Rites of consent: negotiating research participation in diverse cultures.

The significance of informed consent in research involving humans has been a topic of active debate in the last decade. Much of this debate, we submit, is predicated on an ideology of individualism. We draw on our experiences as anthropologists working in Western and non Western (Iban) health care settings to present ethnographic data derived from diverse scenes in which consent is gained. Employing classical anthropological ritual theory, we subject these observational data to comparative analysis. Our article argues that the individualist assumptions underlying current bioethics guidelines do not have universal applicability, even in Western research settings. This is based on the recognition that the social world is constitutive of personhood in diverse forms, just one of which is individualistic. We submit that greater attention must be paid to the social relations the researcher inevitably engages in when conducting research involving other people, be this in the context of conventional medical research or anthropological field work. We propose, firstly, that the consenting process continues throughout the life of any research project, long after the signature has been secured, and secondly, that both group and individual dimensions of consent, and the sequence in which these dimensions are addressed, should be carefully considered in all cases where consent is sought.

Symbolism of community I: the boundary between hospital and community.

OBJECTIVE: To study the symbolism of community as understood and practised in a mental health Crisis and Assessment Service in an Australian city. THEORETICAL APPROACHES: The paper draws on anthropological theories of symbolism and boundary work. METHOD: Ethnographic fieldwork techniques were employed for data collection. Ethnographic analysis was then applied to these data. RESULTS: In mental health practice, community is primarily defined in contradistinction to hospital. Narratives about community, including an orthodox version and a sceptical counter-narrative, revolve around this community-hospital boundary. CONCLUSIONS: This analysis identifies a key symbol, which we have designated community, and enumerates the social values that comprise it.

Symbolism of community II: the boundary between community mental health professional and community.

OBJECTIVE: To study the symbolism of community as understood and practised within a mental health Crisis and Assessment Service in an Australian city. THEORETICAL APPROACHES: The paper draws on anthropological theories of symbolism, boundary work and social networks. METHOD: Ethnographic fieldwork techniques were employed for data collection. Ethnographic analysis was then applied to these data. RESULTS: In mental health practice, rules of professional behaviour established a boundary that prohibited mental health professionals from social engagement with members of the community they served. Ethical imperatives prevented them from forming interpersonal bonds with their clients. Rules of privacy and confidentiality meant that they could not relate to the client's social network as a whole. CONCLUSIONS: The companion to this paper identified a summarizing symbol, which we designated community, and it specified the social values it represented when appropriated to the task of drawing a boundary between hospital and community. This paper specifies additional social values represented by community when it is appropriated to the task of drawing a boundary between community mental health professionals and the community.