This chapter discusses the role of intervention research in bioethical inquiry. Although many ethical questions of interest are not appropriate for intervention research, some questions can only be answered using experimental or quasi-experimental designs. The critical characteristics of intervention research are identified and strengths of this method are described. Threats to internal validity and external validity are discussed and applied to a case example in bioethical research. Several recent intervention studies that were federally funded in the area of informed consent are discussed, and recommendations for future intervention research are presented.
Ethnography is a qualitative, naturalistic research method derived from the anthropological tradition. Ethnography uses participant observation supplemented by other research methods to gain holistic understandings of cultural groups’ beliefs and behaviors. Ethnography contributes to bioethics by: (1) locating bioethical dilemmas in their social, political, economic, and ideological contexts; (2) explicating the beliefs and behaviors of involved individuals; (3) making tacit knowledge explicit; (4) highlighting differences between ideal norms and actual behaviors; (5) identifying previously unrecognized phenomena; and (6) generating new questions for research. More comparative and longitudinal ethnographic research can contribute to better understanding of and responses to bioethical dilemmas.
Content analysis is a family of systematic, rule-guided techniques used to analyze the informational contents of textual data (Mayring, 2000). It is used frequently in nursing research, and is rapidly becoming more prominent in the medical and bioethics literature. There are several types of content analysis including quantitative and qualitative methods all sharing the central feature of systematically categorizing textual data in order to make sense of it (Miles & Huberman, 1994). They differ, however, in the ways they generate categories and apply them to the data, and how they analyze the resulting data. In this chapter, we describe a type of qualitative content analysis in which categories are largely derived from the data, applied to the data through close reading, and analyzed solely qualitatively. The generation and application of categories that we describe can also be used in studies that include quantitative analysis.
While some of us enjoy engaging in many forms of bioethical activity, including philosophical analysis and debate, clinical ethics consultation, and empirical research, only the latter matters much to the practicing physician. Practically minded, most doctors have little concern with fine moral distinctions when faced with a patient's request for assistance in dying or a pharmaceutical company's offer to attend a product “consultation” session at a first class resort in addition to an attractive fee for participation. Physicians want to know what facts might bear on ethical questions they confront, how ethical conflicts that have an impact on patient care can be understood and resolved, and whether research reveals consistently clear, helpful findings. The following discussion offers some examples of how empirical research related to bioethical issues has provided evidence and guides for physicians at both individual-patient care and policy levels, and further reviews areas that warrant continued research attention.
Focus groups can provide a rich and meaningful context in which to explore diverse bioethics topics. They are particularly useful for describing people's experiences of and/or attitudes toward specific ethical conundrums, but can also be used to identify ethics training needs among medical professionals, evaluate ethics programs and consent processes, and stimulate patient advocacy. This chapter discusses these and other applications of focus group methodology. It examines how to ethically and practically plan and recruit for, conduct, and analyze the results of focus groups. The place of focus groups among other qualitative research methods is also discussed.
