Saturday, 19 January 2013

Ethnography: Writing about people.

On arrival at the scene of the incident the EMT and I jumped from the vehicle and ran into the house, while the  paramedic turned the ambulance around in case there was a need to depart quickly. Inside the house the EMT ran into the kitchen where the baby was, while I stayed near the door of the house, ready to run to the ambulance to get any equipment that he might need. As I stood there the grandparents of the baby came out of the kitchen, obviously very distressed, and I tried to calm them down. At this time the midwife also arrived and went into the kitchen. It was a very tense time for everyone concerned. The paramedic stayed near the vehicle with the doors open. All three of us knew from past experience that if it had not been possible to get the baby breathing again, quickly at scene, the other option was to run with the baby as fast as possible to the hospital, which was why we had adopted the positions we had. I stayed with the grandparents trying to reassure them. We all looked to the door of the kitchen expectantly. When the EMT  did emerge he told us that the baby was breathing again. This was a great source of relief to us all. The paramedic and the EMT then went into the kitchen to attend to the baby with the midwife. I stayed outside comforting the grandparents. Obviously they were now a lot more relaxed and they asked me who I was and what was I doing there. We had just been through a very stressful time together, probably for them one of the most stressful few minutes of their lives. When I explained that I was a University researcher they seemed confused at first, perhaps because I was one of the first people that they had seen arrive at the house. I then explained that I had in the past worked in the ambulance service and this seemed to explain matters. 

Although the baby was now breathing, it was not breathing normally so it was conveyed to the hospital for a check up. The journey back although a lot less fraught was still full of tension. The EMT and I sat in the back. The baby was continually monitored in case there was a need to start resuscitation.
When we arrived at the hospital  the baby and mother were taken  into casualty.  I sat in the back of the ambulance with the EMT and talked about the incident. By this time I had my researcher’s hat back on and it was full of ethical and legal concerns. What if I had dropped the patient when transferring  from the stretcher to the trolley? In gaining access I had told nobody that I would be touching patients, as at that time it had not been my intention to do so. What if I had prepared a piece of equipment incorrectly on route to the call? When I worked in the ambulance service that was always a concern then, but now I didn’t work for the ambulance service  and felt that I should not have been doing such things. What right did I have to be in these peoples homes observing them at times of intense emotion and grief? As far as the ambulance staff were concerned I had their informed consent but the patients had not invited me into their houses. What if the baby had stopped breathing in the back of the ambulance? I knew I would have got involved in the resuscitation, if I felt I could have helped. I knew the ambulance crew would have expected me to, and that if I had not, they would have been disgusted with me. But I was now supposed to be the researcher; I felt that I had no right to be attempting to resuscitate people’s babies; probably the most precious thing in their life. As I sat there in the back of the ambulance sharing these rantings with the EMT he said something that made me put the whole thing of research ethics back into perspective. He said “we worked as a team and who gives a fuck as long as the baby  is all right”. I realised then that that said it all. Whatever my role or responsibility as a researcher these were secondary to my roles and responsibilities as a human being. If I could help, I had a duty to help, regardless of any arguments concerning research ethics; the ethical issues in this situation were a lot deeper.

This realisation, however, had various implications to my research strategy. I had been given permission to observe ambulance crews, not to lay my hands on and treat patients. This raised new ethical problems regarding the informed consent of patients to be treated by a researcher. Until I resolved these issues I decided to retire from the field. I felt it was time to consider my ethical position reflexively and then to approach the medical research ethics committee of the  health authority. Although the focus of my research was not the patients, as events had shown, I couldn’t help interacting with them on many levels. In the end it turned out to be Metz who gave me the most guidance in this area. He found that there were many times when being a participant on an ambulance got in the way of observing. The demands of the moment can  prevent the researcher from casually surveying the surroundings, or reflecting on the behaviour seen. What this action showed that when one is conducting social research one’s actions are being judged by others who are involved in the situation and the researcher’s emotions come into play and influence judgement. What is central to any such incident is that the patient’s well being is at stake; therefore the focus necessarily, as a human, is on that goal. Additionally if the researcher does not accept the members’ perspective  then he or she will appear indifferent, hostile or ignorant and will be tolerated only briefly.  These observations and my own previous experience helped me to consolidate in my own mind what role I had as a participant and what role I had as an observer.
In order to resolve this situation I posed the hypothetical question. What would I do if I arrived at the scene of an accident and there were three casualties? What extent of care would I give? What equipment from the ambulance would I use? My answer to such questions was that  I would provide first aid as any citizen who had a knowledge of first aid would.  I would not use any equipment from the ambulance unless directed to by a member of the ambulance crew. That is how I resolved the situation for both myself and to the ethics committee. I felt that I was no longer qualified to offer anything more, but due to the fact that I knew some first aid I was under an obligation to use those skills. Relating it to the position I recounted earlier, as a parent myself  I felt if there was anyone who could help in keeping my child breathing, be they researcher or anything else, I would want them to. 
Normally in the presentation of aspects about my research I do try to resist the gory or dramatic story,  as I feel that these often contribute to the misrepresentation of what the ambulance service is about. However, on this occasion the purpose of using a dramatic story  is that in this incident, what was of concern  was very precious, a child’s life.  As I stated earlier however,  I had begun to have these concerns for some time in my fieldwork, often while involved in more routine  ambulance duties. I  found I was in the position, as every ethnographer is,  of being involved in social relations with others who occupied the field, not only ambulance staff  but patients,  hospital workers and members of the public.
This incident compounds a  concern that I had during the whole research process and one that I feel that other researchers should consider. We, as researchers, are parasites on our subjects. As this incident illustrates I was using a period of intense emotional trauma, for all those concerned, as data for my Ph.D. thesis. This, in turn, I believe, poses both practical and ethical concerns that should be addressed. The question that researchers need to ask themselves, reflexively, is ‘what’s in it for them?’. If we just stand back and observe for our own purposes then we are failing to address these concerns.  If one is to get accepted to observe and record what people are doing, that is the practical concern. However, maybe there is a need for such reciprocities to address the ethical dimension.

Years of experience in the field have taught me that ethical decisions made during ethnography are often problematic, as they often are in everyday life. Akeroyd (1984: 154) has stated that in an “increasingly pluralist discipline consensus about ethical behaviour and research practice is unattainable and compromise seems inevitable. The social researcher must make compromises...between roles as scientist and citizen , commitment and impartiality... The onus for making such decisions rests on the individual researcher.” I do believe that my experiences in the field have shown this dichotomy between the role of the individual as a researcher and as a citizen. The experience has made me believe that it is essential that the researcher consider the humanitarian implications of their actions in the fieldwork situation, although addressing this problem is rarely straightforward. All I feel that we can do as researchers is try to resolve these ethical dilemmas as best we can. To do this we need to consider these decisions reflexively and discuss them openly, not only with our colleagues, but also in a wider arena. What I hope to illustrate by using this concrete example from my own research is that there are times where the researcher should stop being a researcher and engage in action that is not directed towards the goal of producing knowledge. By its very nature ethnography forces us into relationships with people, which, in turn, has an impact on how we behave, or more germane to this case, actions  arise through obligations in another role, in my case not only as a former ambulance worker, but I think more basically as a citizen and as a human being.        

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