Abstract:Obtaining valid individual informed consent is necessary to respect participants’ autonomy in research ethics. However, there are uncertainties in accounting for interpersonal influence that unduly influences participants’ voluntariness, especially by close family members. As authors increasingly adopt the theory of relational autonomy to justify the interpersonal decision-making model, researchers and Institutional Review Boards (IRBs) require principled guidance to safeguard against undue familial influence. Particularly, feminist philosophers’ long-concerned “total deference” decision-making style has direct ramifications for research ethics: how to determine participants’ voluntariness, and by whom, in the case that participants unconditionally defer decisions to their close family member? This article advocates a responsible use of relational autonomy within research ethics. To achieve these, this article claims: (1) following the procedural school of relational autonomy, assessment about voluntariness must take participants’ true belief and desire for reference, thus, voluntariness qua authenticity; and (2) by utilizing Andrea Westlund’s dialogical account of relational autonomy, frontline researchers must sensitively observe the dynamic interplay between participants and their family members. As such, a total deference pattern is a credible flag to check participants’ voluntariness. When frontline researchers observe misaligned reasoning and unusual nonverbal clues, they are obligated to pose subtle “challenges” to the dyad and reorient the decision-making. The IRBs could also perform audits and provide advice for accommodating cultural practices. Practically, an uncritical adherence to a “collective” or “family-oriented” consent model would exacerbate power differences within families and hinder participants’ true preferences.
Keywords: Bioethics, voluntariness, relational autonomy, authenticity, deference, Andrea Westlund
