Tensions Around Ethics Review: Social Equipoise and ‘Maori Consultation’. Barry Smith (Te Rarawa, Ngati Kahu) Planning and Funding Division Lakes District Health Board Rotorua.
Barry Smith (Te Rarawa, Ngati Kahu)Planning and Funding DivisionLakes District Health BoardRotorua
Presentation to the 2012 Conference of theAustralasian Association of Bioethics and Health LawViaduct Events Centre12-14 August
Persistent health disparity
Maori, due to a number of factors, are more likely to be exposed to greater risks and gain fewer benefits from research whether measured against individual participants or the communities from which participants are drawn.
In any piece of research social equipoise refers to situations where there exists an equitable distribution of risks and benefits associated with different categories of participant (as opposed to different interventions).
“Encapsulating the issue”
The Marsden Project
Stage one: a survey of the 2010 applicants to HDECs focusing on their attitudes and experiences of ‘Maori consultation’ before, during and after ethics approval
“While Māori values are acknowledged, they are not given equal weight in ethical deliberations?”
(Based on:Hudson, M. & Russell, K. (2009). The Treaty of Waitangi and research ethics in Aotearoa. Journal of Bioethical Inquiry, 6(1))
“What this might mean for reducing health inequalities”Health inequalities and applying ‘mild’ ethical relativism along with the ‘meaningful engagement’
- collective versus individual consent –
- ethics of dignity and maintenance of ‘mana’ –
- non-physiological harm
A small price paid for improved engagement?