Critical issues on informed consent in Africa

Biomedical research has made tremendous advances during the last decade in improving human health and well being. In spite of these advances, research has encountered serious emerging challenges as it moves across boarders and confronts different societies with different cultural practices, beliefs, moral thoughts and different values. A pervasive and perplexing issue affecting the current advances in research is the perception that research might end up exploiting populations unless it is conducted in the context of a strong ethical framework. Furthermore, informed consent has increasingly become a thorny area for researchers when considering what should be done when introducing the process into a community, especially if the process might destroy the traditional value system and customs of the community. In this paper, I argue that community consent is an unethical process which should be subverted for community dialogue and community education in research in Africa.     

Ethical dilemmas in social problems research: A theoretical framework

Interest in ethical issues in social science has increased greatly in recent years. However, no comprehensive framework for the prediction and elimination of ethical dilemmas has been presented in the literature. This paper first analyzes reasons for increased interest in ethical issues, and then presents a broad framework for prediction and analysis of ethical problems. This framework is based on exchange theory, and shows the interdependencies between five “publics” in the research process: sponsors, researchers, subjects, the media, and the general public. The model also utilizes the sociological concepts of role of each public, the configuration of ascribed and achieved status, and norm abeyance. The primary exchange concepts used are cost, benefit, and trust. The model is illustrated with four actual research projects where ethical dilemmas occurred, and is found to be predictive of ethical problems if there are great disparities in cost/benefit ratios between subjects and researchers or sponsors, if there is great discrepancy between the status of the subjects and the researchers or sponsors, and if the researchers engage in norm abeyance. the author ofMethods of Social Research and numerous articles on research methods. Bailey also is interested in theory and ecology. This research was partially funded by UCLA Senate Research Committee Grant #2884.     

Evaluating effectiveness in social work: sharing dilemmas in practice

Evaluating effectiveness is of primary concern to social work practice; resources will always be limited, and those using services deserve the best. But what is effectiveness, and how should it be measured? This paper explores the challenge of measuring effectiveness in social work by examining two small-scale evaluations of services (statutory and voluntary) in Scotland. Both evaluations used a mixed method approach and both were conducted in a climate of funding cuts. It will be argued that evaluating effectiveness sits uncomfortably between new public management (NPM)’s imperative for measurement and efficiency within a market economy and agencies’ own need to reflect on their practice and respond to the views of their service users. Such processes force agencies into a continual cycle of monitoring and review that may, paradoxically, impede organic change and development. It is suggested that an alternative, critical paradigm in evaluation offers a positive way forward.     

Ethical dilemmas in evaluating programs with family court related clients

Two ethical dilemmas are discussed; breaching client confidentiality in order to intervene in the client's illegal behavior, and defining the role of evaluator as expert witness. The evaluation context concerns a combined program development and evaluation project with clients involved in family court proceedings for child abuse or neglect. Different perspectives, approaches, and experiences in resolving each dilemma are reviewed. The conclusion argues that approaches to ethical dilemmas in evaluation projects must go beyond techniques to disguise data, to include an assessment of the values and value commitments connected to the different roles an evaluator must perform.     

Ethical practice and evaluation of interventions in crime and justice. The moral imperative for randomized trials

In considering the ethical dilemmas associated with randomized experiments, scholars ordinarily focus on the ways in which randomization of treatments or interventions violates accepted norms of conduct of social science research more generally or evaluation of crime and justice questions more specifically. The weight of ethical judgment is thus put on experimental research to justify meeting ethical standards. In this article, it is argued that just the opposite should be true, and that in fact there is a moral imperative for the conduct of randomized experiments in crime and justice. That imperative develops from our professional obligation to provide valid answers to questions about the effectiveness of treatments, practices, and programs. It is supported by a statistical argument that makes randomized experiments the preferred method for ruling out alternative causes of the outcomes observed. Common objections to experimentation are reviewed and found overall to relate more to the failure to institutionalize experimentation than to any inherent limitations in the experimental method and its application in crime and justice settings. It is argued that the failure of crime and justice practitioners, funders, and evaluators to develop a comprehensive infrastructure for experimental evaluation represents a serious violation of professional standards.     

Provider dilemmas with relocation in assisted living: philosophy vs. practice

Support for increasing tenant frailty in assisted living (AL) is a complex and challenging issue. Philosophically, older persons, families, providers, and policymakers want to avoid unnecessary relocation. However, there is considerable opportunity for inconsistency in practice. We examined provider perspectives related to implementing aging-in-place, using information obtained from an evaluation of a three-year AL demonstration project in Illinois. We found differences in approaches to explicit move-out criteria, the actual application of move-out criteria, and provider willingness to develop flexible service plans. These findings raise questions for consideration in all states confronted with implementing the philosophy and intent of AL.     

Ethical universals in practice: An analysis of five principles

This paper discusses the application of five general principles of moral reasoning to situations that are characteristic of negotiations and bargaining scenarios. The five moral theories discussed are: utilitarianism, Kantian reasoning, discourse ethics, the maximization of one's own expected utility, and the maximization of the predictability of the consequences for those involved in the bargaining or negotiation. These principles are individually introduced and criticized by examining how they ‘perform’ in individual test cases taken from common negotiation experience. The purpose of the analysis is to lay bare the difficulties faced by the moral philosopher, economist, psychologist or sociologist when attempting to explain, interpret or normatively endorse behavior in concrete cases of bargaining scenarios on the basis of general principles. Because bargaining underlies most of the phenomena of interest to the economist and sociologist, the analysis illuminates a problem of general interest to practitioners of economics and sociology. It is argued that the calculability of the consequences of acting in accordance to a norm and the communicability of the norm in actual negotiation sessions both sharply constrain the application of the principles in practice. The essay therefore represents a reasoned invitation towards further investigation and reflection about the application of moral principles in bargaining and negotiations.     

Unmanaging public relations: Reclaiming complex practice in pursuit of global consent

Globalisation raises numerous problems for contemporary public relations theory. In a world where the geographic reach of organisations routinely spans cultures and nation states and where issues of culture, economics and politics are inseparably intertwined, the discipline of public relations has established a distance from the immediacy of the marketplace, failed to fully engage with discussions of culture. By taking a relentlessly managerialist approach, theorists have also failed to recognise the true complexity of public relations practice and this has marginalised aspects of practice that, though nebulous and intangible, are none the less real. This paper argues that attention needs to shift towards the complexities of practice, in order to recapture and theorise a distinctive occupational field with the aim of better understanding the relationship between universal humanising principles, on the one hand, and the purposive demands of capital, on the other; the attempt to theorise how public relations makes profitable sense in society. The paper was prompted by the author's reflections on auto-ethnographic research into the public relations field, part of an ongoing research project.     

Parents with a Learning Disability: research issues and informed practice

This paper commences with an examination of the concept of parenting and then applies its findings to parents who have a learning disability. It is argued that views on parenting, drawn from mainstream developmental psychology from parents who do not have a learning disability can inform our thinking about parents who do have a learning disability and provide an agenda for future research. In particular, we look at skills-based approaches to parenting, parenting as a motivated activity, cultural and historical factors influencing parenting, and lay views on children and childhood. The conclusion was reached that, although an audit of what people with a learning disability believe and expect about children is valuable research, the critical issue is how this knowledge is applied in parenting practice.     

Ethical problems in program evaluation: Advice for trapped evaluators

This paper argues that ethical problems in program evaluation are increased when conflicting or incompatible evaluation models are applied concurrently. Three models are illustrated: an Amelioration Model, generating better information for a program's own decision makers; an Accountability Model, focusing on public data disclosure and citizen participation in evaluation; and an Advocacy Model, in which the evaluation is designed to advance the program's interests in the competition for resources. Ethical problems inherent in each model, and arising from combining models are presented, along with case examples and discussion. The authors suggest several directions that program evaluators can consider to reduce their vulnerability to ethical problems.     

Obsessive-compulsive disorder: suffering in silence

Obsessions and compulsions vary in frequency and intensity. Many individuals have habits that cause minimal or no disruption of their lives. OCD, however, causes significant distress and interference with daily life. The problem may go unnoticed by anyone except the involved individual, or it may involve family, friends, and acquaintances. The disorder can be disabling, adversely affecting a student personally, socially, and occupationally. Those who are significantly affected by OC symptoms are encouraged to seek treatment. Behavior therapy and medications are extremely beneficial in helping to relieve symptoms of OCD. Clomipramine and fluoxetine (Prozac) are new drugs available in the US that appear to be effective for OCD symptoms. Several other anti-OCD medications may be available in the US within the next few years. It is important that students and others on campus be made aware that OCD is more common than previously recognized, that more persons with OCD are seeking help, and that effective treatment is available. This "secretive," often disabling disorder is more open now, and it is to be hoped that more individuals will take advantage of current, effective evaluation and treatment modalities.     

The partisanship of silence: Symbolic politics of school desegration in Boston

This article analyzes the symbolic aspects of the school desegration controversy using disputes in Boston as a case in point. The symbolic communication between actors in the public forum contains implicit views of the rights and obligations of different participants in the controversy, and the role of various individuals and collectives in the history of the controversy. These views also provide a framework for understanding the position of specific actors, which may constrain their ability to participate effectively in the controversy. This article analyzes these constraints with respect to those actors who attempted to establish a mediator role between pro-integration and anti-busing forces.Prepared under grants from the National Institute of Education (NIE-6-00-3-0187, NIE-6-76-0038), National Institute of Mental Health, (R01-MH-27618) and the Carnegie Corporation.