Ethical and bioethical aspects in the research interview: the impact on subjectivity

Abstract

Numerous research projects involving interviews give an impression that this is a form of innocuous approach, presenting no risk, which is not true. The interview, as a research method, is subject to an ethic of human relationships. Through a literature review culminating in a critical analysis, the characteristics of the interview, the interviewee and the interviewer are scored separately, to then be gathered as part of the same context when carrying out the interview itself. Some aspects of the interviewer-interviewee interaction cannot fail to be respected, choosing always the most appropriate way to conduct the questioning. Nevertheless, if some issues, however delicate, are an essential part of the research, they cannot be left aside, and this will require an irreproachable ethical position by the interviewer.

Keywords:
Bioethics; Interview; Ethics; research; Researcher-subject relations; Health vulnerability

Resumo

Numerosos projetos de pesquisa envolvendo entrevistas transmitem a impressão de que essa é uma forma de abordagem inócua, não apresentando riscos – o que não é verdade. A entrevista, como método de investigação, está sujeita à ética do relacionamento humano. Mediante revisão de literatura e culminando com uma análise crítica, são pontuadas separadamente características da entrevista, do entrevistado e do entrevistador, para depois serem reunidas como parte de um mesmo contexto ao levar a cabo a entrevista propriamente dita. Alguns aspectos dessa interação entrevistador-entrevistado não podem deixar de ser respeitados, escolhendo-se sempre a forma mais adequada de proceder aos questionamentos. Porém, quando parte imprescindível da pesquisa, algumas questões, mesmo delicadas, não podem ser deixadas de lado, e isso exigirá, por parte do entrevistador, irrepreensível posicionamento ético.

Palavras-chave:
Bioética; Entrevista; Ética em pesquisa; Relações pesquisador-sujeito; Vulnerabilidade em saúde

Resumen

Numerosos proyectos de investigación que implican entrevistas cargan con la impresión de que ésta es una forma de abordaje inofensivo, que no presenta riesgos, lo cual no es cierto. La entrevista como método de investigación está sujeta a una ética de las relaciones humanas. A través de una revisión de la literatura y culminando en un análisis crítico, serán puntuadas separadamente las características de la entrevista, del entrevistado y del entrevistador, para luego ser integradas como parte de un mismo contexto cuando se lleva a cabo la entrevista propiamente dicha. Algunos aspectos de la interacción entrevistador-entrevistado no pueden dejar de ser respetados, eligiéndose siempre la manera más adecuada de proceder a las preguntas. Sin embargo, por constituir una parte esencial de la investigación, algunas preguntas, aunque delicadas, no pueden ser dejadas de lado, y eso requerirá una posición ética irreprochable por parte del investigador.

Palabras clave:
Bioética; Entrevista; Ética en investigación; Relaciones investigador-sujeto; Vulnerabilidad en la salud

In their ongoing dialogue with research ethics committees (REC), researchers describe the interview as part of their methodology in numerous phase III research protocols. When reporting the methods used and describing the possible risks to participants, the same text (or very similar texts) is presented in a somewhat casual manner. Commonly, researchers use the same sentence, the content of which is roughly as follows: The study in question presents no risk to participants as it is only an interview. However, if they wish to comply with the recommendations in Chapter V of CNS Resolution 466/12¹, an interview, in itself, is not without risks:

All human research involves risks of various types and degrees. The larger and more obvious the risk, the more care must be taken to minimize it and the protection offered to participants by the REC/CONEP system. The possibility of immediate or subsequent harm should be examined at an individual and collective level. Risk analysis is an essential component of ethical analysis, from which should arise a monitoring plan that should be provided by the REC/CONEP system in each specific case¹.

The long-term participation of both the authors of the present study in ethics review committees has established a discomfort related to such a trivial usage by researchers. There remains doubt about the reason for this use: is it due to ignorance on the part of researchers, who consider the instrument genuinely innocuous, that an interview could harm the participants; or is it a question of repeating, until exhaustion, an expression coined by their peers?

Out of this frustration – at first personal, but then shared by other members of several RECs – arose the idea of exploring interviews and their nuances a little further through literature on the subject, followed by a critical analysis of such literature. There are questions to be answered in interviews that can be as discomforting as an injection, an invasive test or even an injury. Invisible, it is true, but capable of impacting the subjectivity of the participant.

The interview

According to Lodi², an interview is a process of interaction between people and is therefore subject to the ethics of human relationships. As a form of human interaction, Mann adds that an interview can range from a more relaxed “chat” to a more carefully pre-coded and systematized set of questions and answers prepared in a program or interview script³. Applied in work groups, the interview is an exploratory technique, that involves the conduct and personalities of the participants.

It is important to establish a more defined idea of interviews. As an exploratory technique, it is necessary to remember that any interview is composed of three parts, without which it cannot be described as such. It is essential to have an interviewer, a person who is interviewed and the defined content of the interview.

Interviewer

The interviewer should be aware of their own feelings, prejudices, values and expectations, which can be sources of bias. Szymanski⁴ mentions that an interviewer cannot be chosen randomly and nor can they carry out the interview without the minimal knowledge of the socio-cultural and institutional environment of the respondent. They should realize in advance that such their role is imbued with cultural significance, assigned by the society that surrounds it. Faced with the possibility of assuming such a role, the interviewer should ask about the characteristics of the respondent', which may (or may not) help make the interview a pleasant experience. Similarly, they should also recognize in themselves any previous experiences that may contribute to their perception or personal circumstances that may affect, negatively or positively, the interview.

In short, the interviewer must first observe the requirements of the interview and can therefore decide if they are fit or unfit for the occasion. Grummit⁵ adds that there is no way to control or plan the interview without knowing what it hopes to achieve, nor can it be clear whether the objectives have been achieved if no one is sure what they are. It is also a crucial point in the creation of the interview to realize the impact it may have on the respondent, which is directly related to who is the interviewer, who is being interviewed, when the interview takes place and what is its goal.

The interviewer should know that the answers should be compared with external sources and/or other respondents. He or she should also be aware of the attitudes of the respondents, and note whether the interview takes place under appropriate conditions. It is for the interviewer to clarify concepts or terms that will appear during the interview, as well as establish the average duration of the interview, remaining aware of this factor and, similarly, other social, anthropological and spatial elements. It is also the interviewer's duty to maximize the flow of relevant information and maintain the best possible relationship with the respondent, putting them at ease, reassuring them about the interview and thus avoiding indecision regarding participation.

The qualities required of an interviewer vary according to the complexity and degree of informality allowed in each interview³. Some people will fare better than others in this task, although with a reasonable degree of training, many people can assume the role of interviewer. One cannot ignore the accuracy of the interview - that is, the reliability of the data, which will be used for further analysis.

Respondent

Potential interviewees bring a set of favorable and unfavorable conditions for participating in an interview. Previous experience in interviews can be an assisting factor, depending on the nature of such previous participation. The perception of reward – be it financial, altruistic or other in nature – can also interfere, as well as personal, permanent or temporary circumstances.

The interview creates for the respondent – no matter who they are – situations that involve both burdens and costs and bonuses and rewards that vary from person to person. In general, burdens include: the time required for the interview; threats to their security and safety, with respect to circumstances, motives or issues raised by the interview; forgetfulness or “blank moments” that may occur; and even trauma or embarrassing and uncomfortable situations that the interview can bring up. As for bonuses, the interview may: lead to new relationships; fulfill some of the expectations of the respondent; reveal their kindness and alterity, among other factors².

Subjective elements are also part of the interview, signals of which the good interviewer should be aware of and use as allies. Non-verbal communication (signs of concern or relief, facial expressions in general, a relaxed or tense body) should be considered as a form of revealing details that verbal communication rarely expresses. Regarding burdens and bonuses, the former includes issues concerning the use of time, the sensation of personal security, learned behaviors in general and negative experiences. With respect to bonuses, there may be some sense of personal recognition, the feeling of solidarity/collaboration, the fulfilling of expectations, or the need to do something that has some meaning. It is for the interviewer to maintain the balance between burden and bonuses, preferably increasing one and decreasing the other.

By accepting an invitation to take part in research, the respondent is accepting the interests of those performing the research, while discovering they themselves are the owner of knowledge that is important to another 6. When choosing someone to act as a respondent, that person is assumed to be a representative of the group that is the object of the study, and to provide an overall picture of this group³. The possibility of participating in an interview can be interpreted in many ways: an opportunity to speak and be heard, an assessment, deference to one's person, a threat, an annoyance or even an invasion of privacy. The respondent's interpretation defines the meaning and direction of the interview, which is manifested directly according to how the situation is perceived. The result may be to provoke a certain emotion in the interviewer (pity, admiration, respect, fear, solidarity, etc.)⁴, or even to manipulate the interviewer, by using them to disseminate the respondent's ideas and/or opinions by being overly attentive to the attitudes on display.

Most respondents display defense mechanisms, a lack of motivation, communication disabilities (emotional) and problems of language (vocabulary differences). It is vital to respect the vocabulary of respondents, reflecting the regional meaning of the words used. Another important point is that when there is a question of an emotional nature, some answers may be compromised, which will require some skill on the part of the interviewer. Questions involving topics such as sexual behavior, religion, smoking, substance abuse, alcohol and politics – that is, issues for which it is assumed there will be an obligation to position oneself in one way or other – can produce distorted answers, as the respondents answer how they think is most appropriate, instead of reporting what they really think or practice.

It is also important to pay attention to the degree of importance that the respondent is supposed to give to their participation. Someone who sees themselves as expert in a given subject may well understand that they were chosen for this reason and feel their contribution is important, which should help to better explain the problem for a wider audience.

In terms of the possibility of whether the interview is opened or closed, it should be borne in mind that open interviews enable a wider and deeper investigation of the respondent's personality, although closed interviews allow a more systematic comparison of data, as well as other advantages inherent to the standardized method⁷. Lodi² recalls that respondents from a more modest socioeconomic background or lower hierarchical level do not feel at ease when faced with open questions, which also produce technical difficulties regarding the content analysis of the responses by the interviewer.

The respondent also brings the direct influence of the social group to which they belong, which may be even greater depending on how involved they are with the social and/or cultural activities of the group. As a human being, the interviewer will coexist with conscious and unconscious motivations, ambivalences and objective and subjective reasons for his behavior. Many will be wrapped in prejudices, private opinions, the influence of other people, race, religion and human types.

Method

A bibliographic survey of an exploratory nature was performed. A critical analysis of literature specifically relevant to research interviews, did not reveal many publications on the topic. Several authors have focused on psychological interviews, medical interviews or even journalistic interviews. In some places, these interviews were useful in the construction of the text, but in most cases it was necessary to start with an identification of common aspects, examine them and then build a closer vision of the reality of research interviews, recognizing their peculiarities and establishing conclusions.

This article aims to discuss the research interview as a general technique; there is no intention to describe here the diversity of forms and/or experiences of interviews, as the main focus is the impact on subjectivity. This aspect seems to be more strongly linked to the expertise of the interviewer and the expectation of the respondent than the methods employed. The practice of the interview in each context follows particular and peculiar situations, but includes, in any case, one source that is capable of causing a positive or negative affect on those involved.

Discussion

The act of interviewing is, therefore, a twoway street, in which extreme care must be taken to achieve an effective flow of communication, requiring an atmosphere in which the respondent feels welcomed, understood and safe, and is not put on the defensive, which can certainly undermine the progress or the analysis of the interview. After all, every interviewer seeks honest answers, and a defensive position on the part of the respondent can undermine that possibility. Thus, the interviewer is required to be ethical and professional to avoid creating a relationship of authority with the respondent.

In its multiple uses, the interview may have a wide variety of goals. It cannot be forgotten that, as well as a process of observation, participation and empathy, it is part of so-called research methods. It is, in essence, a movement of wishing to know, a form of enquiry that has advantages over the questionnaire: it generates greater motivation in the respondent; creates greater opportunities for understanding meanings; provides more flexibility regarding the choice of appropriate words and expressions; provides better control of the situation and leads to better assessment of the validity of the answers, as it stimulates the interviewer-respondent interaction and the responses that arise from it.

An interview can be defined as a situation which involves a meeting of two or more people, who often have different affective dispositions. One of them – the interviewer – aims to gather information for research that they are performing or intend to perform. The other – the respondent – may have a variable range of intentions, even if not expressed in an explicit form³.

For a good interview an effective choice of objectives, time, location and script are essential. Still, according to Minayo⁸, it is necessary that the interviewer first introduces themselves, mentions the interest of research, displays their institutional credentials, explains the reasons for the research, justifies the choice of the respondent and ensures anonymity and confidentiality are guaranteed. Only then should they proceed to the interview itself. Garret seems to share the same view when he says that:

For an interview to be successful, the fears of both the interviewer and the interviewee, which can be found in the intentions of both, must be removed. A relationship between the two and an affinity which allows the respondent to reveal the essential facts of their situation, and the interviewer to assist them, must be established⁹.

Accuracy in questions is also important to avoid confusing the respondents; each question must have a single meaning for all respondents, no matter how many of them there are. There is also no reason to inquire about observable facts or ask for information that can be obtained from other sources³. Cicourel also says, that the subjective interpretation, (…) constructs of common sense used in everyday life must be taken into account¹⁰. Ignoring this fact, results in problems or a lack of meaning in both the questions and the answers given¹⁰. The author also points out that any knowledge about the situation of the research should, if possible, be obtained, including literature and field information. If the problem to be investigated allows, the researcher should make it clear that some types of information will be necessary to achieve the aims of the study. In this way, careful notes about each stage of the study can reveal discrepancies or congruencies¹¹.

Whenever recording is necessary, it should be requested and obtained with the permission of the respondent, and guarantees their right not just to anonymity, but access to the recordings and analysis, leaving open the possibility that they can ask the questions they desire¹².

As some interviews require pre-established scripts, it is important to remember that they should live their purpose, always functioning as guides, not as obstacles. It should avoid predicting all the situations and conditions of field work. It should be created and used within this vision¹³ in order to facilitate the emergence of new themes during the field work, perhaps caused by the questioning of the interviewer. Where the script forms part of the interview, it should be drafted with a view to presenting the results in a clear and simple way. As an intermediate stage of the research, the script should allow a team of interviewers to give the same stimuli to respondents, in the same predetermined order, registering their reactions in a standardized manner¹⁴. It should be constructed in order with alterity, in order to ask the smallest possible amount of information, ensuring that the questions can be answered honestly and without the possibility of refusal³. When employing this alterity, those responsible for the formulation of the script should put themselves in the place of the respondent, imagining how they would respond to the interview. Thus, a well-planned script can be used without problems in the definitive study.

The interview is, according to Bleger⁷, a technique of scientific investigation. According to Grummit⁵, it is also a meeting between people, a conversation with a specific objective where one of the participants is responsible for completing this objective. In this way, the curiosity (of the interviewer) should be limited to what is required, for the benefit of the respondent¹⁵. The interviewer should not refrain from their responsibilities, introduce themselves as a friend, treat it as a commercial relationship, nor allow accounts of their life to intermingle with the interview process or seek another benefit other than their fees and their scientific or professional interest. Hiding their identity as a researcher would be the same as acting as a spy³. Similarly, predicts Bleger⁷, the interview should not be used as narcissistic gratification in which the interviewer presents themselves as a magician through a demonstration of omnipotence.

Silvares and Gongora¹⁶ state that the interview should be:

not totally predictable and therefore not completely planned like a questionnaire, for example; but at the same time, it is not a normal conversation, but always has specific objectives of a professional nature. The interest of the interviewer in obtaining certain information from the respondent when dealing with data collection, or observing behavioral changes when dealing with an intervention, will always exist. The very fact of not being completely planned makes it a complex activity requiring the adoption of methods that allow the interviewer to achieve his goals¹⁶.

As it is not totally planned, the interview – which is basically a stimulus-response situation – often shows little standardization either in stimuli or reactions. It works, therefore, as a chain of interactions. Grummit¹⁷ indicates that no technique can help without some form of relationship with the respondent being established.

The interview has an effect on both interviewer and respondent, as the research technique never has complete neutrality, even when it sounds like a purely informal conversation. It is important to have firmly grounded criteria when opting for qualitative or quantitative studies, without the banalities assigned to either one. Ferreira¹⁸ points out that a genuine dialogue requires that the people involved are alert to the issues and intentions of their partners to allow mutual understanding to occur.

With the flow of dialogue, understanding is created, which comes from the relationship established in the field¹⁸. The investigator should be aware that their interpersonal relationships with respondents may not end with the departure from the field: the longer the time spent socializing, the more time it can take for these relationships to dissolve and the more careful the researcher must be in relation to this matter.

Diniz recalls that some research techniques resemble everyday relationships. as the interview is also a meeting of people with common interests. The author states that a good interview is when the researcher genuinely engages in the exchange of information through active listening¹⁹. He goes on:

The question script is not the instrument that ensures the validity of the data, as active listening requires the continuous redescription of the questions based on the uniqueness of each person. This does not mean that the interview techniques depart from the script or the planning of the researcher, but simply that the capacity for planning must be subordinate to the imponderable nature of each meeting between researcher and participant¹⁹.

Other points can also can be critical to the success of the interview. Attention should be paid to where the interview will take place, which should always offer the respondent comfort and total privacy, so they feel free to participate and collaborate. Distraction factors should be avoided to ensure the respondent remains attentive only to the interview.

The duration of the interview will be directly linked to its objective and, although it is not always possible to determine this information precisely, the prospective average duration should be provided, so that the respondent knows beforehand how much time they should make available. An idea of duration, in some cases, can also be a way to help the respondent organize their responses.

The strict confidentiality of the data collected and answers to the interview is another item that should be considered. The respondent often feels most comfortable after learning that nothing that is said or inferred will be shared in a way that can allow their identification. Care and attention to risks should be present at all times, and should be increased if the research involves the need to reveal content hidden by cultural and/or cultural interdicts, and/or family or personal traumas that affected the life story of the participants²⁰. Interviewers have frequently described the emotional involvement of respondents; which can be unexpected, such as when an “innocent” question causes a sudden emotional reaction and a transformation of communicative knowledge, triggered by changes in different aspects of communication, or in other words, of specific content, of an interpersonal situation, of the discourse as a whole, of the social or cultural²¹.

Final considerations

The interview, used as a method of research with humans and presented as part of REC research protocols, operates as a control mechanism, so that the researcher can obtain – in whole or in part – the data required. It should also bring benefits to the research participant, which should be mentioned in the free informed consent form (FICF), which should also describe the type of questioning to be done and the approximate duration. The confidentiality of the data must be made clear both to the participant and on the FICF.

All human behavior occurs within a social, economic, historical and political, which affects such behavior in one way or another. Thus, whatever the technique used - interviews, participant observation or other forms - it is important that it is used by researchers who are aware of their applicability and usage limits. Conducting an interview without a proper theoretical framework or even knowing the proper way to approach the respondent potentially weakens the research and can perhaps cause irrep-arable damage. In the absence of prior knowledge of the reality of the respondent, appropriate use of language and care taken over the use of the questions, the interviewer may induce responses and thus influence the outcome. Thus, the interview is not without risks, which should be clearly specified in the consent form, along with the benefits.

Some questions, even if simple in nature, can have an impact on an individual respondent, depending directly on their life story. Asking about the name of someone who, throughout life, has had to carry the burden of an unpleasant, funny or difficult name may cause discomfort; while revealing age or marital status may not please some; questions about parentage can cause embarrassment to those who does not know their parent(s); schooling can often intimidate those who have little education; and asking about monthly income values will often displease someone. Other questions may also have a greater emotional content, according to the life story of the respondent. Even if precautions are taken, it is impossible to know in advance what these would be. Some examples are:

• Do you go out with friends a lot?

• Have you ever had a pregnancy test?

• Do you often use sunscreen?

• Do you use any form of contraception?

• Do you intend to undergo plastic surgery?

• How would you define your relationships?

• What was the most important moment of your life?

• What do you expect from health treatment?

• How do you see the members of your family?

• Why did you choose this profession?

Some questions, depending on how they are formulated, can have an aggressive connotation and thus should be avoided entirely. These are questions such as:

• How did you feel when you were given a positive diagnosis for this disease?

• In your opinion, has your disease affected your family life?

• How do you intend to go on with your life following the amputation?

Unfortunately, some interviews require the asking of unpleasant questions to achieve their goals. It is therefore important to keep in mind that, if any noticeably unpleasant question cannot be avoided without compromising the objectives and characteristics of the research itself, then the interviewer should be ready to take appropriate action, which could include:

• Being concerned for the other (alterity);

• Guaranteeing conditions of privacy;

• Guaranteeing comfortable conditions;

• Making it clear that they understand the situation;

• Making it clear that they are worried about the discomfort caused;

• Welcoming the respondent, respecting his or her condition;

• Interrupting the interview until the respondent feels able to continue.

In any case, it is important to encourage the respondent to believe that every question raised has its importance and value. In accordance with the precepts of the bioethics of principilism, we must be attentive to the dignity of individuals and groups, whether vulnerable or not; it is necessary that foreseeable damage is avoided and avoidable; the maximum benefits, as well as the minimum risk, should be sought. Finally, there must be a concern for the social importance of the research, in anticipation of providing feedback to those who participated in it, satisfactorily explaining the relevance of questions regarding the benefits that the research can generate.

Referências

• ¹
  Brasil. Ministério da Saúde. Conselho Nacional de Saúde. Resolução CNS nº 466, de 12 de dezembro de 2012. Aprova as diretrizes e normas regulamentadoras de pesquisas envolvendo seres humanos. [Internet]. Diário Oficial da União. Brasília; 13 jun 2012 [acesso 12 jun 2015]. Disponível: http://bit.ly/1mTMIS3
  » http://bit.ly/1mTMIS3
• ²
  Lodi JB. A entrevista: teoria e prática. 7ª ed. São Paulo: Pioneira; 1991.
• ³
  Mann PH. Métodos de investigação sociológica. 3ª ed. Rio de Janeiro: Zahar; 1975. p. 99.
• ⁴
  Szymanski H, organizadora. A entrevista na pesquisa em educação: a prática reflexiva. 4ª ed. Brasília: Liber Livro; 2011.
• ⁵
  Grummit J. Saber entrevistar. Porto: Europa-América; 1992.
• ⁶
  Mann PH. Op. cit.
• ⁷
  Szymanski H. Op. cit. p. 13.
• ⁸
  Bleger J. Temas de psicologia: entrevista e grupos. São Paulo: Martins Fontes; 2003. p. 3.
• ⁹
  Minayo MCS. Pesquisa social: teoria, método e criatividade. 31ª ed. Petrópolis: Vozes; 2012.
• ¹⁰
  Garret A. A entrevista, seus princípios e métodos. 10ª ed. Rio de Janeiro: Agir; 1991. p. 17.
• ¹¹
  Cicourel A. Teoria e método em pesquisa de campo. In: Guimarães AZ. Desvendando máscaras sociais. 2ª ed. Rio de Janeiro: Francisco Alves; 1980. p. 110.
• ¹²
  Cicourel A. Op. cit. p. 118.
• ¹³
  Szymanski H. Op. cit. p. 20.
• ¹⁴
  Minayo MCS. O desafio do conhecimento: pesquisa qualitativa em saúde. 12ª ed. São Paulo: Hucitec; 2010. p. 190.
• ¹⁵
  Mann PH. Op. cit. p. 120.
• ¹⁶
  Bleger J. Op. cit. p. 37.
• ¹⁷
  Silvares EFM, Gongora MAN. Psicologia clínica comportamental: a inserção da entrevista com adultos e crianças. São Paulo: Edicon; 1998. p. 23.
• ¹⁸
  Grummit J. Op. cit. p. 18.
• ¹⁹
  Ferreira LO. A dimensão ética do dialogo antropológico: aprendendo a conversar com o nativo. In: Fleischer S, Schuch P, organizadoras. Ética e regulamentação na pesquisa antropológica. Brasília: Letras Vivas; 2010. p. 141-58.
• ²⁰
  Diniz D. A pesquisa social e os comitês de ética no Brasil. In: Fleischer S, Schuch P, organizadoras. Op. cit. p. 187.
• ²¹
  Amorim E, Alves K, Schettino MPF. A ética na pesquisa antropológica no campo pericial. In: Fleischer S, Schuch P, organizadoras. Op. cit. p. 193-216.
• ²²
  Szymanski H. Op. cit. p. 18.

Publication Dates

• Publication in this collection
  2016

History

• Received
  31 Aug 2015
• Reviewed
  04 Aug 2016
• Accepted
  12 Aug 2016