Doing Better than the Media:
Traumatic events are of considerable interest to the media. Not only are they interested in a story which will please their owners and editors, but the process itself is extraordinarily exciting. It takes them out of the mundane into the essence of survival and human drama. Researchers and therapists can also be attracted to events in a similar way. Even with the best intentions and motives it is hard to avoid the rush of being drawn into a victim's life when they are at their most vulnerable and needy. Our search for understanding through research also requires us to explore the experience of the event and its consequences. But what are the ethical issues of getting involved? Do we have any clear guidelines to follow in research and clinical practice? This paper addresses briefly the ethical issues in researching the effects of traumatic events.
Researchers and therapists can also be attracted to events in a similar way to the media. Even
with the best intentions and motives it is hard to avoid the rush of being drawn into a victim's
life when they are at their most vulnerable and needy. Our search for understanding through
research also requires us to explore the experience of the event and its consequences. But
what are the ethical issues of getting involved? Do we have any clear guidelines to follow
in research and clinical practice?
This paper addresses briefly the ethical issues in researching effects of traumatic events. The
title raises the possibility that traumatic effects may surface in the lives of the next generation.
of researching such a phenomenon.
Trying to unearth effects of traumatic events over time is a complex and sensitive process and
one not easily addressed even with carefully designed questionnaires and measures. This
process can be exciting and finding such observations can be like discovering gold. The
researcher can feel on the verge of an exciting find and become eager to delve more deeply.
However this delving is intrusive. Awareness of this aspect of intervention should alert the
researcher to all the possible roles he/she can play in the process. I would argue that ethics
covers much more than a sensitivity to intruding on long-standing hurts.
What is a code of ethics? An ethical code is a system of moral principles or rules of conduct
according to which an action can be judged right or wrong. - HONESTY AND INTEGRITY
- A code of ethics is established on the presumption that agreement can be reached on the
basis of an agreed set of standards of behaviour within a profession. Presumably these
principles are framed according to underlying values of fairness, integrity and propriety. The
context of research now is such that in a time of increasing competition for research funding
and the products [e.g., a new technique that will eliminate human suffering] that might be
generated by research there is pressure to 'produce' results that have outcomes. It is not
surprising that most professional bodies and institutions have adopted a code of ethics.
How is this addressed in the trauma literature? In the trauma literature, however, ethical
issues have not featured strongly in the past ten years. To my knowledge the International
Society of Traumatic Stress Studies has not issued any guidelines for research into the effects
from traumatic events, particularly. A review of the past seven years of Journal of Traumatic
Stress and recent books such as the International Handbook on traumatic Stress Syndromes
revealed no specific reference or edition devoted to ethical aspects of trauma research. Nor
are ethical issues raised as a major focus in van der Kolk, McFarlane, and Weisaeth's
(1996) recent text. In other areas of human research there is more interest and one is more
likely to find reference to ethical guidelines in a text on qualitative research (e.g., Glesne &
Peshkin, 1992 ). To comment on current understandings of ethical issues in disaster research
is rather difficult and relies on more general material on ethics and research..
Issues of professional and technical propriety in eliciting traumatic memories, particularly in
relation to retrospective reporting, are addressed in a special edition of the Journal of
Traumatic Stress (October 1995) on research and traumatic memory (vol 8, 4 see review by
Bonnie L Green) and these give some guidance for considering ethical practice, but the
emphasis is on developing sound research protocols. The volume ends with a call to adhere
to established principles of research in ensuring a more sophisticated understanding of
traumatic memories which reflect on honesty and integrity in gathering information, analysing
data, developing theory and reporting.
Ethical issues arise in the context of the seeking of 'truth' and the search for an expanded
understanding of traumatic experience. As Bok (1996) pointed out scientists have always
insisted on honesty in reporting results of inquiry. She agues that even in the most rigorous
guidelines there is still the potential for exploitation of participating subject in experimental
work such as drug trials. In trying to find the balance between the need to advance
knowledge and the necessity of acknowledging right of subject she employs Iris Murdoch's
argument that research is more than gathering data and forming conclusions - it is a process
of ' truth-seeking, for imagining and questioning'. This applies not only to adopting rigorous
methods of inquiry but also in the reporting of 'findings'. Findings are more than just
information - they involve interpretation and some degree of creativity and relating to other
In the case of effects of disaster exposure, the inquiry is problematic and the outcomes of
say an interview may not be known until the interaction between interviewer and participant
has begun. Probing/explorative interviews are an essential component of research into trauma
effects. The researcher can not know in advance the course of the interview. It is also
difficult to predict the effect of the inquiry on the participant.
To ensure some regard for standards in research these general safeguards are usually
advocated by professional bodies and research institutions. These standards advocate at east
At all stages of inquiry ethical issues need to be considered and I pose a number of potential questions.
Tertiary institutions are getting increasingly fastidious about ensuring ethical practice ( eg
person typing transcripts identified the interviewee and this led to litigation ). For example
he University of South Australia has a clearly articulated policy on ethical practice in
The Australian National Health & Medical Research Council (NH&MRC) requires that a
research proposal must satisfy the following:
The NH&MRC (1994) warns of the benefits and disadvantages of unanticipated consequences:
A good interview encourages a reflective process where participants explore their feelings,
thoughts and experiences. While this process of reflection often results in people learning
new things about themselves, it may also reopen old wounds. Additionally, people often
reveal things about themselves in an interview that they never had intended to talk about.
Thus, interviews can become confessionals.
- Awareness of the context of the researcher . Research is never value free. A researcher
always operates within a social and professional framework. This social and professional
framework can be very local or international. Outcomes of research can be influenced by the
need to impress at the next conference; pressure for the funding or employing body to have
impressive outcomes; the need to establish a professional standing that can make one
economically viable; the physical surroundings of the contact; the theoretical framework of
- Giving primary consideration to the participant.
- Ways of inquiring and ownership of knowledge.
- Use of other sources - Research into traumatic experience might also involve careful
examination of other sources such as medical records, case notes, court transcripts, personal
writings, other recordings ( eg TV footage ), - this raises the issue of whether a person needs
to know of all observations are being used ( eg using information from the death notices in
a newspaper ).
- Reporting - being explicit about audiences and professional standing.
- The danger of traumatisation or re-traumatisation during the process of research. This
is an accepted principle in therapy but not always strictly adhered to in research.
- The problem of memory. Memory is a key construct in the examination of the effects
of any trauma since it requires not only the careful re-telling by the traumatised person but
also the reconstructing of experience over time . In a commentary on the special issue of
the Journal of traumatic Stress on traumatic memory Jessica Wolfe (1995) pointed out that
accessing autobiographical and personal memory is still subject to ' substantive (e.g.,
mediating events, time of exposure, age, difficulty in differentiating from generalised distress)
and methodological issues (e.g, lack of standardisation, quantifying data, sampling). She
argues that prospective studies (gaining access earlier and following the course of events) is
necessary to address these methodological issues. A similar argument was proposed by Paton
and Smith (1995). However these are not without difficulties and revisit the dilemmas of
informed consent, intrusion, contamination, imposition of a frame of reference to name a few.
- Time and context. Transgenerational research has revealed several dilemmas exposed
by the time lapse since the original trauma during. In this intervening period wartime
experiences, the construction of family narratives, the many other contextual influences,
situational imperatives and intervening events can interact with a specific experience,
rendering the situation for the researher and therapist highly complex.
In exploring the lives of those who may be experiencing hidden trauma I would argue that
as researchers we need to be far more observant of ethical principles than other investigators
such as journalists. We also need to be able to find a balance between respect for privacy
and the safety of our participants and the need to advance knowledge. This sometimes might
mean a trade-off and difficult decisions. Finding out where one stands in the absolutist -
relativist continuum is a necessary part of entering the field.
For all that, as Bok (1996) argues there seems to be always trade-off between strict principle
and the need to advance knowledge. An example close to home is the follow-up after a
major traumatic event. [ eg the study of victims of the Florida hurricane; the instruments sent
to practitioners after the Port Arthur ( no consent; no statement of use of material ) ]. On
the other hand we need to go far beyond the rules of journalism and find a balance between
our editorial and professional needs and the needs of our participants.
Eth, S. (1992) Ethical challenges in the treatment of traumatised Refugees. Journal of
Traumatic Stres. January, 5, 1.
Glesne, C and Peshkin, A. (1992) Becoming qualitative researchers. Longman.
Green, B.L. (1995) Introduction to special issue on traumatic memory research. Journal of
Traumatic Stress, 8, 501-504.
Harkness L, (1993) Transgenerational Transmission of War-Related Trauma, Chapter 53 in
J Wilson and B Raphael (eds.) International Handbook of Traumatic Stress Syndromes,
Plenum Press, New York and London.
McCann L. L. and Pearlman L. A.. (1990) Vicarious traumatisation: a framework for
understanding the psychological affects of working with victims. Journal of Traumatic Stress.
January, 3, 1.
Miller, T.W. and Velkamp L., (1993) Family Violence: Clinical Indicators among Military and
Post-military Personnel, Military Medicine, December, 158, 766-771.
National Health and Medical Research Council Human research Ethics Committee. (1994 )
Ethical aspects of qualitative methods in health research (p 22). Canberra, ACT.
Paton, D and Smith, L.M. (1995) Methodological issues in the evaluation of work-related
psychological trauma. Australian Psychologist, 30, 3, 200-209.
Raftery, J. and Schubert, S. (1995) A very changed man. University of South Australia.
University of South Australia. (1995) Ethics in Human Research. Guidelines and procedures.
Adelaide South Australia.
van der Kolk, B., McFarlane, A.C. & Weisaeth, L.(eds) (1996) Traumatic stress: The effects
of overwhelming experience on mind, body, and society. New York: Guilford Press.
Wolfe, J. (1995) Trauma, Traumatic memory, and research: Where do we go from here?
Journal of Traumatic Stress, 8, 4, 717-726.