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Harm and Risk Reduction
CER projects should be designed and carried out with significant attention to potential risks for community and participants, including to the broader social, political, and economic fabric of a community. Risks should be collaboratively evaluated and actively mitigated in an ongoing manner.
The Hippocratic oath practiced by medical doctors is “no harm,” which entails a commitment to thinking through and mitigating potential risks to patients, and ensuring that actions taken are in the best interest of patients. In the CER context, community engaged research paradigms have emerged in large part as a response to historical instances of exploitative research relationships with marginalized and underserved communities, and the recognition that research has the capacity to inflict unintended harm. Where Indigenous communities are engaged, CER researchers have an added responsibility to understand past injustices: “By acknowledging the historic debt to First Nations that is created by the unjust research practices that have been inflicted upon them, the research community can consider a path forward by designing mechanisms that strive to prevent further harm and to expand upon the benefits of good research” (Assembly of First Nations, 2009, p. 5). Taken together, CER literature cites the overt priority that research processes must protect participants from harm, minimize risks, and be non-malificent (Chou & Frazier, 2019; Ross et al., 2010; Wilson et al., 2018).
Tips & Considerations
Account for additional risks in less controlled environments
As CER, by definition, shifts research into more complex and “real world” environments, usually with explicit goals for university researchers to relinquish control, the potential realm of potential risks expands. Isler and Corbie-Smith (2012) offer this example: “Engaging community partners and participants, particularly within the environments where they already receive health care or other services, may lead to conflation of the obligations, risks and benefits of research participation with other clinical or social services they receive” (p. 907).
Acknowledge historical trauma and harm caused by research in and with specific communities
This acknowledgement of the past should be paired with an active commitment to develop mechanisms that prevent harm and bolster benefits to communities involved (Assembly of First Nations, 2009)
Consider different types of risk that may be broader or more systemic
"Traditional attempts to avert risk have focused primarily on physical harms, whereas relationships with communities introduce the potential for broader emotional, psychological and social harms. The context and influence of relationships with communities broadens the potential risks to be experienced, who conceives and receives the benefits of research, and determination of outcomes.” (Isler & Corbie-Smith, 2012, p. 907)
Undergo collaborative risk assessment with community
“Evaluation of risk is done in partnership with the community, as investigators may not be in the best position to consider the full range of potential harms that may occur within the community context.” (Isler & Corbie-Smith, 2012, p. 908)
Enact additional protections for vulnerable populations
“Consideration is given to what additional protections, if any, are needed for vulnerable populations” (US Department of Health and Human Services as qtd in Ross et al., 2010, p. 34)
Questions to Ask Yourself
- How will the community take part in risk assessment?
- What are the potential risks associated with this research project?
- What are concrete measures that are being taken to mitigate risk and avoid harm?
- What additional protections or considerations are required for this participant / co-researcher group?
- At what phases of the research will there be intentional examinations of the potential for harm and risk? (Consider building in time / conversations for multiple points throughout)
- Has this community had a history of being harmed by research? How will this history be acknowledged and utilised to ensure that similar harms/risks do not play out for this project?