Chip Colwell-Chanthaphonh's Commentary on "Challenges in Obtaining Informed Consent: The Case of Forest Resources in Zigiwan"

Informed voluntary consent is not really about having a signature on a piece of paper, but rather ensuring that research participants are given all the facts necessary to make a sound decision and that their choice to participate is not coerced. Assuming Dr. Clark discloses all the facts about her work — its aims, methods, and applications — then she is well on her way to obtaining informed consent. That said, informed consent in many ways only marks the beginning of the relationship between a participant and a researcher. Dr. Clark will have many other responsibilities on this project, including taking measures to protect the confidentiality of her sources, particularly in a politically tense place such as Zigiwan. The practical problem of having a signed form could be solved in various ways, such as having the form faxed to the United States while the original is destroyed, or perhaps using a coded system that only Dr. Clark and a trusted assistant could decode. However, even if such steps were taken, with this kind of research in a rural setting, it seems likely that community members would still know who participated and be able to identify individual collaborators. The larger problem then concerns whether or not the risks presented to the individual participant outweighs the potential benefits of the research.

Suppose that there is little risk to the research participants in Zigiwan. Intuitively, we might initially think there would be little problem for Dr. Clark to proceed. However, if Dr. Gordon is to be believed, then the implication is that these individuals could potentially face extreme violence — torture or even death. In other words, while the risk in terms of chance is generally small, particularly since the country is now stable, should violence erupt again, the research participants might suffer terribly. With the possibility of extreme brutality, the bar must be raised for the project’s potential benefits. However, the benefits of the project do indeed seem compelling: the heath and diversity of the country’s wooded areas. Since in this case the individuals bear the greatest risks, they should be the ones to decide if the benefits make it worth their effort to participate. Assuming Dr. Clark offers full disclosure and protects her informants so far as possible, the choice should be left to individual community members. Already individuals are reluctant to sign informed consent forms, indicating that they are already cautious and well aware of what kind of behavior creates risk.

What if the risks were great and harm almost certain? Would it still be ethical for Dr. Clark to proceed, even if she could find willing participants? An analogy: imagine a researcher needs to try out a new surgical procedure to cure acid reflux disease. The researcher is close to certain that nine out of the ten needed patients will die as a direct result from the experimental method. Yet, when the researcher posts the advertisement for the procedure, ten sane people come forward and volunteer. Even though these individuals are fully informed and willingly volunteer, would it still be ethical for the researcher to carry out the experiment?

The answer will depend in large part how one views individual autonomy. One response may be that so long as the individual willingly agrees and is fully informed, then the project should move forward. In opposite terms, another response is that while individual autonomy should be respected, this does not mean that scholars may do whatever they please so long as their participants agree to participate. The latter position, to which I am sympathetic, recognizes that even as autonomy is a core value, researchers have responsibilities to enact other values, such as benevolence, the propensity to do good. It is far from charitable to cause certain harm even if some limited good may result. In this case, curing acid reflux is hardly worth the life of nine human beings. Similarly, with the Zigiwan case study, if the risks were great and harm almost certain for the participants, then I do not think it would be ethical for Dr. Clark to continue with the study. While a healthy environment is important for a country, it does not mean that achieving this goal should be pursued at any cost.