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在进行随机对照试验时协商伦理悖论:使干预科学与参与性价值观保持一致。

Negotiating Ethical Paradoxes in Conducting a Randomized Controlled Trial: Aligning Intervention Science with Participatory Values.

机构信息

Steinhardt School of Culture, Education and Human Development, New York University, New York, NY, USA.

出版信息

Am J Community Psychol. 2017 Dec;60(3-4):439-449. doi: 10.1002/ajcp.12185. Epub 2017 Oct 13.

Abstract

In this article, we describe ethical tensions we have faced in the context of our work as intervention scientists, where we aim to promote social justice and change systems that impact girls involved in the juvenile legal system. These ethical tensions are, at their core, about resisting collusion with systems of control while simultaneously collaborating with them. Over the course of designing and implementing a randomized controlled trial (RCT) of an ecological advocacy intervention for girls, called ROSES, ethical paradoxes crystalized and prompted us to engage in critical reflection and action toward the aim of moving away from conducting research on legal-system-involved girls and moving toward a more democratic, participatory process of inquiry with girls. Our experience revealed two intertwined paradoxes that ultimately served generative purposes. First, in collaborating with legal system stakeholders, we observed a single story of girls' pathology narrated for girls, without girls, and ultimately internalized by girls. Second, in reflecting critically on the ethical implications of our study design, it became clear that the design was grounded in a medical model of inquiry although the intervention we sought to evaluate was based, in part, on resistance to the medical model. We describe emergent ethical tensions and the solutions we sought, which center on creating counternarratives and counterspaces that leverage, extend, and disrupt our existing RCT. We detail these solutions, focusing on how we restructured our research team to enhance structural competence, shifted the subject of inquiry to include the systems in which youth are embedded, and created new opportunities for former research participants to become co-researchers through formal roles on an advisory board.

摘要

在本文中,我们描述了在干预科学家的工作背景下所面临的伦理困境,我们的目标是促进社会正义,改变影响参与少年司法系统的女孩的系统。这些伦理困境的核心是抵制与控制系统的勾结,同时与它们合作。在设计和实施一项名为 ROSES 的针对女孩的生态倡导干预的随机对照试验 (RCT) 的过程中,伦理悖论逐渐显现,促使我们进行批判性反思和行动,旨在避免对涉及法律系统的女孩进行研究,转而采用更民主、更具参与性的研究方法。我们的经验揭示了两个相互交织的悖论,最终具有生成性的目的。首先,在与法律系统利益相关者合作的过程中,我们观察到一个单一的关于女孩病态的故事,这个故事是为女孩、没有女孩、最终被女孩内化的故事。其次,在批判性地反思我们的研究设计的伦理含义时,很明显,尽管我们试图评估的干预措施部分基于对医学模式的抵制,但我们的设计是基于医学模式的探究。我们描述了新出现的伦理困境和我们寻求的解决方案,这些解决方案集中在创造反叙事和反空间,利用、扩展和破坏我们现有的 RCT。我们详细介绍了这些解决方案,重点介绍了我们如何重组研究团队以增强结构能力,将调查对象转移到包含青年的系统中,并通过咨询委员会的正式角色为前研究参与者创造成为共同研究者的新机会。

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