Campus Review Volume 28 Issue 12 December 2018 | Page 13

industry & research campusreview.com.au This is because of the way humans make decisions. “We’re not cognitive machines that assess information,” he says. “We keep trying to find ways of giving participants more information, and helping them understand it, when that’s not at all what they’re doing when they make decisions.” So what are they doing? Campus Review spoke with Burgess a few hours before his speech, Too Much to Think About: Making Room for Trust and Practical Judgment in Research Participation, to get the ethical lowdown. and they don’t agree [to do the research], then you can’t do the research ethically. Research ethics committees, when they review research, spend an awful lot of time on the consent form, because it’s documentation in plain language of the nature of the research, the risks, the probabilities and the benefits. They work hard on making sure it communicates well. My suggestion is that a lot of energy is spent on something that has very poor effectiveness. It doesn’t help us build people’s ability to make good decisions about participation very well because it misunderstands several key features. One is that it’s not the way people actually make decisions. We’re not cognitive machines that assess information. People listen through a filter that doesn’t hang onto information that doesn’t concern them. Secondly, when we think about the models of ethics we’re using these days, we focus a lot more on relationships, and how we build them. People make decisions, whether healthcare or research-related, in the context of their activities, in relation to their family, the inconvenience to them, the effects it would have on their friends and the other activities they do, and the kind of identity they have – how being involved in research reflects on them as a person. The third component is that there’s an element of trust. In research, people tend to come in with a predisposition towards trusting. However, there is an exception to trust. Sometimes people come in to institutions, say, from an indigenous background, where they don’t trust them. They might be looking to say, “Why should I participate?” We make decisions out of relationships, and we make efficient decisions with limited information. The emphasis on giving people all the relevant details [in consent forms] doesn’t really support this, so I make some suggestions about what we might do differently. CR: To begin with, could you briefly summarise your topic? Could you give an example of how this could occur in real life? MB: I was asked to address something in research ethics, and what I’ve been working on for a long time are the limitations of the way we think about informed consent. Informed consent is when we get informed voluntary agreement to participate in research. It’s become sort of a linchpin of research ethics: if you can’t get people to understand [what they’re consenting to], A colleague of mine studied children’s decisions to participate in cystic fibrosis research. They asked 19 children, aged 8–19 years, what it was that made them want to participate, and how they made that decision. The children said it was their parent’s attitudes towards research, their own experiences of growing up and participating in research (because they’ve The ethics of consent Informed consent not as effective as you think, ethics professor says. Mike Burgess interviewed by Loren Smith “P ut down the paperwork.” It’s an unlikely message from an ethics professor, but Mike Burgess, chair in biomedical ethics at the University of British Columbia, Canada, says that what’s good on paper isn’t always in practice. In Perth to deliver Curtin University’s Annual Ethics Lecture, Burgess explained how, in his view, research participants’ informed consent is inadequate. 18