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Clinical ethics
Disclosure of non-recent (historic) childhood sexual abuse: What should researchers do?
  1. Sergio A. Silverio1,2,
  2. Susan Bewley1,
  3. Elsa Montgomery3,
  4. Chelsey Roberts2,
  5. Yana Richens2,4,
  6. Fay Maxted5,
  7. Jane Sandall1,6,
  8. Jonathan Montgomery7
  1. 1 Department of Women & Children's Health, King's College London, Westminster, London, UK
  2. 2 Elizabeth Garrett Anderson Institute for Women's Health, University College London, Bloomsbury, London, UK
  3. 3 Department of Midwifery, King's College London, Waterloo, London, UK
  4. 4 Maternity Services, University College London Hospitals NHS Foundation Trust, Fitzrovia, London, UK
  5. 5 The Survivors Trust, Rugby, Warwickshire, UK
  6. 6 Centre for Midwifery, Child and Family Health, University of Technology Sydney, Sydney, New South Wales, Australia
  7. 7 Faculty of Laws, University College London, Bloomsbury, London, UK
  1. Correspondence to Mr. Sergio A. Silverio, Department of Women & Children's Health, King's College London, London SE1 7EH, UK; Sergio.Silverio{at}kcl.ac.uk

Abstract

Non-recent (historic) childhood sexual abuse is an important issue to research, though often regarded as taboo and frequently met with caution, avoidance or even opposition from research ethics committees. Sensitive research, such as that which asks victim-survivors to recount experiences of abuse or harm, has the propensity to be emotionally challenging for both the participant and the researcher. However, most research suggests that any distress experienced is usually momentary and not of any clinical significance. Moreover, this type of research offers a platform for voices which have often been silenced, and many participants report the cathartic effect of recounting their experiences in a safe, non-judgemental space. With regard to the course of such research, lines of inquiry which ask adult participants to discuss their experiences of childhood sexual abuse may result in a first-time disclosure of that abuse by the victim-survivor to the researcher. Guidance about how researchers should respond to first-time disclosure is lacking. In this article, we discuss our response to one research ethics committee which had suggested that for a qualitative study for which we were seeking ethical approval (investigating experiences of pregnancy and childbirth having previously survived childhood sexual abuse), any disclosure of non-recent (historic) childhood sexual abuse which had not been previously reported would result in the researcher being obliged to report it to relevant authorities. We assess this to be inconsistent with both law and professional guidance in the United Kingdom; and provide information and recommendations for researchers and research ethics committees to consider.

  • ethics
  • women
  • research ethics
  • research on special populations
  • public health ethics

Data availability statement

There are no data associated with this work.

https://creativecommons.org/licenses/by/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/medethics-2020-106343

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    Data availability statement

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    Footnotes

    • Twitter @Silverio_SA_, @susan_bewley, @elsamwm, @Yanarichens, @SandallJane, @Prof_JonMont

    • Contributors The paper was developed after receiving feedback on a research ethics committee application for a study devised by CR, SAS and YR. The initial idea for the paper was developed by SAS, JS, SB and EM. SAS prepared the first draft of the paper, with SB and JM re-drafting sections, and EM and FM providing substantial revisions. JS, YR and CR provided extensive feedback. Together the final version was produced.

    • Funding JS (King's College London) is an NIHR Senior Investigator and with SAS (King’s College London) is supported by the National Institute for Health Research Applied Research Collaboration South London (NIHR ARC South London) at King’s College Hospital NHS Foundation Trust.

    • Disclaimer The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

    • Competing interests JM was Chair of the Health Research Authority from 2012-19 and Chair of the Task and Finish Group that supported the development of the GMC’s guidance on Confidentiality: Good practice in handling patient information (2017).

    • Patient and public involvement statement We are also grateful to The Survivors Trust for their input to this paper.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Author note SAS has expertise in qualitative research and has undertaken significant study of women’s mental health. CR and EM have undertaken research with women who have experienced childhood sexual abuse, and CR has worked in a therapeutic setting with survivors. FM leads The Survivors Trust, the largest umbrella agency for specialist rape and sexual abuse services in the UK. JS and YR have extensive research and clinical experience in women’s health, maternity service delivery and provision of midwifery care, with JS holding many internationally reaching research grants. SB and JM are experts in the fields of health care ethics and health care law, with SB having extensive clinical and research experience in women’s health and sexual offences examination.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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