Workbook – Relational ethics and inequality

Relational ethics and inequality: training case studies from Africa for global health researchers

Editorial group: Gemma Aellah, Tracey Chantler, Wenzel Geissler, John Vulule

With additional contributions by: Philister Adhiambo Madiega, Birgitte Brunn, Ann Kelly, Shelley Lees, Ferdinand Okwaro

Relational ethics cover

This book is a collection of fictionalised case studies of everyday ethical dilemmas and challenges encountered in the process of conducting global health research in places where the effects of global political-economic inequality are particularly evident. They are based on stories and experiences collected by a group of anthropologists who have worked with leading transnational medical research organisations across Africa in the past decade. The stories have been anonymised, combined with each other and subtantially altered in order to provide stumbling stones to start discussion, without discussing particular real places or situations. As a collection, these stories will offer a flexible resource for training across a variety of contexts, such as medical research organisations, universities, collaborative sites, NGOs. It can be used by individuals or in groups.

We hope they will encourage global health researchers to think – and talk – about their everyday experiences and practices, and about ethics, in a new light.

We believe that good global health research should concern us all. In today’s world there is no such thing as ‘local health’. We recognise that research ethics must be held accountable to international guidelines and principles, but we also know – both from our personal work experiences and ethnographic research – that crucial ethical decisions are made in situated engagements and face-to-face encounters. We believe these ‘relational ethics’ are vitally important alongside regulatory ethical tools and protocols, and need to be understood well – by everybody involved in the everyday practices and decisions of medical research – in order to conduct good global health research.

Structure of the book

The first half of this book provides an in-depth discussion of the importance of relational ethics, the anthropological research which informed the fictionalised training case studies (TCS), and a potted history of overseas medical research in Africa, which will help orient the user to understanding ethical dilemmas faced in transnational research today. It gives more detail on the aims and philosophy of this book and advice on how it could be used most fruitfully in a health research setting. We include practical suggestions on how each training case study could be used and tips to aid facilitators using them for training.

This is followed by a collection of 40 TCSs, based on a decade of fieldwork and group collaboration among the authors, and designed to be used in research training or to stimulate on going ethical deliberation amongst researchers planning or already in the midst of a project. We have divided this collection of TCSs into four sections, each section focusing on different types of relationships, which characterise the practice of international health research (with some inevitable overlaps).

Each TCS contains a two-page story, framed by keywords, facilitator’s notes to prepare the case, questions for discussion and reflection, suggestions for further reading and in some cases an activity. The facilitator’s notes provide guidance about the core ethical dilemma that the story is designed to address, as well as potential challenges pertaining to the particular case.




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