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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