Author:Aline Sarradon-Eck (Université Paul Cézanne, Aix-Marseille 3)
Paper short abstract:
The paper discusses some dilemmas raised by the application of medical research's ethical principles (informed consent, protection from harm, confidentiality) to ethnography of medical care. It analyzes social meanings and uses of ethical rules by authorities, which control the access to fieldwork.
Paper long abstract:
Based on fieldwork experiences (participant/direct-observation of medical visit), I will present several ethical issues concerning researcher's position when the fieldwork is based on observations of medical care places and practices. Particularly, I will discuss some dilemmas raised by the application of medical research's ethical principles (informed consent, protection from harm, confidentiality) to ethnography of medical care. Various dilemmas are linked to researcher's responsibility such as following one : should he/her attempt to protect the subjects (here patients and physicians) from potential risks related to research, or scrupulously apply ethical principles for research involving human beings defined by the Declaration of Helsinki? Then, I will analyze social meanings and uses of ethical rules by authorities, which control the access to fieldwork (here the Conseil de l'Ordre des médecins). This analysis shows that their interpretations consider patients' words and clinical encounter as sacred; protect the autonomy of medical profession; value quantitative or positivist approaches and depreciate the ethnographic method; overemphasize medical secrecy; essentialize medical ethics. The encounter with a strong biomedical professional ethic is a source of power stakes and of mutual misunderstandings. For ethnographic research, the risk is that biomedicine intrumentalize antheopology - under the cover of ethics - that therefore would limit the fields' open for ethnographic research.
Ethically sensitive researches in anthropology