12 L Ghandour, R. Yasmine, F. El-Kak
GIVING CONSENT WITHOUT GETTING INFORMED:A CROSS-CULTURAL
ISSUE IN RESEARCH ETHICS
LILIAN GHANDOUR, ROLA YASMINE, AND
FAYSAL EL-KAK
American University of Beirut, Lebanon
ABSTRACT: INFORMED CONSENT FORMS (ICFS)
maintain the integrity of research ethics and preserve
participants' rights. Using cross-sectional online sur-
vey data on sexuality and sexual practices of private
university students from Lebanon, this paper ques-
tions whether participants thoroughly read iCFs, and
whether time taken to read ICFs is associated with
data completeness. A total of 2,534 surveys were com-
pleted; a median time of 18.66 seconds was taken to
read the 815-word ICF; 65% of participants consented
within the first 30 seconds and 90% in less than the
minimum predicted time (2.7 minutes). Our data
indicates potential participant neglect of ICFs, raising
the question of whether participants who endorse an
informed consent form are truly informed of the study
objectives and their rights.
KEY WORDS: informed consent, research ethics, IRB,
online study, Lebanon
Received: March 8, 2013; revised June 29, 2013
I
NFORMED CONSENT ENSURES THAT PARTICIPANTS
are informed of the research study and its procedures,
any potential risks or benefits, as well as their rights,
role, and overall contribution (Crow et al., 2006; Nagy
Hesse-Biber Se Leavy, 2009). Securing genuinely informed
consent becomes particularly important when investigat-
ing "sensitive" topics (e.g., drug use, sexual practices) and/
or "vulnerable" populations (e.g., students) (Nagy Hesse-
Biber & Leavy, 2009).
In litigious Western societies, research participants
often do not read or merely skim through consent doc-
uments for various reasons, whether it is because they
trust the investigators/ institution, are rushed for time,
or just become tired of reading and signing forms that
are often incomprehensible to laypeople. Failure to read
consent documents occurs irrespective of whether
informed consent is obtained online or offline
(Varnhagen et al., 2005). In one study, 50% of the par-
ticipants took less than 53 seconds to consent, 93%
consenting in less than the minimum predicted reading
time (Desch et al., 2011). Despite the plethora of survey
research conducted among university youth, the latter
. is the only study, to our knowledge, that has quantita-
tively estimated the time taken by university students
to review the online ICF before participation. However,
with the worldwide increased usé of online surveys, the
issue of signing informed consent forms without truly
being informed warrants further investigation. For
instance, are research participants more likely to read
ICFs when the topic is rather sensitive or is a social
tiaboo? Are educated university youth from non-West-
ern cultures likely to behave differently?
Previous studies have shown ¡strong links between
information provided in an ICF and study outcomes.
One study, for instance, showed that providing too much
detail about the research topic in an ICF may compro-
mise baseline knowledge of participants and subse-
quently the outcomes of behavioral interventions
(Stephenson et al., 2010). Another highlighted the
importance of assuring confidentiality in an ICF, a strong
predictor of increased willingness to respond to sensitive
questions (Singer, 1978). However, no study has yet
explored the possible infiuence of carefully reviewing
ICFs on completeness of the response data that partici-
pants provide, keeping in mind that incomplete
responses can severely jeopardize response quality and
validity of study findings.
We examined the time taken to read an online ICF and
its association with response quality among an educated
sample of university students who took part in the first
online survey of youth sexual values and practices in
Lebanon, an Arab country at the crossroads between
Eastern and Western cultures. The specific questions
include: (1) What is the median time taken to read the
online ICF? (2) Does time taken to read the consent doc-
ument vary by students' sociodemographics? and (3) Is
data completeness related to time taken to read the ICF?
Journal of Empirical Research on Human Research Ethics, VOL. 8, No. 3, PP. 12-21. PRINT ISSN 1556-2646. ONLINE ISSN 1556-2654. © 2013
BY JOAN SIEBER. ALL RIGHTS RESERVED. PLEASE DIRECT ALL REQUESTS FOR PERMISSIONS TO PHOTOCOPY OR REPRODUCE ARTICLE CONTENT
THROUGH THE UNIVERSITY OF CALIFORNIA PRESS'S RIGHTS AND. PERMISSIONS WEBSITE, HTTP://WWW.UCPRESSJOURNALS.COM/REPRINT1NFO.ASP.
DOI: 10.1525/jer.2013.8.3.12