Ethical Issues in Trauma Research Involving 'Vulnerable' Subjects with 'Diminished' Autonomy: A View from the Survivor's Perspective
Journal of Empirical Research on Human Research Ethics, Forthcoming
Posted: 15 May 2006
The current paradigm for ethical research with subjects who are survivors of violence or trauma presumes that these individuals are vulnerable and have diminished autonomy and so require additional protections from research risks, including the risk of coercion. These additional protections purportedly arise from the requirements of the ethical principle of respect for persons. Using the case of research focused on and involving survivors of sexual assault, I argue that conceiving of survivors of violence and trauma in this way - as necessarily altered by the experience of violence such that they are vulnerable, diminished, and less able to choose freely - is a mistake that not only fails to protect these subjects, but disrespects them in ways that may be reminiscent of some of the harms related to the trauma or violence they have experienced. Conceiving of these survivors as vulnerable and diminished in virtue of their victimization suggests not only that they are less free than they may actually be, but that the violence or trauma has had the effect of necessarily, intrinsically, and permanently reducing them as people. In contrast to the assumptions implicit in this paradigm, recent research suggests that treating survivors of sexual assault as if they are "different" or "less worthy" persons - as though the assault permanently transformed them somehow - may exacerbate post traumatic stress disorder symptoms among this population. Moreover, this research suggests that talking about the trauma more extensively with others may be beneficial and therapeutic for survivors of sexual assault, not risky and harmful as many IRBs assert. While researchers need to be cognizant of and diligent in anticipating and recognizing the real, lasting, and at times unpredictable consequences of traumatic experiences, the way to respectfully engage survivors in research is through frank open discussions of research goals and design at all stages of the research process. Rather than respecting survivors' autonomy and maximizing their empowerment, the current paradigm is disrespectful in its presumptive reduction of survivors' ability to choose freely and possibilities for recovery from trauma.
Keywords: research, ethics, violence, trauma, respect for persons
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