Malaysian and American students’ perceptions of research ethics
Laura L. Bowman
Differences in perceptions of research ethics between Malaysian and American students were assessed using a questionnaire that measured perceptions of voluntary informed consent for adults and children, assessment of the risk/benefit ratio, issues of deception, and issues of privacy and confidentiality. As predicted, Malaysian students had less conservative attitudes than American students. This difference may be a result of the role the individual plays in each society or behavioral research history of each country. Demographic characteristics such as research experience with humans and research ethics exposure, as well as response acquiescence also may have influenced the outcome.
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Codes formalizing ethical treatment of human participants in both behavioral and medical research are fairly recent. The Nuremberg Trials (1946-1949), held by an American military tribunal as a consequence of crimes committed against prisoners of war by Nazi physicians during World War II, resulted in the establishment of the Nuremberg Code (Trials of War Criminals Before the Nuremberg Military Tribunals Under Control Council Law No. 10, 1949). This code outlines ten principles that must be followed in order for research with humans to be justified. The main principles require voluntary informed consent of the participant, research designed to be beneficial to society in general, and protection of participants from harm. To provide a broader scope than the Nuremberg Code, in 1964, the World Medical Association adopted the Declaration of Helsinki that established guidelines for physicians conducting biomedical research with human participants. The most recent revision was made in 1992 (World Medical Association, 1992).
International guidelines for treatment of human research participants set forth by the Nuremberg Code and the Declaration of Helsinki are occasionally supplemented by national standards. For example, in 1973, the American Psychological Association (APA) first published guidelines that specifically addressed how human research participants were to be treated in behavioral research (APA, 1973). The most recent APA Ethics Code was revised in 1992 (APA, 1992). By 1977, Canada, the Federal Republic of Germany, Great Britain, the Netherlands, Poland, Austria, Sweden, and France also had adopted ethical codes that addressed research with human participants, although many of the codes were still in preparation (Schuler, 1982). Kimmel’s (1996) informal survey added Australia, Scandinavia (Denmark, Norway, Finland, Sweden, and Iceland), Slovenia, Spain, and Switzerland to the list of countries that reported having a formal ethics code that addressed psychological research issues. Leach and Harbin (1997) reported additional countries that had adopted an ethics code including; Chile, China, Dominican Republic, Hong Kong, Israel, New Zealand, Singapore, and South Africa. Comparison of codes of ethics internationally reveals some consistencies with respect to research issues. However, differences in professional standards exist, most notably between Western countries (e.g., the United States, Canada) and the few Eastern countries (e.g., China, Singapore) that have reported adopting formal ethics codes (Leach & Harbin, 1997).
The tenets of voluntary informed consent, privacy and confidentiality, etc., have been formulated and adopted by societies that have a strong tradition of treasuring and protecting the individual, such as the United States. In American society, concern for individual rights and the fear of litigation have made researchers very sensitive to ethical codes. In some cases, such concerns have led to the termination or disruption of potentially valuable research. A civil suit, Merrikan v. Cressman (as cited in Boruch & Cecil, 1979) resulted in the termination of a high school drug prevention program for fear that students’ records would not be kept confidential. More recently there has been controversy regarding the need for appropriate placebo control groups in which treatment is withdrawn or withheld and research participants’ understanding of their potential assignment to a control group. The New York Times (Hilts, 1998; Lackey, 1998; “Medical Ethics”, 1994) reported on projects in which degree of information about potential effects of treatment provided in informed consent documents and psychiatric patients’ understanding of these documents was in dispute. In a similar vein, a pediatric AIDS research project, being conducted in Zimbabwe, designed to assess the effectiveness of a vitamin A supplement on preventing HIV transmission through breast feeding has been criticized on several counts. One criticism addresses the failure of researchers to provide mothers treatment like AZT to prevent transmission of the HIV virus. Another set of criticisms are relevant to the inclusion of a placebo control group, in which the participants do not get the vitamin A supplement, and participants’ understanding of this design issue (Angell, 1997; Lurie & Wolfe, 1997; Wilson, 1999). In response, Saba and Amman (1997) have insisted that Americans not impose their ethical standards on developing countries given differences in needs, values, and the pragmatics of doing research in non-industrialized countries.
Though the current trend in the United States is to be ethically conservative, it has not always been so. In the 1960’s until the 1970’s, when behavioral research with human participants was blossoming, several controversial psychological studies were conducted (e.g., Humphreys, 1970; Middlemist, Knowles, & Matter, 1976; Milgram, 1963). These cases served to raise researchers’ awareness regarding ethical practices in behavioral research with humans and led to the adoption of the national standards put forth by the APA. Though Sullivan and Deiker (1973) found that student research participants were not as concerned about the ethical nature of deceptive research as were psychologists, it is possible that since then, students have become more exposed and sensitized towards ethical concerns. Today, in the United States, most students of psychology receive ethics training as part of their undergraduate coursework directly through textbook or classroom coverage (Adair, Lindsay, & Carlopio, 1983; Korn, 1984) or indirectly through participation as a volunteer in psychological research. Given that there is heightened awareness and discussion of ethical research issues among professionals and in the media in general, it is likely that American undergraduate students would be ethically conservative.
In Malaysia, there is no formal research ethics code, though the Malaysian Medical Association does have a published ethical code for medical practitioners. Undergraduate students may or may not discuss research ethics during their coursework. Furthermore, casual conversations with professional colleagues have revealed that ethical issues such as confidentiality and voluntary informed consent are not always formally addressed prior to data collection (P. Songan, personal communication, July, 1997). In fact, as Hong (1998) has described, obtaining written informed consent in non-Western cultures can be antithetic to the cooperative process between researcher and participant.
Behavioral research in Malaysia has had a short history and psychology has not been taken seriously (Ward, 1983). Aside from various anthropological and marketing/business studies, local theses and dissertations, relatively little psychological investigation focussing on Malaysians has been published. This is due in part to the emphasis scholars in Malaysia have had on the natural and physical sciences, rather than the social sciences. It could also be due to publication biases of Western journal reviewers/editors (Kim, 1995). With the advent of new university programs in areas such as cognitive science, social science, and human resource development, as well as the burgeoning interest in collecting behavioral data, attention to ethical treatment of human research participants and researchers’ perceptions of how to be ethical investigators is of interest.
Malaysia and the United States differ not only in behavioral research history, but there exists a different value and role the individual plays in society. In Malaysia, the individual is not as important as the community, the family, and/or society in general (Abdullah, 1996). Malaysians have a stronger sense of responsibility towards the family and community and a lesser sense of inherent rights of the individual than do Americans. Collective societies like those in Malaysia differ from individualistic societies in the importance of collective over personal goals. Collectivists are more likely to subordinate personal goals for the good of others (Triandis, Bontempo, Villareal, Asai, & Lucca, 1988). Furthermore, collectivists are more likely to see greater power distance between those with power (e.g., a researcher) and those with less power (e.g., a research participant) (Hofstede, 1980). These value differences may contribute to differences in perceptions of ethical treatment and rights of research participants and behavior of the researcher.
To date, no comparative research on Malaysian and American students’ perceptions of research ethics has been published. This study is designed to address potential differences in perceptions of research ethics. It is anticipated that in general, Malaysian students will have less conservative attitudes towards protecting human research participants than Americans.
Method
Participants
One-hundred and nineteen American undergraduate students enrolled in introduction to psychology at Central Connecticut State University (CCSU) and one-hundred and eleven Malaysian undergraduate students enrolled in various psychology courses at the Universiti Malaysia Sarawak (UNIMAS) participated. The majority of American (97%) and Malaysian (65%) students were between the ages of 18 and 21 years, though Malaysian students tended to be older. The majority of American students (84%) had less than one semester of university experience, while the majority of Malaysian students (76%) had completed at least one semester at the university. All American participants reported their current academic position as “student”. The Malaysian participants included one individual reporting his/her academic position as “tutor” (a non-teaching position similar to a teaching assistant) and one individual reporting his/her academic position as “lecturer/professor” (a teaching position). The remaining Malaysian participants were students. The majority of American students (79%) had no research ethics exposure, while the majority of Malaysian students (65%) had exposure from at least one source. The majority of American (68%) and Malaysian (52%) students claimed to have no research experience with humans. Refer to Table 1 for detailed demographic information.
Materials
A 20-item questionnaire designed to measure perceptions of voluntary informed consent for adults and children, assessment of the risk/benefit ratio, issues of deception, and issues of privacy and confidentiality was prepared. Multiple items were designed to measure aspects of each issue. Three items were designed to measure aspects of the risk/benefit ratio. Five items were designed to measure aspects of the deception issue. Two items were designed to measure issues of informed consent. Three items were designed to measure issues of confidentiality. Three items were designed to measure issues involving children as research participants. Four items were designed to measure issues involving voluntary participation and freedom to withdraw from participation. An example of a question designed to measure perceptions of privacy and confidentiality is as follows: “It is necessary to get as much personal information (e.g., name, address, etc.) as one can from all participants in behavioral research”. Each question required participants to record their responses to each question using a five point scale varying from Strongly Agree to Strongly Disagree. Eleven of the questions were written such that a response of “Strongly Agree” would represent the most conservative or protective attitude (e.g., “Participants should be allowed to withdraw from behavioral research anytime without penalty”). The remaining nine questions were written such that a response of “Strongly Disagree” would represent the most conservative attitude (e.g., “It is acceptable to require children to participate in behavioral research”). Order of the items was randomized. See the Appendix for items assessing perceptions of research ethics (English version). Six questions requesting demographic information including nationality, age, university experience, academic position, research ethics exposure, and research experience were included. The following sentence was included at the beginning of the survey to alert participants to our definition of behavioral research: “Behavioral research is done by psychologists, sociologists, economists, etc., and includes collection of information from people by doing surveys, interviews, and experiments”.
Malaysian students received a version that was written in both Malay (the national language) and in English (required language). Translation into Malay from English was performed by two proficient speakers and one native speaker of Malay. American students received a version written only in English (American spelling).
Procedure
Malaysian students were administered the questionnaire by their instructors at various periods over two different semesters (1997-1998). American students were administered the questionnaire on the first day of class (Fall, 1998) by a faculty researcher who was not their instructor. To avoid biasing responses, information regarding participants’ rights and the researchers’ responsibilities were withheld until all questionnaires were completed. However, students were told before the questionnaire was distributed that completing the questionnaire was not required and they were asked not to include names or student numbers. After students completed the questionnaire, they were given the option to withhold their responses.
Results
A composite score representing overall perceptions of research ethics issues was generated. Scores could range in value from 20-100, with a lower score representing more conservative attitudes towards protecting the individual and a higher score representing less conservative attitudes. Valid composite scores were obtained from 113 American and 99 Malaysian participants. A t-test for independent measures was performed on the composite scores to compare Malaysian and American students’ attitudes towards research ethics. Results indicated that overall American students had more conservative attitudes (M = 45.93, SD = 8.36) than Malaysian students (M = 49.18, SD = 5.65), t (210) = -3.26, p < .05. An item-by-item analysis was performed using a Bonferroni t correction procedure, revealing significant differences on nine items. Seven of these analyses indicated that Americans had more conservative attitudes about protecting the individual (all p's < .0025). Table 2 displays the means, standard deviations, t- and p-values of each of the survey items as a function of nationality.
Discussion
In general, both Malaysians and Americans were concerned with protecting the individual as indicated by the relatively low scores of both groups. However, consistent with predictions, Malaysians have less conservative attitudes towards protecting the individual participating in research than do Americans. This difference may be a result of the role the individual plays in each society as well as the degree of reverence and deference given to those in leadership positions (e.g., university researchers). Malaysians are more likely than Americans to subordinate personal goals, desires, or feelings for the good of others and hold those in leadership positions in high-esteem (Abdullah, 1996). For example, Malaysian colleagues have indicated that in some villages in Sarawak, once permission from the village leader is secured, residents feel obligated to answer researchers’ questions (P. Songan, personal communication, July, 1997). This value may result in more tolerance of what Americans might perceive as personal discomfort or violation of individual rights, at least on some issues. Another factor that contributes to differences in perception is that Malaysia has a much more recent behavioral research history than the United States. It is possible that with exposure Malaysian students’ and researchers’ ethical concerns will change.
These results must be interpreted cautiously for several reasons. Though the overall trend was such that Malaysians were less conservative than Americans, the results of the item-by-item analysis revealed that this was supported on only seven of the twenty items (See Table 2). Two of the items revealed an opposite trend (Malaysians were more conservative) and the remaining eleven items resulted in no significant differences. Had the statistically significant items formed a discernable clustering pattern (e.g., all deception items), we would have had more insight into value differences about ethical practices. However, differences were present within each issue (risks/benefits, deception, informed consent, confidentiality, research with children, and voluntary participation/freedom to withdraw).
One possible explanation of this peculiar pattern is a responding pattern by the Malaysian students akin to an acquiescent response set bias. To appear well-mannered, polite, and to avoid offending others Malaysians have a tendency to be agreeable in the most literal sense and say “yes”, especially to those in leadership positions (Abdullah, 1996; Planisek, 1994). Upon visual examination of the response patterns of the Malaysian students, we see that Malaysians did have a tendency to “strongly agree” and “agree” more often than the Americans did. In fact, of the nine individual items that were statistically significant Malaysians were agreeing to all these items more often (though seven of these were reverse scored). It is also interesting to note that of the nine items that were reverse scored; seven of these were statistically significant with Malaysians agreeing more often than Americans. It is possible that Malaysian students were trying to be polite and were responding in a way that they thought would be congenial. However, contrary to this explanation, there are particular items that appear towards the end of the questionnaire (items 16 and 17) with which the majority of Malaysian students pointedly disagreed or strongly disagreed making us believe that the Malaysian students were responding purposively and thoughtfully rather than according to a response set bias. Had acquiescent response bias been the sole factor underlying response patterns, no overall significant differences would have been obtained, as items were reverse scored. Furthermore, there were five items with which American students agreed more (though these items were not statistically significant) suggesting that there were other factors contributing to response patterns aside from acquiescent response set. Though we acknowledge this bias could have accounted for some of the differences on some of the items or masked differences on others, we believe we have an interesting and important finding about perceptions of research ethics that needs further attention.
Though every attempt was made to ensure clear translation from English to Malay, translation of materials from one language to another can result in meaningful differences in comprehension and interpretation, which can lead to differences in responding regardless of attitude. One Malaysian instructor who had distributed some questionnaires reported that some participants claimed not to clearly understand the meaning of item 8, even though Malaysian students had both English and Malay versions available to them. Clearly the instrument needs refinement to ensure both reliability and validity in both languages.
Finally, demographic characteristics such as age, research experience with humans, research ethics exposure, and how the information gathered by the researcher was to be used, could have influenced perceptions of research ethics. Collins, Kuhn, and King (1979) found that when students were told that their judgements about the ethical nature of proposed research were to be used to make decisions about whether or not the study should be conducted, ethical ratings were more stringent than when they were simply asked to answer questions about the research. American students may have adopted a more stringent attitude believing that they personally would be affected by the way they responded, given that CCSU has an active subject pool and research participation is offered as an option for the introductory course requirements. However, American students were tested on their first day of class before they received a syllabus or were informed about the research participation option. Furthermore, the majority of American students reported no prior exposure to research ethics. Given that this sample was relatively naive about research ethics procedures, we can infer that with exposure their attitudes would become even more conservative.
Malaysian participants claimed to have more university experience, research experience with humans and research ethics exposure than American participants. UNIMAS does not offer a course in research ethics, does not require participation in research either as a participant nor as a researcher, and as stated earlier, research ethics are not always formally discussed in coursework. Therefore, the authors are somewhat skeptical of the validity of the claim by the Malaysian students, many of whom were second and third year students, that they did have exposure to research ethics concepts, at least while attending UNIMAS. It is possible that lack of exposure and understanding may have caused them to overstate their experience. However, we do not have specific information about individuals’ training and it is possible that the responses are factual. Afterall, twenty-four Malaysian students did report reading about research ethics on their own and twenty-nine students did report being exposed to research ethics as part of their course work. It is possible that students were exposed to behavioral or even medical research ethics while enrolled in other courses. Though students may not have actively participated in behavioral research as participants or researchers, they would be familiar with behavioral research as a concept given that all of the students were enrolled in psychology courses. If we take the responses at face value, we may infer that their attitudes may have become more conservative as a result of this earlier exposure. It is possible that Malaysian students with little formal exposure to these issues would be less conservative and conservatism would increase with exposure. Furthermore, it would be of interest to understand how the Malaysian general public views behavioral research practices.
To better understand if these differences in perceptions toward research ethics are due to cultural values or other factors, additional research is indicated. One goal, aside from simply describing and understanding differences in perceptions, is to measure how Malaysians perceive these issues in order that ethical research practices equable to all those involved can be implemented.
Appendix
For the following questions, use the scale below.
Strongly Agree Neutral Disagree Strongly
Agree Disagree
a b c d e
1. If outcomes of behavioral research potentially benefit society as a whole, risks to the individual participant should be tolerated. *
2. Before deception in behavioral research can be used, sound scientific justification must be present.
3. If participating in behavioral research makes a person feel uncomfortable, embarrassed, or stressed, it should not be carried out.
4. It is not necessary to inform behavioral research participants of filming or audio recording unless the participants can be personally identified. *
5. It is necessary to get as much personal information (e.g., name, address, etc.) as one can from all participants in behavioral research. *
6. Consent of children’s parents must be sought before children can be recruited for behavioral research
7. Researchers must tell participants about all potential risks prior to participating in behavioral research.
8. Research participants are required to finish all activities (e.g., surveys, tests) before leaving the research setting. *
9. Participating in behavioral research must be voluntary.
10. The researcher has an obligation to maintain confidentiality of research participants’ data.
11. If research participants are deceived about any aspect of behavioral research, the researcher must explain that they were deceived and why they were deceived.
12. It is acceptable to require children to participate in behavioral research *
13. Participants should be allowed to withdraw from behavioral research anytime without penalty.
14. It is never acceptable to deceive research participants about aspects of research that could cause harm.
15. If a person’s identity could potentially be revealed, without their knowledge, as a result of participating in behavioral research, it should not be carried out.
16. It is acceptable to misinform participants about some aspects of research. *
17. It is acceptable for teachers to give consent for elementary-level students’ participation in behavioral research in place of parents’ consent *
For the following questions, use the scale below.
Strongly Agree Neutral Disagree Strongly
Agree Disagree
a b c d e
18. Researchers can make it compulsory for university-level students to participate in behavioral research. *
19. It is acceptable to withhold information from research participants, if the risks in participating are minimal. *
20. Risks to an individual should be considered carefully before any behavioral research is carried out.
* Items were reverse scored such that a lower score represents a more conservative attitudes towards protecting the individual
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LAURA L. BOWMAN
Central Connecticut State University
ANGELA ANTHONYSAMY
Universiti Malaysia Sarawak
Kota Samarahan, Sarawak, Malaysia
Table 1 Number (Percentage) (a) of American and Malaysian
Participants’ Responses to Demographic Survey Items
Nationality
Survey Items American (b) Malaysian (c)
Age (d)
(18-21 years) 115 (97%) 72 (65%)
(22-30 years) 2 (2%) 25 (22%)
(31-40 years) 0 14 (13%)
(41-50 years) 1 (1%) 0
(51+ years) 0 0
University Experience
(less than one semester) 100 (84%) 22 (20%)
(completed at least one semester) 19 (16%) 84 (76%)
(Bachelor’s degree) 0 4 (4%)
(Master’s degree) 0 1 (1%)
(Doctoral/Professional degree) 0 0
Academic Position
(student) 119 (100%) 109 (98%)
(tutor) 0 1 (1%)
(lecturer/professor) 0 1 (1%)
Research Ethics Exposure (c)
(none) 92 (79%) 39 (35%)
(exposed as part of a course) 17 (15%) 29 (26%)
(exposed as part of graduate training) 1 (1%) 1 (1%)
(exposed by reading on own) 4 (3%) 24 (22%)
(took a course on research ethics) 0 1 (1%)
(more than one indicated) 3 (3%) 16 (15%)
Research Experience With Humans
(none) 81 (68%) 58 (52%)
(some) 36 (30%) 51 (46%)
(a lot) 2 (2%) 2 (2%)
(a) Percentages may not total to 100% due to rounding error
(b) Total number of American participants (N = 119)
(c) Total number of Malaysian participants (N = 111)
(d) Total number of American students reporting age (N =118)
(e) Total number of American (N = 117) and Malaysian students
(N = 110) reporting research ethics exposure
Table 2
Means, Standard Deviations, t- and p-values of Each of the Survey
Items as a Function of Nationality
Nationality
Survey Items Item No. (a) American Malaysian
Risk/Benefits 1 *, (b) 2.94 3.92
(SD = 0.91) (SD = 0.73)
3 (b) 2.19 2.38
(SD = 0.94) (SD = 1.03)
2 (c) 1.73 1.49
(SD = 0.89) (SD = 0.61)
Deception 2 (d) 2.17 2.05
(SD = 0.80) (SD = 0.67)
11 *, (e) 1.97 1.59
(SD = 0.81) (SD = 0.76)
14 (e) 1.75 1.62
(SD = 0.90) (SD = 0.89)
16 (f) 2.38 2.33
(SD = 1.12) (SD = 1.06)
19 *, (e) 2.52 3.47
(SD = 1.11) (SD = 1.03)
Informed Consent 4 *, (b) 2.67 3.26
(SD = 1.13) (SD = 1.13)
7 (b) 1.54 1.68
(SD = 0.81) (SD = 0.81)
Confidentiality 5 *, (b) 3.26 3.74
(SD = 1.09) (SD = 1.08)
10 *, (e) 2.03 1.29
(SD = 1.14) (SD = 0.51)
15 (e) 2.05 2.08
(SD = 0.87) (SD = 0.94)
Children 6 (b) 1.61 1.50
(SD = 0.89) (SD = 0.57)
12 *, (f) 2.90 3.67
(SD = 1.07) (SD = 0.79)
17 *, (e) 2.26 2.78
(SD = 1.14) (SD = 1.09)
Voluntary
Participation/ 8 *, (f) 3.28 3.77
Freedom to Withdraw (SD = 1.02) (SD = 0.94)
9 (e) 1.87 1.66
(SD = 0.97) (SD = 0.67)
13 (e) 1.97 2.13
(SD = 0.84) (SD = 0.90)
18 (g) 2.97 3.02
(SD = 0.96) (SD = 1.12)
Survey Items Item No. (a) t p
Risk/Benefits 1 *, (b) -8.93 .00
3 (b) -1.43 .15
2 (c) 2.33 .02
Deception 2 (d) 1.26 .21
11 *, (e) 3.75 .00
14 (e) 1.12 .26
16 (f) 0.30 .77
19 *, (e) -6.71 .00
Informed Consent 4 *, (b) -3.96 .00
7 (b) -1.29 .20
Confidentiality 5 *, (b) -3.33 .00
10 *, (e) 6.27 .00
15 (e) -0.25 .80
Children 6 (b) 1.11 .27
12 *, (f) -6.15 .00
17 *, (e) -3.54 .00
Voluntary
Participation/ 8 *, (f) -3.78 .00
Freedom to Withdraw
9 (e) 1.95 .05
13 (e) -1.40 .16
18 (g) -0.38 .70
Note. Lower scores represent more conservative attitudes towards
protecting the individual.
(a) Bold represents reverse scoring.
(b) Number of Americans (N = 119) and Malaysians (N = 111)
with valid responses.
(c) Number of Americans (N = 115) and Malaysians (N = 101)
with valid responses.
(d) Number of Americans (N = 119) and Malaysians (N = 110)
with valid responses.
(e) Number of Americans (N = 118) and Malaysians (N = 111)
with valid responses.
(f) Number of Americans (N = 117) and Malaysians (N = 111)
with valid responses.
(g) Number of Americans (N = 117) and Malaysians (N = 110)
with valid responses.
* p < .0025
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