Focus groups and ethics

 Sim and Waterfield (2019)

(Sim and Waterfield, 2019).

https://link.springer.com/article/10.1007/s11135-019-00914-5

The principal challenge in obtaining consent lies in giving a clear account of what will take place in the group, owing to unpredictability of the discussion and interaction that will occur. (Sim and Waterfield, 2019) (CONSENT)

Moreover, it is less straightforward for the participant to revoke consent than in one-to-one interviews. (Sim and Waterfield, 2019)

Confidentiality and anonymity are potentially problematic because of the researcher’s limited control over what participants may subsequently communicate outside the group. If the group discussion encourages over-disclosure by some participants, this problem becomes more acute. Harm in a focus group may arise from the discussion of sensitive topics, and this may be amplified by the public nature of the discussion.(Sim and Waterfield, 2019) (DURING)

A focus group can be defined broadly as ‘a type of group discussion about a topic under the guidance of a trained group moderator’ (Stewart 2018: p. 687). Agar and MacDonald (1995) suggest that a focus group lies somewhere between a meeting (reflecting the fact that it is specifically organized in advance and has a structure) and a conversation (reflecting the fact that the discussion has nonetheless a degree of spontaneity, with individuals picking up on one another’s contributions).(Sim and Waterfield, 2019) (BENEFITS)

Consent is a central ethical concern in research using human participants.(Sim and Waterfield, 2019) (CONSENT)

Participants ‘are not only persuaded by skilled facilitators to disclose intimate views, but also to do this in front of peers’ (Green and Hart 1999: p. 31).(Sim and Waterfield, 2019)

The underlying moral ground of consent is centred primarily in the notion of autonomy, on the basis that the consent process can be seen as a means of protecting and supporting autonomous decision making on the part of the research participant (Beauchamp 2009) (Sim and Waterfield, 2019) (CONSENT)

Consent may be seen as having four essential elements: disclosure (the adequacy of the information given by the researcher); comprehension (the extent to which this information is understood by the participant); competence (the participant’s cognitive or emotional capacity to give or withhold agreement); and voluntariness (the absence of inducement of coercion). Fulfilment of each of these elements is necessary for informed consent to carry its intended moral force (Sim 2010). (Sim and Waterfield, 2019). (CONSENT)

The onus is therefore on the researcher to provide a suitable type and quantity of information as a basis for the participant’s choice. In interview-based studies, such information usually states the purpose of the study, gives an outline of the topic(s) to be covered, indicates the way in which the interview will be conducted and how long it is likely to last, draws attention to any potential benefits or risks associated with taking part, and describes what will be done with the data collected. Using the details provided, the participant should be able to foresee or imagine the situation to which he or she is consenting—therefore, the process is perhaps better seen as creating (or perhaps modifying) certain expectations in the mind of the participant rather than as simply the conveying of information. (Sim and Waterfield, 2019) (INFORMED CONSENT)

One potentially problematic issue relating to consent in focus groups stems from the degree of disclosure that is possible. In qualitative research generally, the fact that design and methods are to some extent emergent—rather than pre-specified, as they usually are in quantitative research—makes it hard to provide fine-grained detail on what will occur in a study (Wiles 2013). (Sim and Waterfield, 2019) (DISCLOSURE)

what takes place in the group depends in part upon other participants, who may spontaneously raise issues not necessarily intended, or predicted, by the moderator. As Warr (2005: p. 203) puts it, focus groups can be noisy ‘as opinions and anecdotes are shared, challenged, and truncated as participants join in, or drop out of, the discussions taking place.’ Furthermore, individual participants have less control than in a one-to-one interview. Although focus group participants can decline to respond to a particular question—probably more easily than in a one-to-one interview—they may not be able to divert the discussion away from a topic that they find uncomfortable. (Sim and Waterfield, 2019)

If the researcher obtains consent on the basis of seeking the participant’s views, there is a responsibility to ensure that the individual has an opportunity to express these views, otherwise the expectation on which consent was based may not be realized. (Sim and Waterfield, 2019)

Lezaun (2007) characterizes an underlying principle of the focus group as isegoric—a concern to provide all participants with an equal opportunity to express (or to decline to express) their views. This obligation may be heightened by the expectations created in the consent process. (Sim and Waterfield, 2019)

Participants they should understand that the predominant insights that emerge from the focus group, and that are subsequently reported, may not reflect their individual views (especially if the issue is controversial, giving a rise to a range of possibly conflicting viewpoints). (Sim and Waterfield, 2019)

A common practice in qualitative research based on interview data is respondent validation (Lincoln and Guba 1985). Its purpose is to allow research participants to review and comment on a transcript and/or the researcher’s interpretation of it. In focus group research, however, a decision to provide a transcript to an individual participant entails also providing a written record of other participants’ contributions, as it is hard to extract an individual account from the text in the transcript. (Sim and Waterfield, 2019)

Respondent validation would therefore be hard to carry out unless consented to by all participants. (Sim and Waterfield, 2019) (VALIDATION)

Consent is normally regarded as revocable, such that an individual can withdraw from the study at any point after initially consenting to participate (Faden and Beauchamp 1986) (Sim and Waterfield, 2019) (CONSENT)

Revoking consent to participation is thus less straightforward in a focus group than in many other research contexts. It is less straightforward for the participant in a focus group to revoke consent that it is in one to one interviews. (Sim and Waterfield, 2019)

This principle that consent is revocable may also be extended to an individual’s data. Just as participants may withdraw their participation in an interview, it is claimed that they may similarly withdraw their data, either from the transcript, or from those parts that are reported as quotations, or from both (Kervin et al. 2006) (Sim and Waterfield, 2019)

Probably the only way to resolve this problem is to make it explicit in the consent process that whilst a participant can withdraw from the group, and may ask that his or her data are not quoted when the study is reported, withdrawing data prior to analysis is simply not possible. Accordingly, the inability to retract their data in this way is something to which participants will have consented. (Sim and Waterfield, 2019)

Confidentiality relates to what is done with information once it is in the researcher’s possession, and specifically the extent to which it is disclosed to others. Anonymity, in contrast, is concerned with the attribution of information—can individuals be identified from the data that they provide or from other information relating to them? (Sim and Waterfield, 2019) (ANONYMITY)

The nature of the group setting is such that participants are obliged to express in public what they usually regard as private, and neither the reaction nor the discretion of the group can necessarily be predicted. (Wellings et al. 2000: p. 256). (Sim and Waterfield, 2019)

An obvious way to preserve anonymity is to ensure that no real names or other directly identifying information are reported. However, individual participants may be identified by other, indirect means through what is referred to as deductive disclosure: ‘A narrative description of what an individual said to a researcher may, with a little collateral information, be sufficient to identify the individual [even] if no clear identifier, such as a name, is attached to the description’ (Boruch et al. 1996: p. 161)(Sim and Waterfield, 2019) (IDENTIFICATION)

Thus, even if nobody is named, it may be possible to link seemingly innocuous pieces of information together and determine a participant’s identity, particularly in small and/or geographically circumscribed communities. (Sim and Waterfield, 2019) (IDENTIFICATION)

In the context of focus groups, Tolich (2009) draws a distinction between internal and external confidentiality. Whereas external confidentiality concerns the possible disclosure of information by the researcher, internal confidentiality has to do with information that might be disclosed by members of the group. Clearly, external confidentiality can normally be assured by the researcher, as he or she is in control of what is reported from the study. Internal confidentiality relies on adherence to ground rules and observance of aspects of the consent process, over both of which the researcher has much more limited control. (Sim and Waterfield, 2019) (CONFIDENTIALITY)

In individual interviews respondents are protected by the relative intimacy and privacy of the interview situation. In a focus group session, in contrast, respondents are under pressure to perform (and possibly to conform) under the scrutiny of fellow participants. (Ransome 2013: p. 41). (Sim and Waterfield, 2019)

The consent process: If the researcher provides information with a suitable level of detail and with due clarity, in principle this will help focus group participants to frame appropriate expectations of what will occur during the discussion. The purpose of the focus group can be explained and examples given of the sorts of questions that will be asked. Clarification can also be provided on what will be done with the data to be collected and the steps to be taken to preserve confidentiality and/or anonymity. Thus, certain assurances can be given, though these can strictly only relate to those aspects of the focus group over which the researcher has a degree of influence (Carey and Asbury 2012). Morgan (1998) and Tolich (2009) provide suggested content for informed consent documentation. (Sim and Waterfield, 2019) (INFORMED CONSENT)

Briefing: In addition to giving information in advance of a focus group, researchers normally discuss and negotiate a set of ground rules immediately prior to starting the discussion (Kevern and Webb 2001; Kleiber 2004; Breen 2006) (Sim and Waterfield, 2019) (INFORMED)

The researcher can emphasize the public nature of a focus group and the need for confidentiality and anonymity, and provide guidance on subjects that might be felt unsuitable to be raised during the discussion, subject to the caveats discussed earlier. The briefing also allows participants’ expectations of the group to be managed. (Sim and Waterfield, 2019) (EXPECTATIONS)

Importantly, the collective nature of the briefing allows the individual to reflect on his or her decision to take part in a situation that is closer than the formal consent process to the context of such participation. Furthermore, if at this point a participant has reconsidered the decision to take part in the study, the briefing can create an opportunity to withdraw less obtrusively than once the discussion has begun. (Sim and Waterfield, 2019) (INFORMED CHOICE)

Debriefing: After the focus group has finished, and its content summarized to participants, the moderator can reiterate key messages around confidentiality and anonymity, and clarify or comment upon any potentially sensitive or problematic issues that were raised during the discussion, where it was not appropriate to do so at the time. Participants can also be invited to discuss their reactions to such issues (Smith 1995). The moderator can stay in the room for a while at the end of the focus group, or otherwise make him- or herself available, to give individual participants the opportunity to address any issues or concerns (Bloor et al. 2001; Sherriff et al. 2014).

The dynamics within the group may lead to some individuals dominating the discussion and thereby denying the expression of others’ views. (Sim and Waterfield, 2019) (DOMINATING PARTICIPANTS)

Some of the ethical challenges posed by focus groups can be addressed through the consent process, provided that appropriate expectations have been expressed and received, but steps should also be taken to supplement and reinforce these issues closer to the actual context of the focus group: in a briefing immediately prior to the discussion, during the discussion itself, and in a debriefing immediately after the focus group. (Sim and Waterfield, 2019). (INFORMED CONSENT).