Research interviews with drug users: confidentiality and 'heinous discovery'

Imagine that you are carrying out research interviews with drug users as part of your research into the effectiveness of Drug Treatment and Testing Orders that were introduced as a community penalty by section 61 of the Crime and Disorder Act 1998. The interviews were conducted in accordance with the British Criminology Society Code of Ethics and you were at pains to emphasise that all disclosures would be absolutely confidential. In doing so, you were aware that drug users may disclose details of offences committed under the Misuse of Drugs Act 1971 and you also contemplated that they may reveal details of property offences such as theft and burglary committed in order to fund drug purchases.

However, during the interview with one drug user, he claimed to be the person responsible for a series of muggings that have taken place locally. You have seen the reports of this detailed in the local paper and know that most of the victims were elderly and some were badly injured. Two days after this interview, you read that one of the victims died in hospital as a result of her injuries.

What could you have done differently to avoid this situation?

The ethical dilemma at the heart of this situation is simple: should the researcher breach the promise of confidentiality and disclose to the police that the participant admitted to responsibility for the muggings? However, this dilemma could have been avoided if the researcher had anticipated that such disclosures might be made.

The key thing that needed to be done differently here was that the researcher needed to have foreseen the possibility that violence might be used and that injury, even death, may result from this. Armed with this information, the researcher could then have made a conscious decision about whether offences of violence were something that they were prepared to protect with a promise of confidentiality. If they were prepared to keep some disclosures of violence confidential, they should than have decided if there was a level of violence that they would feel compelled to disclose.

In this situation, the researcher has contemplated that the participant may have committed criminal offences associated with drug taking as well as acquisitive offences that would facilitate the purchase of drugs but insufficient thought has been given to the way that those offences might be committed. In other words, the researcher has identified theft and burglary as potential offences but has not gone beyond that to think about the way that those offences could be committed. For example, burglary can involve no human contact if the offender breaks into an unoccupied building but may also involve confrontation between the offender and the owner if the building is occupied and the owner is disturbed. The way that the offence is committed does involve the potential for confrontation and therefore carries the possibility that violence will be used. Once the researcher has realised that violence could be used, they can consider two questions: would I be comfortable in keeping information about violent offences confidential and, if so, does this confidentiality only cover violence that involves a certain level of harm and injury to the victim. By thinking about the type of behaviour likely to be involved in the offences, the researcher is less likely to be unprepared for a disclosure of the use of violence and the harmful consequences of this. If the researcher has made a conscious decision prior to the interview that violence, even if it has fatal consequences, should be kept confidential then there is no ethical dilemma here.

An alternative way of thinking about the boundaries of confidentiality would be to contemplate what offences could be disclosed that you would not be prepared to keep confidential, irrespective of the likelihood that they have been committed by the participant. For example, if you would be unwilling to uphold a promise of confidentiality if the participant revealed that he was a rapist or that he was involved in the sexual abuse of children then this can be communicated to the participant at the start of the interview. He will then either withhold such information or disclose it in the knowledge that it is not protected as it is an exception to the general promise of confidentiality. Remember that the ethical dilemma is raised by revelation of a disclosure that appears to be covered by confidentiality. In other words, it is not the disclosure of information provided during a research information that is unethical: it is such a disclosure if the participant has been given the impression that his words would not go any further. If a participant has been told that certain disclosures are not protected then there is nothing unethical in passing on information that falls within the exception that you have identified to the participant.

A warning can be given in quite general terms. You could tell participants that you will keep everything confidential unless it relates to harm caused to an identifiable person.

What can you do about it now that this has happened?

It is really important that thought is given to any limitations on confidentiality prior to the interview so that these can be shared with the participant before they start to make disclosures. It is far trickier to work out how to act in an ethical way if unexpected disclosures are made once a promise of confidentiality has been given. In this case, the researcher did not consider that they would receive information about violence or death so they now face a considerable dilemma: either they breach the promise of confidentiality or they uphold it in the knowledge that they are protecting a violence criminal who has caused death once and may go on to attack and possibly kill other victims.

In such a situation, the researcher has to decide which of the two options is least offensive to them. This balances personal morality (the desire to ensure that a violent offender who has killed an elderly person is bought to justice) against professional ethics (the promise of absolute confidentiality was given). It is important to note that Codes of Ethics offer a guide to dealing with such issues; they are not hard and fast rules that cannot be broken so there is scope to take personal considerations into account.

On a practical level, it would be useful to talk the situation through with a colleague, a supervisor or a member of the Ethics Committee. Remember, though, that people’s views on this sort of issue may differ: there are those who feel that a promise of confidentiality should never be broken whereas others may feel that disclosure is justified in these circumstances. There is no single correct answer. That is why it is far better to avoid such a situation occurring by being very thorough in contemplating possible disclosures.