By guest contributors Nancy Angeline Gnanaselvam and J Charles Davis
Human dignity is the inherent value that every human being possesses equally because they are a human, independent of their abilities, characteristics, or actions (1,2). The value of international collaboration in research is well understood. However, there is a global South and North divide, causing power differences and inequities among the researchers during collaboration (3). While the Global Code of Conduct recommends practice of fairness, respect, care and honesty in such relationships (4), the ethical practice of respecting human dignity in collaborative research, needs much improvement. Using intersectional lens, if we view the public health research landscape in Global South, researchers can be of female gender, younger or older age, experiencing descent based discrimination, having disabilities, experiencing poverty, identifying as LGBTQI or any other identity causing them to face discriminations. These identities can intersect with a Global South identity, causing interlocking structures of oppression. Academically global South residents might be disadvantaged due to their lack of opportunities and adverse socio-political environments. If the research team is not cautious of the possible neocolonialism(5), straining of the collaborative relationship can happen due to control in the relationship and lack of agency among the researchers from South. Refusal to acknowledge privilege and identify implicit biases can also result in microagressions which can strain research relationships. The guiding principle that research teams can abide by, is the human dignity, which can be considered as an antidote to inequities that can rise during collaboration.
Respect for the country in which the research study is being conducted should start by inclusion of researchers from the study region or those who are from the region but settled elsewhere, now. These researchers with lived experiences of the socio-cultural and economic conditions of the study country, offer rich insights into the study methods and recommendations that can arise from the study which can potentially guide policies (6). This is more relevant in fragile socio-political settings such as conflicts, where local researchers’ constructive inputs cannot be compared to any other expertise (7). Researchers from the Global North may argue that even though they are from elsewhere, knowledge of language, brief periods of exposure in the local country, affiliation with host country research organization are sufficient to not include any local researchers in the research team. However, this approach is not in line with the target 10.6 of Sustainable Developmental Goals, which aims to ensure enhanced representation and voice of developing countries (8). Ethics committees and regulatory authorities are crucial in ensuring the conduct of research according to Declaration of Helsinki. One might question of standards and accreditation status of local ethics committees in South(9). However, a blind spot of ethics committees is created, when the research does not involve human participants and non-human data is collected from countries which are non-local to the international researcher, without any collaboration with the local country researchers. Power dynamics in research collaborations are not often elaborated in the guidelines and ethics committees often focus on biomedical research, with clinical trials and participants’ welfare being the centre of attention.
In global health research partnerships, dialogue between the researchers from Global North and South should start from proposal preparation phase, well in advance before submission for funding; on the feasibility, methods, socio-cultural aspects, budget and ethics of the proposed research. All researchers in the team, regardless of their background, should be given the psychological safety to negotiate and offer consultation during communications. Teams should assess if each team member has sufficient autonomy through the dimension of liberty (no researcher should be coerced into commitment for the research or methods of the research), opportunity (each researcher should have options to choose from), capacity of the individual and authenticity (choices of the researcher should be truly of their own, based on their reasoning and available information) (10). After obtainment of funding, fair and transparent manner of transfer of funds should be done and researchers should be able to exercise fundamental right of freedom of expression and obtain information regarding the details of funding of all the institutions involved in the research. In the course of the research, researchers are encouraged to practice beneficence through capacity building on research methods, support in dissemination and research ethics within research team members. Previous compounding experience of institutional exclusion or neurodiversity can hinder communication paths within the team. This can be addressed by inclusive and diverse communication plan which is developed in advance and approved by the team. The plan can be reviewed and adapted regularly based on the needs.
Respect for the culture of a country is vital for the ethical implementation of the research. Lack of awareness of political and cultural aspects of the research in the study settings by the non-local members of the team can introduce research methods and tools, which when implemented without proper debriefing and psychological support might cause harm to the local research team through vicarious trauma (11). The local researcher might not aware of this phenomenon, due to overlapping identities and the secondary traumatization can occur. Researchers from North who are conducting research on sensitive subjects such as child abuse should be cognizant of this harm to the researchers and plan remediation measures in proposal writing stage itself, since it violates the non-maleficence principle. Researchers, due to widespread use of social media could be collecting media content as well during research. During this process, dignity and privacy should not be compromised, in the name of academic freedom. Written informed consent is crucial to ensure autonomy during the process and joint ownership or transfer of ownership to participant, benefit sharing should be clearly detailed in the consent document. The intent of a research cannot be used as a reason to cause injustice such as compromising the dignity of researchers or participants. In conflict situations, the negative principle of non-maleficence (primum non nocere) takes precedence over the positive principle of beneficence. The good arising due to research should not be achieved through harm. Data generated during research should be responsibly and equitably shared between team members, as per regulatory guidelines and written policies. Data analysis plan and analysis should be done in communication with all team members.
In manuscript writing phase, due to challenges in writing in English language and emotional struggles of coping with potential paper rejection and reviewers’ comments, some researchers might struggle with different phases of publication such as, first draft preparation, obtaining review of co-authors, submitting to journal and responding to reviewer phases. This can be addressed by capacity building sessions. While deciding on authorship order and contributor roles, privileged authors should review the list of contributor roles in journals and include all researchers who have contributed to the research substantially, even those who have supported only in data acquisition (12). In conclusion, at each stage of the collaborative research, from conception to dissemination, applying decolonization through respecting human dignity will foster equity and promote partnerships.
References:
1. University of Notre Dame. 2022. Upholding human dignity-a literature review.pdf [Internet]. [cited 2024 Dec 18]. Available from: https://pulte.nd.edu/assets/506923/upholding_human_dignity_a_literature_review.pdf
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About the authors:
Dr. Nancy Angeline Gnanaselvam is an Assistant Professor, Department of Community Health and Member, Institutional Ethics Committee, St. John’s Medical College, Bangalore, India. She can be found at www.linkedin.com/in/nancy-angeline-gnanaselvam-791636193
Rev. Dr. J Charles Davis is a visiting Professor at Albert-Ludwigs University in Freiburg and Associate Director of St. John’s Medical College and Research Institute. He is a corresponding member of the Vatican’s Pontifical Academy for Life. He can be found at https://charlesdavis.in
Disclaimer: Views expressed by contributors are solely those of individual contributors, and not necessarily those of PLOS.
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