Negotiating human research ethics: Case notes from anthropologists in the field (Respond to this article at http://www.therai.org.uk/at/debate)

The human ethics issues surrounding the conduct of health science research have been the subject of increasing debate among biomedical and social science researchers in recent years. Ethics procedures in health‐science research are typically concerned with protecting anonymity and confidentiality, and are tailored to work that primarily uses quantitative methodologies. For qualitative research in the health social sciences, a different set of ethical issues often arises in the research process. This article examines three case studies of qualitative researchers working with Indigenous Australian communities, focusing on the researchers’ experiences with ethics committees and how they approached a range of ethical issues arising in the course of their research. Key issues include: obtaining informed consent for participant observation; the evolving nature of qualitative research; the difficulties in foreseeing changes in approach; and the distinction between the research team and the researched in participatory action research.     

On the invisibility of the emasculated (Respond to this article at http://www.therai.org.uk/at/debate)

Castrating a male by destroying his testicles is a practice that most people assume ended a century or so ago with the collapse of the Chinese and Ottoman Empires and the death of the last castrato in the Vatican choir. However, because advanced prostate cancer is treated by either chemical or surgical castration, there are probably more castrated men alive today than ever before in history. Castration is also used in the western world as either a step in the sexual reassignment of male to female (MtF) transsexuals or rarely to treat recidivist sexual predators. In addition, some men desire emasculation who are neither cancer patients, MtF transsexuals, nor sexual predators. In this essay I argue that the public association of castration with sexual predators and deviant behaviour is so great that men, who require it as a medical treatment for cancer or who seek it for other reasons typically hide from public view. One consequence of the shame associated with castration is that those, who desire emasculation but do not have a diagnosis of cancer, too often subject themselves to risky and illegal amateur surgeries outside the medical system. I argue that for whatever reason a male seeks castration, the overall invisibility of the emasculated in modern society is a disservice. It minimizes the public's understanding of the magnitude of the impact of castration on cancer patients and it inhibits those in need of medical treatment from getting it in an appropriate and timely fashion.     

Bedside manner and the invisible patient: The silence surrounding women's gynaecological health in Niger (Respond to this article at http://www.therai.org.uk/at/debate)

Women with gynaecological and obstetrical disorders in Niger such as obstetric fistula, often negotiate the clinical experience for years or even decades without ever receiving a diagnosis. The withholding of information is common practice among clinicians, who due to the lack of time, the lack of follow‐up, or ethical considerations that discourage delivering patients ‘bad news’, frequently do not explain women's conditions or options for treatments. Instead, women interfacing with the clinic are often told only one thing: be patient. This call for patience strips women, and their families, of the agency to participate in treatment decisions and the decision as to when, or if, to abandon the search for care.     

Something for posterity or hostage to fortune? Archiving anthropological field material (Respond to this article at http://www.therai.org.uk/at/debate)

What do anthropologists do with all the data (both primary and secondary) they accumulate while doing fieldwork? Most continue to draw on it for many years, but there is increasing pressure (e.g. from the ESRC) to place much of it in archives, usually in electronic form. What kind of material could be deposited? What use may be made of such material by others? What are the ethical dilemmas which face anthropologists in depositing confidential data? Are there differences between paper and electronic archives and between textual and other forms of material, such as photos and sound recordings? How can anthropologists best protect their sources? Does anthropology become a form of historiography when its raw data are archived? What forms of ‘knowledge’ are created by archiving?     

Enter the myopticon: Uncertain surveillance in the Danish asylum system (Respond to this article at http://www.therai.org.uk/at/debate)

Asylum seekers in Europe face increasingly restrictive policy regimes across the continent. In Denmark, they are held at designated asylum centres while their cases are processed and are subject to limitations on their movement, education and employment, as well as to a degree of surveillance from both the state and the Danish Red Cross, which operates the majority of the asylum centres. While these structures are in some ways reminiscent of Foucault's panopticon, I want to suggest a counterpoint to the panopticon, which I call the ‘myopticon’ to indicate the near‐sightedness of the central surveying eye. The myopticon is a near‐sighted system of surveillance practices, knowledges and sanctions, deployed as though it were panoptic. I want to suggest that the uncertainty that has soaked through the Danish asylum system and profoundly affected the asylum seekers in it is not a byproduct of bureaucratic processing, but intrinsic to the operation of the myopticon. By drawing out points of distinction with Foucault's panopticon, I sketch the outlines of a new technology of power that has powerful consequences for the daily lives of asylum seekers in Denmark.     

Anthropology and the military: AFRICOM, ‘culture’ and future of Human Terrain Analysis (Respond to this article at http://www.therai.org.uk/at/debate)

This article updates new developments in the evolution of the US Army's controversial Human Terrain System program (HTS). Building upon the recent report on the HTS program by the American Anthropological Association's Commission on the Engagement of Anthropology with the Security and Intelligence Communities, this article discusses how HTS‐type arrangements are becoming part of the US Department of Defense's (DoD's) newest Combatant Command for the continent of Africa, or AFRICOM. Of particular note is the way “human terrain” no longer refers simply to the HTS program, but has acquired expanded reference to describe a broader array of approaches to the leveraging of socio‐cultural knowledge within DoD. Most notably for AFRICOM, this includes moving beyond rapid assessment ethnography to incorporate cultural data into the predictive work of cultural modelling, as this informs the implementation both of counterinsurgency doctrine as well as military humanitarianism in Africa and elsewhere. This article explores the ethical, practical and cultural implications of such a turn.     

Ethical dilemmas? UK immigration,Legal Aid funding reform and caseworkers (Respond to this article at http://www.therai.org.uk/at/debate)

The article considers the kinds of responsibilities anthropologists might have when working on immigration and asylum matters, particularly in the light of recent ‘reforms’ to the funding of legal aid in the UK. The article focuses on a single case study in its context, exploring an interaction between an immigrant applicant and a lawyer/case worker in a not‐for‐profit Law Centre. The paper shows how case workers find themselves caught in the middle, squeezed between increasing financial pressures and their ethical obligation to their clients. In their everyday work they are faced with the contradictory imperatives of giving sympathy and advice to genuinely deserving cases on the one hand while being required to check up on opportunist and possibly deceitful clients on the other. In the context of ‘reform’, they are increasingly encouraged to prejudge the probable outcomes of cases by reference to ‘value for money’. These effects, we argue, have severe consequences given the adversarial nature of the UK's system of law. As anthropologists, our aim was to investigate the day‐to‐day realities of case worker/client interactions, to enable both ourselves and legal practitioners, in conversation, to reflect on our own and each others' interpretations of the situation, and to place these in the public domain.     

Rapid response ethnographies in turbulent times: Researching mass grave exhumations in contemporary Spain (Respond to this article at http://www.therai.org.uk/at/debate)

Sometimes a social process under engaged research can swiftly grow out of control, in scale and complexity. Such was the case in my ten‐year‐long study of mass grave exhumations from the Civil War (1936–1939) in contemporary Spain. In such circumstances, I argue for the deployment of a rapid response ethnography, an extreme modality of both public and/or engaged research. This type of instant engagement forces the ethnographer to constantly refashion research designs; recognize and reabsorb emerging social actors and research scenarios; reinvent ethnographic presence; face unanticipated ethical dilemmas; and reimagine how to transfer our acquired knowledge and reflection in (a) multiple non‐academic formats for a myriad of potential publics and (b), in time frames more attuned to the rhythms of fast‐moving public debates and technological transformations in communications. More importantly, rapid response ethnography takes place whenever there is swift and strong public demand for academic analysis within a broader process of social, political and media controversy. In turn, rapid response research is necessarily committed to the transformation of the social and political conditions under study.     

After the landing: Moral control and surveillance in Italy's asylum seeker camps (Respond to this article at https://www.therai.org.uk/publications/anthropology-today/debate)

Though the recent tragedies in the Strait of Sicily and the daily arrival of refugees on Italy's southern shores, have captured international media attention, institutional silence shrouds what happens after the landing, and the courses asylum seekers follow within the bureaucratic and assistance apparatuses are overshadowed by official data and state regulations. This article sheds light on some aspects of the protection and assistance system in Italy, documenting the experiences of asylum seekers who have reached Italy after crossing the Mediterranean, and now live in the camps run by the Italian government for the detention and control of undocumented migrants. Although these women and men experienced terrible abuses in their journey to Europe, once in Italy, and in particular within the camps, they are subjected to harsh forms of surveillance, as well as to moral and ethical regimes. By referring to research carried out in the reception centres for asylum seekers (CARA – Centri di Accoglienza per Richiedenti Asilo) in western Sicily where men, women and children are held after their arrival on Italy's southern coast, the author shows how the protection and assistance system does not limit itself to recognizing refugees as ‘victims’ or ‘bare life’. Rather, it pursues a more ambitious project in which moral and disciplinary regimes overlap in a systematic, long‐term process of subjection. The overlap of care, control and discipline emphasizes the close connection between the humanitarian apparatus and technologies of control. In particular, it is in the daily rules and practices performed by the personnel running the camp and aimed at governing the intimate and social life of women asylum seekers that the overlap between moral project and techniques of control becomes evident.     

The ‘invisible scars’ of breast cancer treatments (Respond to this article at http://www.therai.org.uk/at/debate)

Drawing on 38 fieldwork interviews with women living with breast cancer conducted in Spain between 2006 and 2008, I draw attention to the significance of what Ludica (2013) refers to as the “invisible scars of cancer” for a holistic understanding of women's experiences. I highlight two under acknowledged thematic concerns that emerged during our conversations: (1) the impact of treatments on women's ability to experience sexual pleasure; (2) the pain caused by axillary lymph node dissection (ALND) or armpit surgery. The present article is a timely reminder of the fact that for a shockingly high number of women diagnosed, the experience of breast cancer is emotionally and physically painful and quite often disabling. An understanding of women's experiences is essential to provide resources more sensitive to women's needs.     

Vaginismus: a Franco-American story

In November 1861, Dr. J. Marion Sims, an American gynecologist, named and described the syndrome of vaginismus, which linked symptoms of vaginal hypersensitivity to muscular spasm. The only rational treatment for this disorder, said Sims, was surgery. His work was taken up immediately in France, but the story of its interpretation and application is a rather complicated one. Félix Roubaud, a leading specialist on matters of impotence and sterility, revised earlier writings in order to make a clear place for Sims's theories. But in the succeeding decades, Sims was subject to more and more criticism in French medical circles. Some argued that French specialists had already identified all the key elements of vaginismus, and that Sims was no more than a successful publicist. Others-and these were finally the most influential-argued against surgical treatment. More and more French writers on sexual medicine argued that vaginismus was a "moral" disorder that could not properly be treated by physical methods. And within French medical circles the Sims operation for vaginismus came to represent an "American" approach that was too rational, and too straightforwardly physical.     

Charity and self‐help: Migrants' social networks and health care in the homeland (Respond to this article at http://www.therai.org.uk/at/debate)

This article examines the delivery of healthcare by Haalpulaar immigrants' village association in France to their rural villages in Senegal. In the context of the neo‐liberal reforms in Senegal, the Haalpulaar immigrants have been very active in funding community project in the health sector for their communities of origin left to fend for themselves by the State. Haalpulaar migrants associations like TAD (Thilogne Association Developpement) and Fuuta Santé are improving access to healthcare in the Senegal River valley through the remittances of biomedicine, medical equipment as well as the organization of annual health caravans with the participation of French health professionals and local partners.     

Caesar: a life in Western culture

Abstract

Professional associations of archaeologists and anthropologists have produced numerous codes of ethics in recent years. Their compilation is motivated as much by the desire to promote standardized professional practice as a wish to enshrine correct ethical responses. The precise wording of these is often minutely scrutinized (although not minutely enough, I argue), but their overall purpose, status or value is rarely considered. This paper considers that the formulation of ethical codes is of limited value and may even be counter-productive. The ambiguities and problems in interpreting concepts such as ‘respect’, ‘indigenous’ and ‘compromise’ are never explored or even acknowledged. Instead, the complexities of genuine ethical dilemmas, when contradictory or incompatible values collide, are circumvented or ignored. Codes of ethics fail to provide a clear guide to practice in cases of profound and complex conflicts of interest. Instead, it is argued here that ethics are historical and contextual; appropriate responses to ethical dilemmas should be developed on a case-by-case basis and require thought, debate and discussion, rather than the application of a rule. Codes of ethics promote conservatism and conformity, reinforce the power of hegemonic institutions and pre-empt ethical debate. Moreover, because they pretend to supra-contextual applicability, several of the principles enshrined in ethical codes could easily be used to support racist or otherwise politically objectionable movements.     

An epidemic on wheels? Road safety,public health and injury politics in Africa (Respond to this article at http://www.therai.org.uk/at/debate)

Anthropologists have showed only marginal interest in road safety, despite the loss of some 1.3 million people killed in road crashes every year, the bulk of which occurs in ‘developing’ countries. 2011 marks the beginning of a UN Decade of Action for Road Safety. Its scope is ambitious: to save five million lives and fifty million injuries by the end of the ‘decade’ in 2020. In this article, the author examines the way public health professionals and educators have appropriated the language of epidemiology to argue that road death and injury can be viewed as an ‘epidemic on wheels’ or a ‘disease of development’, to mention two often cited epithets among participants in the global road safety lobby. One major consideration of interest to anthropologists and policy makers is to what extent this effectively essentializes road death in Africa and depoliticises its injury politics. Bearing in mind the historical context of medical interventions in Africa, the article examines the global road safety lobby and its affinity with public health as a form of transnational governance, arguing alternatively that if the UN Decade of Action on Road Safety is to have any significant impact, it must recognize more clearly the political stakes being raised in claims to reduce deaths and injuries caused by automobility.     

THE CHILDREN'S COUNTRY: ETHICAL STATEMENTS / USEFUL INSTRUCTIONS

This paper brings a number of post-structuralist concerns to the analysis of a text in Aboriginal English from Paddy Roe in Broome, Australia. Accordingly the text is reproduced in full as a statement, or set of statements, standing next to the analysis. It deals with issues of Aboriginal land-rights. The analysis characterises structuralist thought as having a preoccupation with the metaphor of depth in textual analysis, bringing with it the idea of foundational mechanisms for the establishment of meaning. Post-structuralism, on the other hand, treats texts as surface enactments and statements (rather than sentences), seeing meaning more in shifting relations of context, distribution and circulation of texts. The notion of commentary and the speaking subject are problematised in the (rhetorical) analysis which highlights the ethical dimensions of the text, treating it as a set of enabling statements which construct a certain sort of Aboriginal listener who is then positioned to take over and repeat the discourse for the benefit of land-rights. In a more general way the paper proposes an ethical dimension to statements in language in general as well as positing indirect or reported speech as a kind of norm.     

Beautiful face,beautiful place: relational geographies and gender in cosmetic surgery tourism websites

Cosmetic surgery tourism is a significant and growing area of medical tourism. This article explores the gendered construction of cosmetic surgery tourism in different geographical locations through an analysis of destination websites in Spain, the Czech Republic and Thailand. We examine the ways in which gender and other intersections of identity interact with notions of space, place and travel to construct particular locations and cosmetic surgery tourist experiences. The relational geographies of skill, regulation and hygiene in discourses of cosmetic surgery risk are also explored. We conclude that accounts producing cosmetic surgery tourism as undifferentiated experience of ‘non-place’ fail to acknowledge the complex constructions of specific destinations in promotional materials targeting international consumers in a global marketplace.     

Consuming Ethics: Articulating the Subjects and Spaces of Ethical Consumption

Geography's debates about how to maintain a sense of morally responsible action often emphasise the problematic nature of caring at a distance, and take for granted particular kinds of moral selfhood in which responsibility is bound into notions of human agency that emphasise knowledge and recognition. Taking commodity consumption as a field in which the ethics, morality, and politics of responsibility has been problematised, we argue that existing research on consumption fails to register the full complexity of the practices, motivations and mechanisms through which the working-up of moral selves is undertaken in relation to consumption practices. Rather than assuming that ethical decision‐making works through the rational calculation of obligations, we conceptualise the emergence of ethical consumption as ways in which everyday practical moral dispositions are re‐articulated by policies, campaigns and practices that enlist ordinary people into broader projects of social change. Ethical consumption, then, involves both a governing of consumption and a governing of the consuming self. Using the example of Traidcraft , we present a detailed examination of one particular context in which self‐consciously ethical consumption is mediated, suggesting that ethical consumption can be understood as opening up ethical and political considerations in new combinations. We therefore argue for the importance of the growth of ethical consumption as a new terrain of political action, while also emphasising the grounds upon which ethical consumption can be opened up to normative critique.     

Aeroponic gardens and their magic: Plants/persons/ethics in suspension

Out of the fire bombed ruins and food deprivation of the Second World War came one innovator’s prototype for growing edible plants, suspended above earth and requiring a minimum of water. His aeroponic apparatus would later be referred to as The Genesis Machine, from the movie Star Trek II. This paper travels with roots in air into different spheres where the relations of persons, plants, and technology conspire to place future – growing into ethical suspension. The aim is to open questions for an anthropocenic future: Are plants ‘for’ persons or persons ‘for’ plants? Is it ethical to separate growing plants from earth/Earth and from earthlings? Where might ‘responsible innovation’ and ‘innovative eclecticism’ find a place in post-genomic discourse? And might a commitment to a dividual ethics guide lives in co-becoming to devise (as Latour recognizes in like terms) a scitech-diplomacy capable of resisting the programmatic pressures of new climatic regimes?     

Anthropology in the world: Limits and unity (Respond to this article at http://www.therai.org.uk/at/debate)

This editorial anticipates the conference Anthropology in the World by reflecting upon the influence of anthropology, and its limits, arguing that it is only by knowing where these limits are that we can be sure where and how it can best be judged. It is too, a call for unity, suggesting that in seeking to influence the external world, anthropology should unite across its sub‐disciplines, and in doing so a mutually‐beneficial exchange of practice, ideas and methodology will emerge.