As an anthropologist, the way I work has particular features which are, in my view, both empowering and paralysing. This is especially the case when working with people who define themselves or who are defined as vulnerable, and in field contexts which are challenging, difficult or unpredictable. In this post, I would like to address Prior Informed Consent procedures as an example of the ethical challenges that I need to address in my new project which aims to interact and collaborate with one of the most vulnerable populations entering the European Union today: undocumented pregnant refugees and migrants.
My ERC-funded project, entitled ‘Intimate Encounters in EU Borderlands: Migrant Maternity, Sovereignty and the Politics of Care on Europe’s Peripheries’ is a comparative study of maternity care delivery towards undocumented pregnant migrants in EU Borderlands. Research will be carried out in 7 maternity care services located in the densely crossed borderlands of 4 EU Member States. Most of the maternity care services in question are in the Mediterranean, in Italy, Spain and Greece, but two field sites are also located in Overseas France, in French Guiana and Mayotte (in South America and in the Indian Ocean respectively). All of the field sites are to be found on Europe’s external borders, in remote peripheries which have very specific social and economic identities in relation to the rest of the country. My main interest lies in studying doctor-patient interaction from a moral and biographical point of view, and in documenting life in these peripheries from the perspectives of the full range of actors involved. Ethnographic data will be collected during a 16 months long fieldwork period which will span the second and third years of the project, and which will involve all project team members (that is myself and three other researchers).
Research will be carried out through long-term participant observation of everyday life in the field locations. Commitment to the research from all research participants will have to be total, as my team and myself will have to physically move (taking our families along with us) to the field sites for the whole duration of the fieldwork. Working times will vary according to circumstances, but could involve day and night-time work, every day of the week. This kind of research requires flexibility, adaptability and resilience.
Long-term participant observation is peculiar: it is an ecosystem of its own, which may appear intense and exotic, but which often feels awkward, lonely and frustrating. Time takes on a different texture and daily routines are upset by the turns of events. Building social relations based on amity at first, and trust in the long-term with a wide range of people is not generally something which can happen overnight. For this reason I am convinced that when working with vulnerable subjects, the investment of time affords a great advantage in contributing to ethically-sound research.
Anthropologists approaching a field site have to prepare their fieldwork through an extensive, collaborative, multi-level process of introduction, presentation, authorisation and consent, which works concurrently at communal and individual level. It is very common to hear that for anthropologists fieldwork starts at home, as they slowly gather the first contacts and points of reference, through which they will seek affiliations, authorisations, permits, and translate their research objectives according to the audiences they deal with.
As anthropologists, our entry into a field context often follows a gradual scoping process based on information and presentation, which navigates several levels of leadership and authority. Only once all authorisations are cleared can fieldwork at community-level begin. And from community-level, one can approach individuals or family units. Because the personal and emotional involvement of fieldwork is so high, the social bonds which develop through long-term fieldwork are deep and long-lasting. In this context, consent in research is to be considered as a flexible, long-term commitment to the well-being of the source communities, and their regular updating on the progress of the research. This commitment can last a lifetime.
In the context of my new research project, a good proportion of the persons I will be working with belong to a highly mobile and invisible population with whom the nurture of social bonds may not be easy to maintain, to say the least. My ERC-funded project includes, among other research participants, undocumented migrants. Some of these migrants will be pregnant, others may be minors, and some will be both. This means that they represent another category of vulnerability than people I had been previously working with who belong to remote ethnic minorities (I have been working with Amerindian communities of northern Amazonia in Suriname and French Guiana since 2003). The social and political contexts in which research is carried out are always shifting, and there is no single definition of vulnerability, nor one single form of social interaction during ethnographic fieldwork. Approaching each specific social context requires good prior knowledge and a great deal of flexibility. For instance the pregnant patients I might have to interview are generally likely to have higher levels of literacy than the indigenous women with whom I was sharing the intimacy of daily life in the interior of Suriname. It may be easier to establish some form of initial communication, since there are likely to be more common cultural references. Personal, emotional and physical circumstances may however be extremely different. Moreover, whereas I have been working since 2005 in clinical contexts, these can vary greatly, and medical environments can be extremely hierarchical structures in which self-determination and agency can be challenged by the most simple acts.
In such challenging research environments, single solutions are impossible to envisage as circumstances can change very rapidly. As others have noted, ‘prior informed consent of research participants does not in itself make human-subject research ethical’ (Rosenthal 2006: 119), nor does it guarantee that all research participants and other human subjects will behave ethically. Obtaining prior informed consent in such challenging contexts first of all requires time. Having time to use the appropriate channels to seek authorisations in due course, to develop an extensive web of social contacts, and only gradually to approach the most vulnerable research participants. To ensure as independent and unbiased a process as possible, researchers in the field have to be aware of local circumstances and dynamics, and resist the temptation to rush into a challenging research environment currently at the centre of a media frenzy over what is often portrayed as an escalating EU migration crisis.
Reading a newspaper in Italy – and any other EU Member State for that matter – is a painful experience. I am constantly exposed to images of despair and tragedy unfolding in my country’s territorial waters. I often feel like rushing there to finally get started documenting the voice of those who remain invisible, but rushing is not the way to go about it, despite the climate of crisis and urgency. Ethically-sound research takes time, even more so in the midst of a crisis.
Rosenthal, J. 2006. ‘Politics, Culture, and Governance in the Development of Prior Informed Consent in Indigenous Communities’, Current Anthropology 47(1): 119-142.