victoria) states that special care is to be taken and refers to children as vulnerable participants, but there is no further comment. Two universities (Massey, Otago) discuss this in terms of obtaining consent for participation.
Three universities (AUT, Auckland, Massey) have included a statement to the effect that research with children should not be undertaken unless there is a specific and demonstrable need for it and no other way to gain the knowledge. This echoes one of the key principles in the Operational Standards for Ethics Committees (Ministry of Health 2002): namely, that research should only be done with children if comparable research with adults could not answer the same question. These three institutions also state that the research must not be against the interests of the individual child participant.
The guidelines of one university (Auckland) give reasons for protecting children, including the potential for research to raise concerns for children. Another university’s (AUT) ethics documentation refers to the particular vulnerability of children, the need for special consideration of ethical issues surrounding their involvement in research, and the power imbalance that exists between adults and children. It states that “pressure must not be placed on a child to agree to participate in a research project”. The requirements for both institutions (AUT, Auckland), in addition to those for adult participants, include issues of consent and assent, provision of information, and inducements.
Ethics documentation from five of the institutions (AUT, Auckland, Massey, Otago, Unitec) states that information must be provided for children in a form that is appropriate and understandable for them. Information sheets are to be provided for children, although Unitec notes that with young children it may be more appropriate to provide a verbal explanation. The University of Auckland’s guidelines specify that children must be fully informed, have the opportunity to ask questions and have those answered satisfactorily.
Two of the institutions (AUT, Otago) provide an example of an information sheet and consent form for children with their ethics documentation. These are specifically tailored for children and use appropriate language for child participants.
Little mention is made of confidentiality or anonymity, specifically in relation to research with children, in institutions’ ethics documentation. One university (Waikato), in providing guidelines for observation and research in schools and early childhood centres, states that research data must be kept confidential and that no individual should be identifiable. Parents do not have a right to access individual data, and this is expected to be clearly explained to parents and children before obtaining consent.
Two universities (Auckland, Massey) provide a statement regarding the anonymity of children in school class or group settings. Procedures must be put in place to protect the anonymity of those children who do not wish to participate, or whose parent or guardian has declined consent to participate. The provisions for non-participants, when others in the group are participating, must be explained in the information sheet.
Three of the universities (AUT, Auckland, Massey) refer to financial inducements in the ethics documentation. In keeping with the guidelines of the Operational Standards for Ethics Committees (Ministry of Health 2002), they all state that no financial inducement is to be offered to children or to families to persuade them to allow the child to participate in the research. Provisions may be made for the compensation of research-associated costs, and a small gift for children may be offered after their participation in the project.
The two research associations particularly relevant to this study are the NZARE and the ASSR. Both of these associations play a supportive and guiding role for researchers. They do not have ethics committees or consider research proposals, but both have ethics documentation to guide researchers.
The NZARE Ethical Guidelines (1998) include avoiding harm, informed consent, and confidentiality. The guidelines state that these are to be read in conjunction with institutional guidelines and the ethical codes promulgated by professional bodies. A specific reference is made to children in regard to informed consent, stating that this should “normally be obtained from parents or others who are responsible for them, and (where age permits) the child” (NZARE 1998: 2).
The ASSR Code of Ethics (1996) states that members should abide by the ethical codes of their professional organisations. However, the ASSR Code of Ethics operates as a default ethical code for applicants to the Research Access Committee operated by Child, Youth and Family Services if they do not have an ethical code to abide by: for example, if they are not members of a professional body. The ASSR Code specifically mentions children and informed consent. The UNCROC is referred to, with the statement that “children should give informed consent on their own behalf, subject to the limitations of the age and maturity of the child, in accordance with Article 12” (ASSR 1996: 1). The code states that normally parental consent should be sought but that sometimes the refusal of consent by a parent or caregiver may not be in the best interests of the child, citing Article 3 of the UNCROC (paramountcy of best interests). Age is also mentioned in the ASSR Code in regard to avoiding harm and being sensitive in relation to individual circumstances.
The majority of participants were familiar with the process of applying for ethics approval and found it relatively straightforward. Some participants commented on the lengthy time involved but indicated that it was a worthwhile process. Comments included reference to ensuring that the project was well thought through, worthwhile and of benefit, and provided back-up for both the researcher and participants if needed.
The key issues raised by participants regarding the ethics approval process were related to consent and protection from harm. The requirement to gain parental consent is a controversial issue, and there were indications of inconsistency in participants’ experiences of ethics committee requirements with regard to this. However, in all the research projects outlined in this study, the ethics committees required parental consent with research involving children under the age of 16 years, which suggests that this is the usual requirement.
Ensuring children’s safety and using skilled researchers/interviewers were required by most ethics committees. Several participants had the view that clearly attending to these features, particularly when sensitive research topics were involved, contributed to a straightforward ethics approval process, whereas two other participants expressed frustration that their skills and expertise appeared to be disregarded.
Lack of consistency from ethics committees, both between committees and within them, was raised as an issue, mostly with regard to consent requirements. One participant also raised cultural issues in relation to consent requirements, noting that for Pasifika representatives, parental consent is always deemed necessary.
The findings of this review demonstrate considerable variation in the existing ethics documentation with regard to research with child participants. The extent to which specific child-related issues are addressed fluctuates widely as does the extent to which the documentation reflects a respect for children’s participation rights.
The findings indicate that, for the most part, the situation in New Zealand is congruent with Lindsay’s (2000) assertion that scant attention has been devoted specifically to children in existing codes of research. Therefore, consistent respect for children’s participation rights within social science research ethics documentation is demonstrably lacking. The variations between ethical codes, policies, and guidelines would seem to suggest that this is not a static state. However, these variations and the experiences of the researchers who participated in the study reflect an increase in consideration of ethical issues relating to research with children and young people.
The child-related issues that occur most frequently in the ethical policies, guidelines, and codes in New Zealand are those of informed consent and protection of research participants. These were also the key issues raised by participants we interviewed and are consistent with Morrow & Richards’ (1996) contention that discussions about research ethics with children are centred on these two key preoccupations.
There is considerable variation in the guidance provided with regard to these two issues. While obtaining informed consent for any research participant is recognised by the institutions as critical, the overall impression gained is that there is no real consensus regarding child research as to the nature of the consent to be gained, the process through which this should occur, or the ethical considerations involved. This has serious ramifications for children’s participation in research in New Zealand, with a lack of consistency between institutions, as noted by some of the participants interviewed. Some institutions continue to require only parental or guardian consent, and we share Ireland & Holloway’s (1996: 157) assertion that gaining consent from parents or guardians “does not negate the moral obligation of asking children for their agreement”. Although the majority of researchers interviewed consider children’s consent a critical component of the research process, it clearly needs to be specifically stated as a requirement in ethical codes and guidelines. Two institutions make reference to gaining a child’s assent as an alternative to consent. Assent is regarded by some researchers as a substitute for consent, so that children do not consent in their own right but assent to their parent’s consent. This is a view not shared by the authors, as we would argue that obtaining consent is fundamental to respecting children’s participation rights.
An important aspect of informed consent is the provision of information to the participants. The need for age appropriate information to be provided to child participants was addressed in the ethics documentation of one-half of the institutions, with two providing samples. Informed consent involves children understanding the purpose and the process of the research and “is a two way exchange of information” (Alderson 2002), continuing through the research process (Alderson 1995). Discussions of competence to give informed consent usually focus on the age of the children (Morrow & Richards 1996). This is being challenged, however, and studies have demonstrated that even very young children are able to give informed consent if approached ethically (Hedges 2002; Bone 2005). We contend that obtaining the informed consent of children is an essential aspect of the research process and a necessary requirement for ethical research practice, demonstrating respect for children and their participation rights, and that the ethics documentation must be amended to reflect this.
There is also considerable variation between institutions regarding the issue of the protection of child participants. Generally, there is a lack of elaboration around the understanding of protection or the vulnerability and dependency of children. The use of undefined terminology and generalised statements and the lack of procedural detail are problems. How ideas of protection, vulnerability, and dependency impact on children’s participation in research is not addressed. However, this is not the case across the board, as some institutions have gone to considerable lengths to ensure that children are both protected and have access to participation in research.
There is a need for elaboration on these issues if the ethical codes are to provide useful guidance. While other child-related issues are present in the documentation, for example, anonymity, confidentiality, and financial inducements, the dominance of the issues of informed consent and the protection of child participants has important implications. It highlights the tension that exists in balancing the participation and protection rights of children, both of which are important areas as recognised in the UNCROC. The inherent vulnerability of children, as a consequence of biological immaturity and thus a greater dependency on adults for guidance and safety, means that researchers and significant adults in children’s lives have an ethical responsibility to protect children. This ethical responsibility can develop into overprotection, however, which affects their access to participation in a range of experiences including research (Morrow & Richards 1996). The overprotection contributes toward the structural vulnerability of children, which is not a biological reality but rather children’s lack of power and status within our societal structures (Lansdown 1994). Although this is most salient in relation to sensitive topics, it is also evident in other research, with a general perception of children as vulnerable implying a need for adult protection (Miller 2000). The nature of protection is a disputable concept, however, with some researchers noting that overprotection may be as harmful as neglect (Alderson 1995) and that true protection of children requires protection of their rights, including that of participation (Sandbaek 1999; Miller 2000).
Lindsay (2000: 18) notes that “research on ethical dilemmas has indicated that practice cannot be made to fit written codes, however well they are devised”. There is a danger that after gaining approval from an ethics committee, a project may be regarded as ethical in its entirety. The issues given precedence by ethics committees (consent and protection), and the requirements that are consequently attached to these, can mean that other ongoing ethical issues are given less attention (Christensen & Prout 2002). This is of particular concern given the fluctuating level and depth of reference to children and the lack of consistency found in the review of ethics documentation. It is conceivable that research projects could be undertaken attending only to the ethical requirements as stipulated by the specific codes and requirements. Conversely, ethical codes do not necessarily reflect research practice, as indicated in our interviews with researchers, or ethics committees’ requirements.
Ethical issues are ongoing throughout the research process (Alderson 1995; Morrow & Richards 1996; Lindsay 2000; Tolich 2001) and the recognition of this is particularly pertinent when the research participants are children, given the existing and ongoing power differential between adult researchers and child participants. We share Tolich’s (2001: 10) view that “ethics, then, is not just access-related or concerned with informed consent … Its focus needs to be the entire research process so as to protect the people in the study”.
The research associations considered each have a code of ethics for members, focusing on ethical professional conduct. These codes contain specific reference to child-related issues, including the issues of consent and protection. The ASSR regards the issue of children’s informed consent in the context of the UNCROC and thus a children’s rights framework. In doing so, it brings the policy into line with New Zealand’s obligations under the Convention.
The findings show that institutions differ in the amount and nature of guidance given to researchers regarding ethical issues with children. Influences of differing views about children, competency, vulnerability, protection, and rights are apparent in the differing guidelines. However, the existing documentation in New Zealand, like ethical codes in other countries, currently has a relative lack of specific and consistent attention to these unique ethical issues (Lindsay 2000; Mishna et al. 2004).
A disparity clearly exists between the increased recognition of children’s participation rights as a consequence of new theoretical perspectives and the lack of recognition specifically accorded children and child-related issues in research ethics documentation. The vast majority of researchers interviewed indicated a keen awareness of, and consequent attendance to, ethical issues in conducting research with children. The overwhelming implication is that the institutions in New Zealand have been slow to grasp and systematically address the ethical issues specific to conducting research with child participants.
A key issue to arise out of this review is how the unique ethical issues can be attended to within the codes. Ethical principles may conflict and researchers sometimes have to give greater emphasis to one principle over another. Alderson & Morrow (2004) suggest that ethics raise questions rather than provide clear solutions. They promote the use of frameworks that have been developed, based on philosophical debate about duty, rights, and harm and benefit, which “offer useful ways to think about potential problems in social research and of preventing or reducing the problems” (Alderson & Morrow 2004: 31).
Frameworks and guidelines that encourage researchers to consider ethical issues and methods that enhance children’s participation throughout the research process do exist in some areas and could usefully be incorporated into ethics documentation. Ethical guidelines have been written in the New Zealand context, relating to health research with children (Peart & Holdaway 2000) and research in early childhood settings (Cullen et al. 2005). Peart & Holdaway’s (2000) guidelines have been incorporated into the Health Research Council and Ministry of Health ethics documentation, and are cited in some institutional ethics guidelines. The framework developed by Cullen et al. (2005) is structured around the processes of planning, undertaking, and disseminating research in early childhood settings, and raises practical questions and considerations for researchers and others involved in the research process.
The indications from this review are that ethics documentation lacks specificity and consistency, and that ethics committees vary widely in their responses. An implication of this is that the level of expertise and knowledge fluctuates within and between ethics committees. A possibility in providing ethical guidance to ethics committees, organisations, and researchers, could be the development of specialist research ethics committees for consultation regarding research with children and young people, which would allow those with specific expertise and greater awareness of the ethical issues to review research proposals (Stalker el al. 2004). A further suggestion is the use of independent agencies to review research proposals (Gilbertson & Barber 2002). The Office of the Children’s Commissioner “is an independent authority and promotes children’s and young people’s wellbeing through advocacy, consultation, monitoring, research and investigation” (Office of the Children’s Commissioner 2004). As such, the Office and its Young People’s Reference Group could potentially have a role in reviewing research proposals.
It would seem there is some way to go before ethics documentation across the board in New Zealand achieves an ethical balance reflecting respect for children’s participation and protection rights. There are some fundamental issues that we argue should be standard to ethical requirements. Firstly, children should always be required to give consent to participation and the opportunity to refuse and withdraw at any stage during the research process. Secondly, information should always be provided in a child-friendly form about the project, including what participation will require, the purpose of the research, and any potential risks or effects. Thirdly, the researchers should have sufficient knowledge and understanding to be able to reflexively consider children’s responses as the research process unfolds, and thus any ethical issues as they arise. We consider that these three criteria are essential ethical requirements and integral to ensuring children’s participation rights are upheld. Ethical research should:
… enable children to be heard without exploiting them, protect children without silencing and excluding them, and pursue rigorous inquiry without distressing them. (Alderson & Morrow 2004: 12)
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1 Article 12: State parties shall assure to the child who is capable of forming his or her own views the right to express those views freely in all matters affecting the child, the views of the child being given due weight in accordance with the age and maturity of the child.
2 Article 13: The child shall have the right to freedom of expression, freedom to seek, receive and impart information and ideas of all kinds, regardless of frontiers, either orally, in writing or in print, in the form of art, or through any other media of the child’s choice.
3 Zenith Technology Corporation, the other institution accredited by HRC, does not conduct research with participants under the age of 18 years and thus is excluded from this review.
4 These include the eight universities and the two relevant HRC accredited institutions—Wintec and Unitec.
5 For detail regarding the email interview method used, see Powell (2006), or for an excellent guide see Meho (2006).
6 Operational Standards for Ethics Committees (Ministry of Health 2002), Appendix 1, Guidelines for Health Research with Children.
7 That is, with the exception of Wintec, which as noted makes no specific reference to children in the ethics documentation accessed.
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K06009; Online publication date 24 November 2006
Received 4 July 2006; accepted 17 October 2006
Kōtuitui: New Zealand Journal of Social Sciences Online, 2006, Vol. 1: 125–138
1177–083X/06/0102–0125 © The Royal Society of New Zealand 2006