Guest editorial: Sensitive issues in healthcare research: the protection paradox

Abstract

Most research in nursing is unlikely to cause physical harm. Psychological harm however, such as upsetting people or exposing them to uncomfortable questions, may be more likely. For this reason it is widely acknowledged that the psychological effects of research need to be considered carefully. Our contention here is twofold: first, that such consideration has largely been in relation to research participants and to some extent, researchers. But potential unwitting psychological harm to an invisible group of people has been largely ignored. Second, by exposing research protocols to people who may have closeted negative or skewed attributions to the topic under scrutiny, a new layer of gatekeeping has been introduced. Quite simply, there is a protection paradox at play. Protection of research participants forms the cornerstone of all well-conducted research. The research protection agenda hinges on the fact that allowing a researcher into one’s life implies a loss of power (Iphofen 2005). Thus, nurse researchers have a plethora of international guidance to help them protect research participants (Social Research Association (SRA) 2003; International Council of Nurses (ICN) 2006; World Medical Association 2008; Royal College of Nursing (RCN) 2009). Specifically within the UK, robust research governance procedures provide an additional protective mechanism (Department of Health (DH) 2005). The loss of power to which Iphofen refers is applicable to all research participants. Understandably however, there is significant emphasis on the protection of those who are most vulnerable, such as children and those who lack capacity to consent (SRA 2003; RCN 2009), especially when researchers seek out the views of seldom-heard or marginalized groups (Serrant-Green 2011). Our own research focus, such as many other clinical topics, is concentrated in populations where double or even triple vulnerability exists. This arises from participants’