Differential attrition rates and active parental consent.

Active parental consent in survey research poses ethical and practical concerns. One common argument against the requirement of active consent procedures is its effect on participation rates. There is additional concern that higher risk groups may be underrepresented in the final sample. Empirical support of differential attrition, however, is lacking. In the current multisite longitudinal study, passive consent procedures were approved for the collection of pretest data. For subsequent years of data collection, active parental consent procedures were required. In this article, we use the pretest data to examine demographic, attitudinal, and behavioral differences between those students for whom active consent was provided and those for whom active consent was either denied or for whom no response was received. The results indicate that active consent procedures produce deleterious effects on participation rates and lead to an underrepresentation of at-risk youth in the sample.     

Characteristics of responding-, nonresponding- and refusing-parents in an adolescent lifestyle choice study.

The acquisition of a random sample is one of the many methodological problems that arise when conducting research with adolescent populations. Frequently, due to ethical considerations associated with collecting data from adolescents, active parental consent procedures are required. The current study examined characteristics of parents who consented, refused consent, or did not respond to an active consent request for their children to participate in a large-scale study of adolescent lifestyle behaviors. Results indicated nonresponding-parents were more likely to be employed than consenting-parents. Further, differences were found for a number of attitudinal variables and about the importance of adolescent research. There were significant differences between refusing-parents, and consenting- and nonresponding-parents who were similar in their attitudes toward adolescent research. The findings suggest that nonresponding-parents are characteristically more similar to consenting-parents than to refusing-parents, which supports the use of passive consent procedures as a reasonable alternative to requiring active parental consent in adolescent research.     

Sensitive research with adolescents: just how upsetting are self-report surveys anyway?

Distress related to answering personal survey questions about drug use, suicidal behavior, and physical and sexual abuse were examined in multiple convenience samples of adolescents. Samples varied in consent procedures utilized (active vs. passive parental consent), data collection setting (school vs. juvenile justice), developmental level (middle school vs. high school). Participation rates differed across consent procedures (e.g., 93% with passive vs. 62% with active parental consent). Results indicated that small percentages of adolescents in every sample reported frequently feeling upset while completing the survey (range 2.5% to 7.6%). Age, race, gender, and data collection strategy did not emerge as significant predictors of feeling upset. Instead, as hypothesized, adolescents reporting a history of suicidal ideation or attempt, illicit drug use, or experiences of physical or sexual victimization endorsed more frequent feelings of upset while completing the survey than peers without these experiences. Taken together, however, these sensitive event experiences explained only 6.6% of the variance in adolescents' upset ratings. The scientific and ethical implications of these findings are discussed with regard to adolescent participation in survey research about sensitive topics.     

How does active parental consent influence the findings of drug-use surveys in schools?

This study examines the impact of passive and active parental consent procedures on the type of adolescents participating in a school-based survey examining substance use. Schools recruited from a random sample of metropolitan schools were assigned to passive or active parental consent condition. Results showed that participation rates in active consent schools were lower than in passive consent schools for junior students (60% vs. 80%) but not senior students. Although consent condition had limited impact on prevalence estimates among older students, among younger students estimates of cannabis use and ecstasy use were higher in the passive consent condition than the active consent condition. Active consent procedures introduce some degree of selection bias into studies of adolescents' substance use and may compromise the external validity of prevalence estimates produced, especially among younger students.     

Do participation rates change when active consent procedures replace passive consent

Researchers face considerable ambiguity and controversy regarding the issue of informed consent. Decisions about consent procedures can affect study participation rates and prevalence estimates among specific populations. Changing from passive to active parental consent procedures was examined in a case study with an anonymous survey of sixth- through eighth-grade students' substance use. Four types of procedures for obtaining parental consent were examined. Results suggest that certain types of consent procedures can yield high levels of participation. This study also demonstrates that low participation rates with some active consent procedures can cause biases in sample characteristics and outcome data.     

Active parental consent in school-based research: how much is enough and how do we get it?

Active parental consent policies have been blamed for low participation rates and selection bias (i.e., loss of "high-risk" youths) in school-based studies. In this article, the authors describe active consent procedures that produced an overall active consent rate of 79% in a sample of more than 4,500 middle school students attending 29 schools in seven cities across the United States. Consent rates, however, varied considerably both within and between schools. To better understand factors associated with active parental consent rates, the authors examined district-level, school-level, and teacher-specific effects on consent rates.     

Counseling minors without parental consent

Counseling services provided to minors without parental knowledge or consent are based on uncertain and often conflicting policies and procedures. This article examines these services from legal and psychological perspectives, explores current agency policies and practices, and makes recommendations with regard to the counseling needs and rights of minors.     

Research with Children and Young People: The Issue of Parental (Proxy) Consent

This study examines the potential problems with the parental consent requirement, substantiated with examples mainly from healthcare and social research studies. This will illustrate how the parental consent requirement, instead of promoting high ethical standards, may result in some instances of children’s rights and ethical considerations being ignored or receiving cursory attention. The ‘blanket’ requirement of parental consent for all research involving children under the age of 18 years needs to be challenged as it fails to recognise children’s capacities and accord children due respect as persons in their own right. Flexible ethical guidelines should be developed that take cognisance of children’s competence in contemporary society and at the same time protects children from inappropriate research and procedures.     

Characteristics of adolescents who provide neither parental consent nor refusal for participation in school-based survey research

Schools offer a convenient setting for research on adolescents. However, obtaining active written parental consent is difficult. In a 6th-grade smoking study, students were recruited with two consent procedures: active consent (parents must provide written consent for their children to participate) and implied consent (children may participate unless their parents provide written refusal). Of 4,427 invited students, 3,358 (76%) provided active parental consent, 420 (9%) provided active parental refusal, and 649 (15%) provided implied consent (parental nonresponse). The implied consent procedure recruited more boys, African Americans, students with poor grades, and smokers. This dual-consent procedure is useful for collecting some limited data from students who do not provide active consent or refusal.     

The effect of active parental consent on the ability to generalize the results of an alcohol,tobacco, and other drug prevention trial to rural adolescents

The authors report the effect of active parental consent on sample bias among rural seventh graders participating in a drug abuse prevention trial. Students obtaining active consent from their parents to complete the survey were of higher academic standing, missed fewer days of school, and were less likely to participate in the special education program at their school as compared to students who did not return a parental consent form. However, students with consent were not significantly different from students whose parents actively declined. The sample obtained under active parental consent represents students less at risk for problem behaviors than would have been obtained under passive consent procedures.     

A comparison of methods to obtain active parental consent for an international student survey

Many school-based research efforts require active parental consent for student participation. Maximizing rates of consent form return and agreement is an important issue, because sample representativeness may be compromised when these rates are low. This article compares two methods for obtaining active parental consent: return of consent forms in the mail versus return by students to their classrooms. The methods were tested in a pilot study of 46 schools (1,058 students), with half of the schools randomly allocated to each of the alternative methods. A hierarchical nonlinear model of consent form return and agreement rates suggests that the student-delivered method is more successful at producing higher rates of consent form return and agreement to participate in the study, after controlling for school-level characteristics. The authors discuss the findings and their implications for other researchers engaged in school-based research with adolescents.     

The impact of child obesity on active parental consent in school-based survey research on healthy eating and physical activity

Previous studies have shown that active consent procedures result in sampling bias in surveys dealing with adolescent risk behaviors such as cigarette smoking and illicit drug use. To examine sampling bias from active consent procedures when the survey topic pertains to childhood obesity and associated health behaviors, the authors pair data obtained from both active and passive consent procedures. The authors find that parents of children who are overweight or at risk for being overweight are significantly less likely to give active consent. In addition, parents of children enrolled in lower grades are more reluctant to consent to participate.     

Ethical Issues in the Provision of Online Mental Health Services (Etherapy)

ABSTRACT

A number of ethical issues involved in face-to-face therapy are examined in relation to online therapy (etherapy). Etherapy is defined and its strengths and weaknesses discussed. Specific ethical issues addressed include boundaries of competence, basis in science, avoidance of harm, confidentiality, avoidance of false or deceptive statements, forums, testimonials, solicitation of clients, fees, and informed consent. A concluding section briefly addresses legal issues, particularly interstate etherapy. It is recommended that federal licensing legislation be enacted, informed by the NASW, the APA, and similar groups.     

Desiring Self‐Determination in Research and Beyond: Parental Consent Requirements and Situated Ethics for Migrant Young People Living amid Changing Family Dynamics

How are procedural research ethics complicit in homogenising and paternalising young people? Through a youth‐centred ethnographic study completed in Canada, I illustrate how migrant young people's complex experiences of family separation, responsibility, and autonomy sit in relation to parental consent requirements for research. By complicating notions of childhood and critically discussing capacity to consent, I elucidate how procedural ethics can negate diversity among young people and perpetuate the structural barriers some face in determining their lives. More flexible ethical procedures and responses could reduce barriers and better accommodate young people's inclusion by recognising their specific circumstances, desires and competencies through heightened contextual awareness.     

Patient Rights: An Advocate's Perspective

Abstract

The current growing concern about patients' rights and the delivery of student health care precipitates an environment of fear, distrust, and uneasiness within university health services. This paper addresses several selected clinical, ethical, and legal issues which have come into conflict during recent years. Our examination surveys ethical and legal principles of confidentiality, defines areas in which breaches are most likely to occur, and suggests ways of preventing breaches of confidence between students and health services.

While the fundamental ethical principle underlying confidentiality is the individual's right of privacy, many issues of confidentiality are extremely difficult to resolve. University health services have expanded the concept of health care to encompass all the conditions — medical, emotional, social, economic and environmental — which affect the health of students. As a result, health service administrators should be fully aware of the laws and associated legal complexities in their own state which affect confidentiality. Furthermore, student health physicians, and particularly mental health therapists must be sensitive to needs for protecting the privacy of students.

Legal principles of confidentiality discussed in this paper with respect to specific problem situations which might arise in a student health center include: 1) right to privacy; 2) privileged communications; 3) releasing information from the medical record; 4) releasing information to the student; and 5) treating minors without parental consent. Finally, in addition to the responsibilities which must be assumed by the health professional, certain student responsibilities in the selection and utilization of health professionals are recommended.     

Ethical Issues for Qualitative Research in On-line Communities

Recent years have witnessed a rapid growth in Internet technologies, which offer new possibilities for researching hard to reach groups. However, research guidelines, which could aid research in this new forum, have not yet been fully developed. The focus of the article will be ethical issues that may arise from using the Internet as a research tool if we are to protect and respect our participants. Questions surrounding gaining informed consent, privacy of participants and new power differentials, which may arise through interaction in an on-line forum, are raised. These are supplemented by reflections from work conducted by the authors using on-line discussion formus as method of research with people with autism.     

Passive versus active parental permission in school-based survey research: does the type of permission affect prevalence estimates of risk behaviors?

This study investigates whether the type of parental permission affects prevalence estimates for risk behaviors from the national 2001 Youth Risk Behavior Survey. Participants were 13,195 students from 143 schools, of which 65% used passive permission and 35% active permission. Student participation rates were 86.7% in passive permission schools and 77.3% in active permission schools. For 24 of 26 behaviors tested, no significant differences were seen in the prevalence of risk behavior by type of parental permission. As long as high response rates are obtained, type of parental permission does not affect prevalence estimates for risk behaviors that are based on self-report.     

Informed Consent as Process: Problematizing Informed Consent in Organizational Ethnographies

This article examines the implications of informed consent in organizational ethnographies, where the research site is a bounded and formal institution that has its own sets of rules which govern action and membership. While there is considerable scholarship on the issue of ethics in ethnography in general, very little has been written about informed consent in organizational ethnographies where researchers often simultaneously observe managers, “studying” up according to Nadar, and employees referred to as “studying down”. Organizational researchers tend to discuss ethics in terms of obtaining informed consent for individual interviews or in terms of access to an organization as a research site. This essay examines ethical dilemmas experienced in fieldwork studying participatory work arrangements in a Mexican garment firm. By discussing practical issues of gaining access, problems of maintaining access and consent, and concerns of how gatekeeper consent affects subordinates, I problematize the practice of obtaining informed consent in organizations. I argue that thinking of informed consent as an on-going process that requires an active reflexivity on the part of the ethnographer will help researchers to navigate the ever-shifting web of power dynamics present in organizations.     

Contentious issues in research on trafficked women working in the sex industry: Study design,ethics, and methodology

The trafficking of women and children for work in the globalized sex industry is a global social problem. Quality data is needed to provide a basis for legislation, policy, and programs, but first, numerous research design, ethical, and methodological problems must be addressed. Research design issues in studying women trafficked for sex work (WTSW) include how to (a) develop coalitions to fund and support research, (b) maintain a critical stance on prostitution, and therefore WTSW, (c) use multiple paradigms and methods to accurately reflect WTSW's reality, (d) present the purpose of the study, and (e) protect respondents’ identities. Ethical issues include (a) complications with informed consent procedures, (b) problematic access to WTSW, (c) loss of WTSW to follow‐up, (d) inability to intervene in illegal acts or human rights violations, and (e) the need to maintain trustworthiness as researchers. Methodological issues include (a) constructing representative samples, (b) managing media interest, and (c) handling incriminating materials about law enforcement and immigration.     

My Auto/Ethnographic Dilemma: Who Owns the Story?

This article explores ethical issues of co-mingled data, demarcating the field and informed consent in a study researching the consequences of Christian fundamentalist ideology on the lives of “Bible Belt gays”. When what constitutes informed consent is ambiguous, how does the qualitative researcher justify her decision either to include or exclude meaningful data? To illustrate these ethical issues, I analyze four instances of co-mingled data, two featuring Christian fundamentalists and two Bible Belt gays, in which I gain theoretical insights under conditions of blurry consent, and weigh potential harm to subjects against the liberatory goals of the project.