Ethical and definitional considerations in research on child sexual violence in India

Radhika Dayal,Divya Pillai,Klaus Beier,Vikram Patel,Vikas Choudhry,Ameeta S Kalokhe

doi:10.1186/s12889-018-6036-y

Abstract

BackgroundWhile critically important, child sexual violence (CSV) research poses numerous ethical and safety challenges. Recently, the studies dedicated to understanding and addressing CSV in India have been on the rise, but no published ethical guidelines to direct such research currently exist. To help inform ethical and safety recommendations for the design, conduct, and reporting of future CSV research in India and similar settings, we systematically reviewed the ethics and safety practices reported in recent Indian CSV literature.MethodsA multi-tiered approach was used to understand current ethical practices and gaps: 1) systematic review of Indian CSV studies published over the past decade, 2) examination of existing guidelines on related topics to develop an ethical framework, 3) development of an ethics checklist based on the recommendations from the surveyed guidelines, and 4) application of the checklist to each of the reviewed studies.ResultOur search yielded 51 eligible studies. From each, data from 6 major thematic areas was extracted: informed consent, confidentiality, selection, training, and protection of study team members, validity of CSV measurement methods, measures to minimize participant harm, and participant compensation. Several gaps were noted: only two-thirds reported approval by ethics committees, obtaining informed consent, and assured participants of confidentiality. Only 25% (13/51) reported assessing ongoing CSV risk and providing necessary support services, none noted whether ongoing CSV was reported to authorities (required by Indian law), and none reported safeguards to protect staff from the effects of conducting CSV research. Further, 43% (22/51) limited surveillance of CSV to one form of abuse and/or used a “loaded term,” increasing the potential for underreporting.ConclusionsThrough enhancing understanding of current ethical practices and gaps in CSV research in India, this systematic review informs reporting protocols and future guidelines for CSV research in India and other similar settings.

Highlights

While critically important, child sexual violence (CSV) research poses numerous ethical and safety challenges
The strong cultural taboos associated with discussing sex and sexual violence in India may result in greater emotional distress for the participant of a CSV study, or alternatively, a stronger sense of relief from the opportunity to openly discuss one’s experience
This review utilized a multi-tiered approach: 1) conduct of a systematic review of the past-decade of CSV studies conducted in India, 2) review of existing guidelines that could help inform an ethical framework for the future conduct of CSV research, 3) development of an ethics checklist based on the recommendations from the surveyed guidelines, and 4) application of the ethics checklist to each of the studies found in our CSV systematic review

Summary

Introduction

Child sexual violence (CSV) research poses numerous ethical and safety challenges. The World Health Organization defines child sexual violence (CSV) as “the involvement of a child in sexual activity that he or she does not fully comprehend, is unable to give informed consent to, or for which the child is not developmentally prepared and cannot give consent, or that violates the laws or social taboos of society.” [1] In 2007, the India Ministry of Women and Child Development (MWCD) conducted the most extensive national survey of child abuse in India to date [2]. Use of computer-based data collection tools to help maintain confidentiality and potentially work around the mandatory reporting laws may be limited by the availability of required technology and associated literacy

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