Elsevier

The Lancet

Volume 359, Issue 9317, 4 May 2002, Pages 1599-1604
The Lancet

Series
Bearing witness: ethics in domestic violence research

https://doi.org/10.1016/S0140-6736(02)08521-5Get rights and content

Summary

Epidemiological research involving people has inherent risks. The Council for International Organization of Medical Sciences provides guidance on the ethical principles of epidemiological research, including respect for people, non-maleficence, beneficience, and justice. In this article we discuss the challenges of applying each principle to population research on domestic violence, an issue in which poorly designed research could put women in violent relationships at substantial risk. Main concerns include ensuring safety of respondents in a context in which many live with their abuser, protecting confidentiality when breaches could provoke an attack, and ensuring the interview process is affirming and does not cause distress. The inherent risks entailed in research can only be justified if the interview is used to provide information on available services and is a source of immediate referral when necessary, if high-quality data are obtained, and if findings are used to raise awareness of, and improve services for, women who experience domestic violence.

Section snippets

Ethical concerns in research on violence against women

WHO have published guidelines for addressing ethical and safety issues in domestic violence research (panel).11 The guidelines were based on the experiences of the IRNVAW, and were developed to inform the WHO study,8 an ongoing research project involving large household surveys of women in eight countries.8

Minimising harm (non-maleficence)

The main ethical concern related to researching violence against women is the potential to inadvertently cause harm or distress. Respondents might be vulnerable to physical harm if a partner finds out that she has been talking to others about their relationship. Additionally, there is the potential for respondents to become distressed by an insensitive interview, or from having to recall painful or frightening experiences. Field-workers can also be put in danger if an abuser finds out about the

Beneficence (maximising benefits)

The principle of beneficence refers to the ethical obligation to maximise possible benefits both to the study participants and to the wider group of individuals they represent. This principle gives rise to norms requiring that research design be methodologically sound, that the research has tangible benefits to participants, and that investigators be competent both to do the research and to ensure the well being of participants.

Respect for individuals

The principle of respect for individuals incorporates two fundamental ethical principles: respect for autonomy and protection of vulnerable people. These principles are commonly addressed by procedures to obtain individual informed consent that ensure that respondents understand the purpose of the research, the risks and benefits of participation, and that their participation is voluntary.

Justice: balancing risks and benefits

The principle of distributive justice demands that individuals bearing the burden of research should receive an appropriate benefit, and those who stand to benefit most should bear a fair proportion of the risks and burdens of the study. In the case of gender-violence research, risks are potentially large, but so too are the risks of ignorance, silence, and inaction. Researchers and ethics review boards must constantly balance these risks. Fontes2 cited the case of a colleague from India who

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