In this case, Ms Pisal and Ms Bandewar raise two important (and related) ethical challenges facing social science researchers, particularly those conducting community-based research. These are: evolving an appropriate concept of informed decision-making in community-based research, and negotiating the dynamic and multiple dimensions of field relationships.

Social science research, particularly anthropological research, is often relatively long term, contingent, and flexible. That is, its course (including choice and application of methods) is dependent on emergent findings. In this context, the concept of informed decision-making needs to be understood not as a one-time “essentially contractual encounter between strangers,” but as an evolving, “negotiable, long-term” process (1).”

In the case description, although the researchers detail the information presented to potential participants, they do not elaborate on the kind of dialogue HP engaged in. What kinds of questions did potential participants pose? Was there an active discussion about their concerns (including concerns regarding their gurus’ perspectives) and expectations? Would sustained dialogue and discussion have led to alternative solutions for the consent and participation dilemma faced by HP? For example, increasingly, researchers are forming community advisory groups (CAG) to assist in the development and implementation of research protocols. These groups may help anticipate and negotiate research-related risks and harms. Dialogue with potential participants and/or with a CAG may help identify additional modes of data collection (such as interviewing trans-gendered people in locations other than their homes), modes that may help one circumvent the dilemma faced by HP.

However, when such a dilemma is unavoidable, that is when promoting individual autonomy and minimising harm are at odds with each other, there is no clear-cut answer. For this reason, debate and dialogue that seek to build consensus on the application of ethical principles to concrete situations are essential.

The case also highlights the challenge of negotiating the dynamic and multiple dimensions of field relationships. The anthropologist (or the community-based researcher) by virtue of spending considerable amounts of time in the ‘field’ often goes beyond the researcher-participant relationship to develop dynamic and multiple relationships involving multiple obligations, responsibilities and expectations. Distinguishing between expectations and obligations arising from the researcher-participant relationship and those arising from other kinds of relationships developed over the duration of a study may be difficult. But this may help in identifying potential responses. When undertaking long-term research in a community, expectations may grow (or recede) depending on the trajectories of these relationships, but research-related obligations may remain static.

If one subscribes to the view that ethical principles are universal (although their application may be context-specific), then there is not likely to be any dispute about the idea that all researchers, regardless of whether they are ‘independent’ or affiliated to an institution, have similar responsibilities and obligations. Obligations and responsibilities are tied to what research participation entails, including the risks and benefits. In this case, one might argue that at a minimum, the researcher may need to have been prepared to provide referrals for health-related concerns, issues that are the focus of the study. A researcher may not be obliged to address needs that do not arise from research participation or those that arise from other types of relationships a researcher knowingly or unwittingly enters into. However, a researcher may be expected or feel compelled to respond to such needs. Expectations may be addressed and/or responded to through sustained dialogue between researchers and participants. Researchers’ compulsions, however, should give one pause. An active attempt to intervene (to file a case, for example) means that the researcher-participant relationship is further blurred by the introduction of a new dynamic. The application of ethical principles to these other types of relationships and interactions may lead to different kinds of obligations and responsibilities.

In conclusion, the case presents highly relevant and challenging ethical issues facing social science researchers. The case highlights the need to conceptualise informed consent as a process that evolves through sustained dialogue between researchers and participants; argues for greater reflexivity regarding the dynamic and multiple relationships that develop in community-based research; and calls for maintaining distinctions between obligations, expectations and compulsions in these relationships.