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Research ethics guidelines grew out of several infamous episodes where research subjects were exploited. There is significant international synchronization of guidelines. However, indigenous groups in New Zealand, Canada and Australia have criticized these guidelines as being inadequate for research involving indigenous people and have developed guidelines from their own cultural perspectives. Whilst traditional research ethics guidelines place a lot of emphasis on informed consent, these indigenous guidelines put much greater emphasis on interdependence and trust. This article argues that traditional guidelines are premised on relationships of equal power, and that often the researcher has more power that is not fully equalized by providing information. Where there is a relationship of unequal power, then focusing on interdependence and trust is more likely to achieve ethical safety. We illustrate this thesis by describing the detail of a research project looking at the use of interpreters, where we video-recorded live consultations and then interviewed the patient, interpreter and doctor. We conclude by suggesting that mainstream research ethics guidelines should pay more attention to the development of a trustworthy relationship between subject and researcher, and that, following the lead from clinical medicine, we should develop a culturally competent ethical framework for research on human subjects.

In health decision-making, the distinctions between manipulation, persuasion and coercion are easily blurred. Manipulation, viewed through a bioethics lens is problematic only when it affects a person's ability to make autonomous decisions. In contrast, in critical discourse analysis (CDA), manipulation usually has negative connotations. This article uses childhood MMR (measles, mumps and rubella) vaccine information as a case study in manipulative discourse. Online vaccine information across three organisations was analysed using CDA methodology. Each organisation used manipulative discourse in their vaccine information but with varying degrees of transparency. The less transparent an organisation's motivations are, the less compatible it is with autonomous decision-making. This paper argues for adding further nuance to how discursive manipulation is defined within CDA, particularly in the field of public health. In this setting, manipulation is not necessarily immoral or unfair, but it may be, depending on whether it controls a person's ability to make an autonomous, informed decision. [ABSTRACT FROM AUTHOR]

How diagnosis fits within the overall activity structure of surgical consultations remains under-researched. We set out to contribute to this developing area of research with a particular focus on responses to diagnosis as an achievement of patient agency. We identified 26 diagnostic sequences in a collection of 35 video recorded surgical consultations and examined these in detail using conversation analysis. The activity of diagnosis and the transition to treatment recommendation appear to be structured somewhat differently in surgeon-patient consultations than has been reported for primary care settings. In particular, patient responses to diagnosis are more frequent and more likely to be extended. The analysis provides evidence that both parties orient to surgeons' accountability for their own diagnostic reasoning, and also the medical authority of the referring doctor and the subjective experience of the patient. In delivering the diagnosis, the surgeon must be cognizant of the opinions of both the patient and the referring doctor, which may align to a greater or lesser extent with their own diagnosis. [ABSTRACT FROM AUTHOR]

Examined the frequency and type of pragmatic devices used in oral New Zealand English, based on analysis of the Wellington Corpus of Spoken New Zealand English. It found "you know" and "eh" were both found more frequently in working-class than middle-class speech. Other age, gender, and class distinctions are discussed. (45 references) (MDM)

It is argued that quantitative research methods used alone often fail to adequately capture the complexities of spoken interaction; the inclusion of qualitative analysis can produce a greater insight into the functions of different interactive strategies and provides a valuable additional perspective to research into gender differences. (Contains 29 references.) (Author/LB)

To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1467-9566.2009.01229.x Byline: Kevin Dew (1), Maria Stubbe (2), Lindsay Macdonald (2), Anthony Dowell (2), Elizabeth Plumridge (2) Keywords: elective surgery; prioritisation tools; doctor-patient interaction Abstract: Abstract Priority setting and rationing is a dominant feature of contemporary health policy. In New Zealand, clinical priority assessment criteria (CPAC) tools have been developed to make access to elective surgery more equitable and efficient. Research was undertaken to identify how surgeons used these tools in the consultation. Forty-seven consultations with 15 different surgeons have to date been video- and audio-recorded. There were no instances where CPAC tools were explicitly used in the consultation. Drawing on the methodology of conversation analysis and the concept of news delivery as developed by Maynard, this paper argues that the delivery of diagnoses and treatment plans can usefully be seen in part as the delivery of bad or good news. Using three case studies to illustrate the argument, it is suggested that the interactional work required in the delivery of such news challenges the ability of clinicians to use protocols such as CPAC. The analysis sheds light on important consultation processes that need to be more carefully considered when designing interventions to influence clinician behaviour. In order to influence the behaviour of clinicians to achieve policy goals, greater attention needs to be paid to the interactional demands of the consultation process. Author Affiliation: (1)Sociology Programme, Victoria University of Wellington, New Zealand (2)Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand Article note: Address for correspondence: Kevin Dew, Sociology Programme, Victoria University of Wellington, PO Box 600, Wellington 6140, New Zealand, e-mail: Kevin.dew@vuw.ac.nz