Abstract
An ongoing problem in emergency departments and intensive care units is that patients can behave aggressively and, in some cases, actively attack staff – either because of underlying conditions, intoxication or general belligerence.
A qualitative researcher wants to carry out research on attacks from patients on caregivers in the critical care setting. They intend to spend three months in the Royal Adelaide Hospital’s Emergency Department as an observer focusing on aggressiveness towards caregivers, specifically on Friday and Saturday nights between 8pm and 3am. They intend to publish details of the attacks (appropriately anonymized) along with an analysis of the reasons for the attacks (based on observation and interviews with the attacked caregivers); they intend to build a classification schema of types of staff attacks and causes with the intent of doing further work in the future on how such attacks might best be minimized.
The researcher doesn’t intend to seek general consent from patients in the unit they are observing since they will not be observing the majority of the patients, only those acting aggressively towards staff. They also doesn’t want to seek consent from those acting aggressively because they are likely to either not be in a state of mind where they are either competent to consent or, if competent, they are not liable to consent. Instead they will ask for consent from the caregivers since they are observing them and their interactions with the patients.
Along with their observations they intend to ask staff who are subjects of attack for follow-up interviews, and will seek consent for this separately.
Questions
What ethical issues does this case raise?
Does the consent process seem appropriate to you?
If your committee was considering this piece of research, how do you think you would decide? What changes, if any, would you require?