research ethics for interview

University of Chicago

Ethical Guidelines for Online Interviews

In all research encounters, it is vital to keep in mind that the ethnographer’s primary goal should be maintaining the wellbeing of interlocutors. This mission extends into virtual environments as well, including in the realm of online interviews. In order to ensure that both the ethnographer and the participant benefit from this experience, the following ethical guidelines should be kept in mind:

Before coming to the interview, the ethnographer should create a set of open-ended questions that invite the participant to share as much as they see fit. The researcher should not create leading questions in an attempt to fish for certain responses, but rather write questions that encourage the interviewee to respond freely and openly.
Transparency and honesty are two of the most important facets of conducting an online interview. Prior to formally beginning the interview, the researcher should give a thorough explanation of the interview’s purpose in a manner that is accessible to the interviewee. Encourage the participant to ask questions so that they fully understand the course of the interview and feel comfortable providing the information they will be asked for. The ethnographer should explain the specific use for this information and ask for consent to use what the interviewee shares with them in future endeavors. It is important to disclose that the interview will be recorded, but also assure that the recording will only be used by the researcher as a reminder of their conversation and will not be shared with anyone else. This will further help to ensure that the interviewee feels as comfortable as possible.
Respect that interaction in an online environment feels different from community to community and from person to person, much like interaction in real life. Be conscious of how you approach conversation, and, above all, ensure that the interviewee feels comfortable and listened to wholeheartedly. If something is unclear, the researcher should ask for clarification so that misunderstandings are greatly reduced.
Throughout the course of the interview, the researcher should remember that the interviewee is the primary focus. The interviewee should feel comfortable speaking whatever comes to their mind, and the researcher should be mindful of how the interviewee feels throughout the conversation. If the interviewee expresses discomfort or is unwilling to answer a question, the researcher should not push for an answer, as this goes against protecting the interviewee’s wellbeing.
Understand that, in an online space, the right to privacy and anonymity should still be afforded to interlocutors. Even though the lines between private and public can often be blurred in online worlds, it is important to preserve the wellbeing of the participant. This means taking extra steps to ensure that the interviewee remains anonymous if they so choose, and that the dissemination of the final product does not impose on the interviewee’s personal and private life in any way. Participants may be providing extremely personal, sensitive, or even sacred information, and it is the responsibility of the researcher to keep this in mind during the interview as well as after.
At the end of the interview, the researcher should be sure to remind the interviewee of the purpose of their conversation, as well as what the information obtained will be used for. This allows the interviewee to once again feel assured and informed of what their words will be going towards.
After completing the interview, the ethnographer should continue to ensure that the privacy of the interviewee is protected in write-ups and further research endeavors by paying adequate attention to how the interviewee’s information is integrated into conclusions.

No Comments Yet

Interviews in the social sciences

Eleanor Knott ORCID: orcid.org/0000-0002-9131-3939 1 ,
Aliya Hamid Rao ORCID: orcid.org/0000-0003-0674-4206 1 ,
Kate Summers ORCID: orcid.org/0000-0001-9964-0259 1 &
Chana Teeger ORCID: orcid.org/0000-0002-5046-8280 1

Nature Reviews Methods Primers volume 2 , Article number: 73 ( 2022 ) Cite this article

697k Accesses

40 Citations

42 Altmetric

Metrics details

Interdisciplinary studies

In-depth interviews are a versatile form of qualitative data collection used by researchers across the social sciences. They allow individuals to explain, in their own words, how they understand and interpret the world around them. Interviews represent a deceptively familiar social encounter in which people interact by asking and answering questions. They are, however, a very particular type of conversation, guided by the researcher and used for specific ends. This dynamic introduces a range of methodological, analytical and ethical challenges, for novice researchers in particular. In this Primer, we focus on the stages and challenges of designing and conducting an interview project and analysing data from it, as well as strategies to overcome such challenges.

The fundamental importance of method to theory

Rick Dale, Anne S. Warlaumont & Kerri L. Johnson

How ‘going online’ mediates the challenges of policy elite interviews

Karin Vaagland

Participatory action research

Flora Cornish, Nancy Breton, … Darrin Hodgetts

Introduction

In-depth interviews are a qualitative research method that follow a deceptively familiar logic of human interaction: they are conversations where people talk with each other, interact and pose and answer questions 1 . An interview is a specific type of interaction in which — usually and predominantly — a researcher asks questions about someone’s life experience, opinions, dreams, fears and hopes and the interview participant answers the questions 1 .

Interviews will often be used as a standalone method or combined with other qualitative methods, such as focus groups or ethnography, or quantitative methods, such as surveys or experiments. Although interviewing is a frequently used method, it should not be viewed as an easy default for qualitative researchers 2 . Interviews are also not suited to answering all qualitative research questions, but instead have specific strengths that should guide whether or not they are deployed in a research project. Whereas ethnography might be better suited to trying to observe what people do, interviews provide a space for extended conversations that allow the researcher insights into how people think and what they believe. Quantitative surveys also give these kinds of insights, but they use pre-determined questions and scales, privileging breadth over depth and often overlooking harder-to-reach participants.

In-depth interviews can take many different shapes and forms, often with more than one participant or researcher. For example, interviews might be highly structured (using an almost survey-like interview guide), entirely unstructured (taking a narrative and free-flowing approach) or semi-structured (using a topic guide ). Researchers might combine these approaches within a single project depending on the purpose of the interview and the characteristics of the participant. Whatever form the interview takes, researchers should be mindful of the dynamics between interviewer and participant and factor these in at all stages of the project.

In this Primer, we focus on the most common type of interview: one researcher taking a semi-structured approach to interviewing one participant using a topic guide. Focusing on how to plan research using interviews, we discuss the necessary stages of data collection. We also discuss the stages and thought-process behind analysing interview material to ensure that the richness and interpretability of interview material is maintained and communicated to readers. The Primer also tracks innovations in interview methods and discusses the developments we expect over the next 5–10 years.

We wrote this Primer as researchers from sociology, social policy and political science. We note our disciplinary background because we acknowledge that there are disciplinary differences in how interviews are approached and understood as a method.

Experimentation

Here we address research design considerations and data collection issues focusing on topic guide construction and other pragmatics of the interview. We also explore issues of ethics and reflexivity that are crucial throughout the research project.

Research design

Participant selection.

Participants can be selected and recruited in various ways for in-depth interview studies. The researcher must first decide what defines the people or social groups being studied. Often, this means moving from an abstract theoretical research question to a more precise empirical one. For example, the researcher might be interested in how people talk about race in contexts of diversity. Empirical settings in which this issue could be studied could include schools, workplaces or adoption agencies. The best research designs should clearly explain why the particular setting was chosen. Often there are both intrinsic and extrinsic reasons for choosing to study a particular group of people at a specific time and place 3 . Intrinsic motivations relate to the fact that the research is focused on an important specific social phenomenon that has been understudied. Extrinsic motivations speak to the broader theoretical research questions and explain why the case at hand is a good one through which to address them empirically.

Next, the researcher needs to decide which types of people they would like to interview. This decision amounts to delineating the inclusion and exclusion criteria for the study. The criteria might be based on demographic variables, like race or gender, but they may also be context-specific, for example, years of experience in an organization. These should be decided based on the research goals. Researchers should be clear about what characteristics would make an individual a candidate for inclusion in the study (and what would exclude them).

The next step is to identify and recruit the study’s sample . Usually, many more people fit the inclusion criteria than can be interviewed. In cases where lists of potential participants are available, the researcher might want to employ stratified sampling , dividing the list by characteristics of interest before sampling.

When there are no lists, researchers will often employ purposive sampling . Many researchers consider purposive sampling the most useful mode for interview-based research since the number of interviews to be conducted is too small to aim to be statistically representative 4 . Instead, the aim is not breadth, via representativeness, but depth via rich insights about a set of participants. In addition to purposive sampling, researchers often use snowball sampling . Both purposive and snowball sampling can be combined with quota sampling . All three types of sampling aim to ensure a variety of perspectives within the confines of a research project. A goal for in-depth interview studies can be to sample for range, being mindful of recruiting a diversity of participants fitting the inclusion criteria.

Study design

The total number of interviews depends on many factors, including the population studied, whether comparisons are to be made and the duration of interviews. Studies that rely on quota sampling where explicit comparisons are made between groups will require a larger number of interviews than studies focused on one group only. Studies where participants are interviewed over several hours, days or even repeatedly across years will tend to have fewer participants than those that entail a one-off engagement.

Researchers often stop interviewing when new interviews confirm findings from earlier interviews with no new or surprising insights (saturation) 4 , 5 , 6 . As a criterion for research design, saturation assumes that data collection and analysis are happening in tandem and that researchers will stop collecting new data once there is no new information emerging from the interviews. This is not always possible. Researchers rarely have time for systematic data analysis during data collection and they often need to specify their sample in funding proposals prior to data collection. As a result, researchers often draw on existing reports of saturation to estimate a sample size prior to data collection. These suggest between 12 and 20 interviews per category of participant (although researchers have reported saturation with samples that are both smaller and larger than this) 7 , 8 , 9 . The idea of saturation has been critiqued by many qualitative researchers because it assumes that meaning inheres in the data, waiting to be discovered — and confirmed — once saturation has been reached 7 . In-depth interview data are often multivalent and can give rise to different interpretations. The important consideration is, therefore, not merely how many participants are interviewed, but whether one’s research design allows for collecting rich and textured data that provide insight into participants’ understandings, accounts, perceptions and interpretations.

Sometimes, researchers will conduct interviews with more than one participant at a time. Researchers should consider the benefits and shortcomings of such an approach. Joint interviews may, for example, give researchers insight into how caregivers agree or debate childrearing decisions. At the same time, they may be less adaptive to exploring aspects of caregiving that participants may not wish to disclose to each other. In other cases, there may be more than one person interviewing each participant, such as when an interpreter is used, and so it is important to consider during the research design phase how this might shape the dynamics of the interview.

Data collection

Semi-structured interviews are typically organized around a topic guide comprised of an ordered set of broad topics (usually 3–5). Each topic includes a set of questions that form the basis of the discussion between the researcher and participant (Fig. 1 ). These topics are organized around key concepts that the researcher has identified (for example, through a close study of prior research, or perhaps through piloting a small, exploratory study) 5 .

a | Elaborated topics the researcher wants to cover in the interview and example questions. b | An example topic arc. Using such an arc, one can think flexibly about the order of topics. Considering the main question for each topic will help to determine the best order for the topics. After conducting some interviews, the researcher can move topics around if a different order seems to make sense.

Topic guide

One common way to structure a topic guide is to start with relatively easy, open-ended questions (Table 1 ). Opening questions should be related to the research topic but broad and easy to answer, so that they help to ease the participant into conversation.

After these broad, opening questions, the topic guide may move into topics that speak more directly to the overarching research question. The interview questions will be accompanied by probes designed to elicit concrete details and examples from the participant (see Table 1 ).

Abstract questions are often easier for participants to answer once they have been asked more concrete questions. In our experience, for example, questions about feelings can be difficult for some participants to answer, but when following probes concerning factual experiences these questions can become less challenging. After the main themes of the topic guide have been covered, the topic guide can move onto closing questions. At this stage, participants often repeat something they have said before, although they may sometimes introduce a new topic.

Interviews are especially well suited to gaining a deeper insight into people’s experiences. Getting these insights largely depends on the participants’ willingness to talk to the researcher. We recommend designing open-ended questions that are more likely to elicit an elaborated response and extended reflection from participants rather than questions that can be answered with yes or no.

Questions should avoid foreclosing the possibility that the participant might disagree with the premise of the question. Take for example the question: “Do you support the new family-friendly policies?” This question minimizes the possibility of the participant disagreeing with the premise of this question, which assumes that the policies are ‘family-friendly’ and asks for a yes or no answer. Instead, asking more broadly how a participant feels about the specific policy being described as ‘family-friendly’ (for example, a work-from-home policy) allows them to express agreement, disagreement or impartiality and, crucially, to explain their reasoning 10 .

For an uninterrupted interview that will last between 90 and 120 minutes, the topic guide should be one to two single-spaced pages with questions and probes. Ideally, the researcher will memorize the topic guide before embarking on the first interview. It is fine to carry a printed-out copy of the topic guide but memorizing the topic guide ahead of the interviews can often make the interviewer feel well prepared in guiding the participant through the interview process.

Although the topic guide helps the researcher stay on track with the broad areas they want to cover, there is no need for the researcher to feel tied down by the topic guide. For instance, if a participant brings up a theme that the researcher intended to discuss later or a point the researcher had not anticipated, the researcher may well decide to follow the lead of the participant. The researcher’s role extends beyond simply stating the questions; it entails listening and responding, making split-second decisions about what line of inquiry to pursue and allowing the interview to proceed in unexpected directions.

Optimizing the interview

The ideal place for an interview will depend on the study and what is feasible for participants. Generally, a place where the participant and researcher can both feel relaxed, where the interview can be uninterrupted and where noise or other distractions are limited is ideal. But this may not always be possible and so the researcher needs to be prepared to adapt their plans within what is feasible (and desirable for participants).

Another key tool for the interview is a recording device (assuming that permission for recording has been given). Recording can be important to capture what the participant says verbatim. Additionally, it can allow the researcher to focus on determining what probes and follow-up questions they want to pursue rather than focusing on taking notes. Sometimes, however, a participant may not allow the researcher to record, or the recording may fail. If the interview is not recorded we suggest that the researcher takes brief notes during the interview, if feasible, and then thoroughly make notes immediately after the interview and try to remember the participant’s facial expressions, gestures and tone of voice. Not having a recording of an interview need not limit the researcher from getting analytical value from it.

As soon as possible after each interview, we recommend that the researcher write a one-page interview memo comprising three key sections. The first section should identify two to three important moments from the interview. What constitutes important is up to the researcher’s discretion 9 . The researcher should note down what happened in these moments, including the participant’s facial expressions, gestures, tone of voice and maybe even the sensory details of their surroundings. This exercise is about capturing ethnographic detail from the interview. The second part of the interview memo is the analytical section with notes on how the interview fits in with previous interviews, for example, where the participant’s responses concur or diverge from other responses. The third part consists of a methodological section where the researcher notes their perception of their relationship with the participant. The interview memo allows the researcher to think critically about their positionality and practice reflexivity — key concepts for an ethical and transparent research practice in qualitative methodology 11 , 12 .

Ethics and reflexivity

All elements of an in-depth interview can raise ethical challenges and concerns. Good ethical practice in interview studies often means going beyond the ethical procedures mandated by institutions 13 . While discussions and requirements of ethics can differ across disciplines, here we focus on the most pertinent considerations for interviews across the research process for an interdisciplinary audience.

Ethical considerations prior to interview

Before conducting interviews, researchers should consider harm minimization, informed consent, anonymity and confidentiality, and reflexivity and positionality. It is important for the researcher to develop their own ethical sensitivities and sensibilities by gaining training in interview and qualitative methods, reading methodological and field-specific texts on interviews and ethics and discussing their research plans with colleagues.

Researchers should map the potential harm to consider how this can be minimized. Primarily, researchers should consider harm from the participants’ perspective (Box 1 ). But, it is also important to consider and plan for potential harm to the researcher, research assistants, gatekeepers, future researchers and members of the wider community 14 . Even the most banal of research topics can potentially pose some form of harm to the participant, researcher and others — and the level of harm is often highly context-dependent. For example, a research project on religion in society might have very different ethical considerations in a democratic versus authoritarian research context because of how openly or not such topics can be discussed and debated 15 .

The researcher should consider how they will obtain and record informed consent (for example, written or oral), based on what makes the most sense for their research project and context 16 . Some institutions might specify how informed consent should be gained. Regardless of how consent is obtained, the participant must be made aware of the form of consent, the intentions and procedures of the interview and potential forms of harm and benefit to the participant or community before the interview commences. Moreover, the participant must agree to be interviewed before the interview commences. If, in addition to interviews, the study contains an ethnographic component, it is worth reading around this topic (see, for example, Murphy and Dingwall 17 ). Informed consent must also be gained for how the interview will be recorded before the interview commences. These practices are important to ensure the participant is contributing on a voluntary basis. It is also important to remind participants that they can withdraw their consent at any time during the interview and for a specified period after the interview (to be decided with the participant). The researcher should indicate that participants can ask for anything shared to be off the record and/or not disseminated.

In terms of anonymity and confidentiality, it is standard practice when conducting interviews to agree not to use (or even collect) participants’ names and personal details that are not pertinent to the study. Anonymizing can often be the safer option for minimizing harm to participants as it is hard to foresee all the consequences of de-anonymizing, even if participants agree. Regardless of what a researcher decides, decisions around anonymity must be agreed with participants during the process of gaining informed consent and respected following the interview.

Although not all ethical challenges can be foreseen or planned for 18 , researchers should think carefully — before the interview — about power dynamics, participant vulnerability, emotional state and interactional dynamics between interviewer and participant, even when discussing low-risk topics. Researchers may then wish to plan for potential ethical issues, for example by preparing a list of relevant organizations to which participants can be signposted. A researcher interviewing a participant about debt, for instance, might prepare in advance a list of debt advice charities, organizations and helplines that could provide further support and advice. It is important to remember that the role of an interviewer is as a researcher rather than as a social worker or counsellor because researchers may not have relevant and requisite training in these other domains.

Box 1 Mapping potential forms of harm

Social: researchers should avoid causing any relational detriment to anyone in the course of interviews, for example, by sharing information with other participants or causing interview participants to be shunned or mistreated by their community as a result of participating.

Economic: researchers should avoid causing financial detriment to anyone, for example, by expecting them to pay for transport to be interviewed or to potentially lose their job as a result of participating.

Physical: researchers should minimize the risk of anyone being exposed to violence as a result of the research both from other individuals or from authorities, including police.

Psychological: researchers should minimize the risk of causing anyone trauma (or re-traumatization) or psychological anguish as a result of the research; this includes not only the participant but importantly the researcher themselves and anyone that might read or analyse the transcripts, should they contain triggering information.

Political: researchers should minimize the risk of anyone being exposed to political detriment as a result of the research, such as retribution.

Professional/reputational: researchers should minimize the potential for reputational damage to anyone connected to the research (this includes ensuring good research practices so that any researchers involved are not harmed reputationally by being involved with the research project).

The task here is not to map exhaustively the potential forms of harm that might pertain to a particular research project (that is the researcher’s job and they should have the expertise most suited to mapping such potential harms relative to the specific project) but to demonstrate the breadth of potential forms of harm.

Ethical considerations post-interview

Researchers should consider how interview data are stored, analysed and disseminated. If participants have been offered anonymity and confidentiality, data should be stored in a way that does not compromise this. For example, researchers should consider removing names and any other unnecessary personal details from interview transcripts, password-protecting and encrypting files and using pseudonyms to label and store all interview data. It is also important to address where interview data are taken (for example, across borders in particular where interview data might be of interest to local authorities) and how this might affect the storage of interview data.

Examining how the researcher will represent participants is a paramount ethical consideration both in the planning stages of the interview study and after it has been conducted. Dissemination strategies also need to consider questions of anonymity and representation. In small communities, even if participants are given pseudonyms, it might be obvious who is being described. Anonymizing not only the names of those participating but also the research context is therefore a standard practice 19 . With particularly sensitive data or insights about the participant, it is worth considering describing participants in a more abstract way rather than as specific individuals. These practices are important both for protecting participants’ anonymity but can also affect the ability of the researcher and others to return ethically to the research context and similar contexts 20 .

Reflexivity and positionality

Reflexivity and positionality mean considering the researcher’s role and assumptions in knowledge production 13 . A key part of reflexivity is considering the power relations between the researcher and participant within the interview setting, as well as how researchers might be perceived by participants. Further, researchers need to consider how their own identities shape the kind of knowledge and assumptions they bring to the interview, including how they approach and ask questions and their analysis of interviews (Box 2 ). Reflexivity is a necessary part of developing ethical sensibility as a researcher by adapting and reflecting on how one engages with participants. Participants should not feel judged, for example, when they share information that researchers might disagree with or find objectionable. How researchers deal with uncomfortable moments or information shared by participants is at their discretion, but they should consider how they will react both ahead of time and in the moment.

Researchers can develop their reflexivity by considering how they themselves would feel being asked these interview questions or represented in this way, and then adapting their practice accordingly. There might be situations where these questions are not appropriate in that they unduly centre the researchers’ experiences and worldview. Nevertheless, these prompts can provide a useful starting point for those beginning their reflexive journey and developing an ethical sensibility.

Reflexivity and ethical sensitivities require active reflection throughout the research process. For example, researchers should take care in interview memos and their notes to consider their assumptions, potential preconceptions, worldviews and own identities prior to and after interviews (Box 2 ). Checking in with assumptions can be a way of making sure that researchers are paying close attention to their own theoretical and analytical biases and revising them in accordance with what they learn through the interviews. Researchers should return to these notes (especially when analysing interview material), to try to unpack their own effects on the research process as well as how participants positioned and engaged with them.

Box 2 Aspects to reflect on reflexively

For reflexive engagement, and understanding the power relations being co-constructed and (re)produced in interviews, it is necessary to reflect, at a minimum, on the following.

Ethnicity, race and nationality, such as how does privilege stemming from race or nationality operate between the researcher, the participant and research context (for example, a researcher from a majority community may be interviewing a member of a minority community)

Gender and sexuality, see above on ethnicity, race and nationality

Social class, and in particular the issue of middle-class bias among researchers when formulating research and interview questions

Economic security/precarity, see above on social class and thinking about the researcher’s relative privilege and the source of biases that stem from this

Educational experiences and privileges, see above

Disciplinary biases, such as how the researcher’s discipline/subfield usually approaches these questions, possibly normalizing certain assumptions that might be contested by participants and in the research context

Political and social values

Lived experiences and other dimensions of ourselves that affect and construct our identity as researchers

In this section, we discuss the next stage of an interview study, namely, analysing the interview data. Data analysis may begin while more data are being collected. Doing so allows early findings to inform the focus of further data collection, as part of an iterative process across the research project. Here, the researcher is ultimately working towards achieving coherence between the data collected and the findings produced to answer successfully the research question(s) they have set.

The two most common methods used to analyse interview material across the social sciences are thematic analysis 21 and discourse analysis 22 . Thematic analysis is a particularly useful and accessible method for those starting out in analysis of qualitative data and interview material as a method of coding data to develop and interpret themes in the data 21 . Discourse analysis is more specialized and focuses on the role of discourse in society by paying close attention to the explicit, implicit and taken-for-granted dimensions of language and power 22 , 23 . Although thematic and discourse analysis are often discussed as separate techniques, in practice researchers might flexibly combine these approaches depending on the object of analysis. For example, those intending to use discourse analysis might first conduct thematic analysis as a way to organize and systematize the data. The object and intention of analysis might differ (for example, developing themes or interrogating language), but the questions facing the researcher (such as whether to take an inductive or deductive approach to analysis) are similar.

Preparing data

Data preparation is an important step in the data analysis process. The researcher should first determine what comprises the corpus of material and in what form it will it be analysed. The former refers to whether, for example, alongside the interviews themselves, analytic memos or observational notes that may have been taken during data collection will also be directly analysed. The latter refers to decisions about how the verbal/audio interview data will be transformed into a written form, making it suitable for processes of data analysis. Typically, interview audio recordings are transcribed to produce a written transcript. It is important to note that the process of transcription is one of transformation. The verbal interview data are transformed into a written transcript through a series of decisions that the researcher must make. The researcher should consider the effect of mishearing what has been said or how choosing to punctuate a sentence in a particular way will affect the final analysis.

Box 3 shows an example transcript excerpt from an interview with a teacher conducted by Teeger as part of her study of history education in post-apartheid South Africa 24 (Box 3 ). Seeing both the questions and the responses means that the reader can contextualize what the participant (Ms Mokoena) has said. Throughout the transcript the researcher has used square brackets, for example to indicate a pause in speech, when Ms Mokoena says “it’s [pause] it’s a difficult topic”. The transcription choice made here means that we see that Ms Mokoena has taken time to pause, perhaps to search for the right words, or perhaps because she has a slight apprehension. Square brackets are also included as an overt act of communication to the reader. When Ms Mokoena says “ja”, the English translation (“yes”) of the word in Afrikaans is placed in square brackets to ensure that the reader can follow the meaning of the speech.

Decisions about what to include when transcribing will be hugely important for the direction and possibilities of analysis. Researchers should decide what they want to capture in the transcript, based on their analytic focus. From a (post)positivist perspective 25 , the researcher may be interested in the manifest content of the interview (such as what is said, not how it is said). In that case, they may choose to transcribe intelligent verbatim . From a constructivist perspective 25 , researchers may choose to record more aspects of speech (including, for example, pauses, repetitions, false starts, talking over one another) so that these features can be analysed. Those working from this perspective argue that to recognize the interactional nature of the interview setting adequately and to avoid misinterpretations, features of interaction (pauses, overlaps between speakers and so on) should be preserved in transcription and therefore in the analysis 10 . Readers interested in learning more should consult Potter and Hepburn’s summary of how to present interaction through transcription of interview data 26 .

The process of analysing semi-structured interviews might be thought of as a generative rather than an extractive enterprise. Findings do not already exist within the interview data to be discovered. Rather, researchers create something new when analysing the data by applying their analytic lens or approach to the transcripts. At a high level, there are options as to what researchers might want to glean from their interview data. They might be interested in themes, whereby they identify patterns of meaning across the dataset 21 . Alternatively, they may focus on discourse(s), looking to identify how language is used to construct meanings and therefore how language reinforces or produces aspects of the social world 27 . Alternatively, they might look at the data to understand narrative or biographical elements 28 .

A further overarching decision to make is the extent to which researchers bring predetermined framings or understandings to bear on their data, or instead begin from the data themselves to generate an analysis. One way of articulating this is the extent to which researchers take a deductive approach or an inductive approach to analysis. One example of a truly inductive approach is grounded theory, whereby the aim of the analysis is to build new theory, beginning with one’s data 6 , 29 . In practice, researchers using thematic and discourse analysis often combine deductive and inductive logics and describe their process instead as iterative (referred to also as an abductive approach ) 30 , 31 . For example, researchers may decide that they will apply a given theoretical framing, or begin with an initial analytic framework, but then refine or develop these once they begin the process of analysis.

Box 3 Excerpt of interview transcript (from Teeger 24 )

Interviewer : Maybe you could just start by talking about what it’s like to teach apartheid history.

Ms Mokoena : It’s a bit challenging. You’ve got to accommodate all the kids in the class. You’ve got to be sensitive to all the racial differences. You want to emphasize the wrongs that were done in the past but you also want to, you know, not to make kids feel like it’s their fault. So you want to use the wrongs of the past to try and unite the kids …

Interviewer : So what kind of things do you do?

Ms Mokoena : Well I normally highlight the fact that people that were struggling were not just the blacks, it was all the races. And I give examples of the people … from all walks of life, all races, and highlight how they suffered as well as a result of apartheid, particularly the whites… . What I noticed, particularly my first year of teaching apartheid, I noticed that the black kids made the others feel responsible for what happened… . I had a lot of fights…. A lot of kids started hating each other because, you know, the others are white and the others were black. And they started saying, “My mother is a domestic worker because she was never allowed an opportunity to get good education.” …

Interviewer : I didn’t see any of that now when I was observing.

Ms Mokoena : … Like I was saying I think that because of the re-emphasis of the fact that, look, everybody did suffer one way or the other, they sort of got to see that it was everybody’s struggle … . They should now get to understand that that’s why we’re called a Rainbow Nation. Not everybody agreed with apartheid and not everybody suffered. Even all the blacks, not all blacks got to feel what the others felt . So ja [yes], it’s [pause] it’s a difficult topic, ja . But I think if you get the kids to understand why we’re teaching apartheid in the first place and you show the involvement of all races in all the different sides , then I think you have managed to teach it properly. So I think because of my inexperience then — that was my first year of teaching history — so I think I — maybe I over-emphasized the suffering of the blacks versus the whites [emphasis added].

Reprinted with permission from ref. 24 , Sage Publications.

From data to codes

Coding data is a key building block shared across many approaches to data analysis. Coding is a way of organizing and describing data, but is also ultimately a way of transforming data to produce analytic insights. The basic practice of coding involves highlighting a segment of text (this may be a sentence, a clause or a longer excerpt) and assigning a label to it. The aim of the label is to communicate some sort of summary of what is in the highlighted piece of text. Coding is an iterative process, whereby researchers read and reread their transcripts, applying and refining their codes, until they have a coding frame (a set of codes) that is applied coherently across the dataset and that captures and communicates the key features of what is contained in the data as it relates to the researchers’ analytic focus.

What one codes for is entirely contingent on the focus of the research project and the choices the researcher makes about the approach to analysis. At first, one might apply descriptive codes, summarizing what is contained in the interviews. It is rarely desirable to stop at this point, however, because coding is a tool to move from describing the data to interpreting the data. Suppose the researcher is pursuing some version of thematic analysis. In that case, it might be that the objects of coding are aspects of reported action, emotions, opinions, norms, relationships, routines, agreement/disagreement and change over time. A discourse analysis might instead code for different types of speech acts, tropes, linguistic or rhetorical devices. Multiple types of code might be generated within the same research project. What is important is that researchers are aware of the choices they are making in terms of what they are coding for. Moreover, through the process of refinement, the aim is to produce a set of discrete codes — in which codes are conceptually distinct, as opposed to overlapping. By using the same codes across the dataset, the researcher can capture commonalities across the interviews. This process of refinement involves relabelling codes and reorganizing how and where they are applied in the dataset.

From coding to analysis and writing

Data analysis is also an iterative process in which researchers move closer to and further away from the data. As they move away from the data, they synthesize their findings, thus honing and articulating their analytic insights. As they move closer to the data, they ground these insights in what is contained in the interviews. The link should not be broken between the data themselves and higher-order conceptual insights or claims being made. Researchers must be able to show evidence for their claims in the data. Figure 2 summarizes this iterative process and suggests the sorts of activities involved at each stage more concretely.

As well as going through steps 1 to 6 in order, the researcher will also go backwards and forwards between stages. Some stages will themselves be a forwards and backwards processing of coding and refining when working across different interview transcripts.

At the stage of synthesizing, there are some common quandaries. When dealing with a dataset consisting of multiple interviews, there will be salient and minority statements across different participants, or consensus or dissent on topics of interest to the researcher. A strength of qualitative interviews is that we can build in these nuances and variations across our data as opposed to aggregating them away. When exploring and reporting data, researchers should be asking how different findings are patterned and which interviews contain which codes, themes or tropes. Researchers should think about how these variations fit within the longer flow of individual interviews and what these variations tell them about the nature of their substantive research interests.

A further consideration is how to approach analysis within and across interview data. Researchers may look at one individual code, to examine the forms it takes across different participants and what they might be able to summarize about this code in the round. Alternatively, they might look at how a code or set of codes pattern across the account of one participant, to understand the code(s) in a more contextualized way. Further analysis might be done according to different sampling characteristics, where researchers group together interviews based on certain demographic characteristics and explore these together.

When it comes to writing up and presenting interview data, key considerations tend to rest on what is often termed transparency. When presenting the findings of an interview-based study, the reader should be able to understand and trace what the stated findings are based upon. This process typically involves describing the analytic process, how key decisions were made and presenting direct excerpts from the data. It is important to account for how the interview was set up and to consider the active part that the researcher has played in generating the data 32 . Quotes from interviews should not be thought of as merely embellishing or adding interest to a final research output. Rather, quotes serve the important function of connecting the reader directly to the underlying data. Quotes, therefore, should be chosen because they provide the reader with the most apt insight into what is being discussed. It is good practice to report not just on what participants said, but also on the questions that were asked to elicit the responses.

Researchers have increasingly used specialist qualitative data analysis software to organize and analyse their interview data, such as NVivo or ATLAS.ti. It is important to remember that such software is a tool for, rather than an approach or technique of, analysis. That said, software also creates a wide range of possibilities in terms of what can be done with the data. As researchers, we should reflect on how the range of possibilities of a given software package might be shaping our analytical choices and whether these are choices that we do indeed want to make.

Applications

This section reviews how and why in-depth interviews have been used by researchers studying gender, education and inequality, nationalism and ethnicity and the welfare state. Although interviews can be employed as a method of data collection in just about any social science topic, the applications below speak directly to the authors’ expertise and cutting-edge areas of research.

When it comes to the broad study of gender, in-depth interviews have been invaluable in shaping our understanding of how gender functions in everyday life. In a study of the US hedge fund industry (an industry dominated by white men), Tobias Neely was interested in understanding the factors that enable white men to prosper in the industry 33 . The study comprised interviews with 45 hedge fund workers and oversampled women of all races and men of colour to capture a range of experiences and beliefs. Tobias Neely found that practices of hiring, grooming and seeding are key to maintaining white men’s dominance in the industry. In terms of hiring, the interviews clarified that white men in charge typically preferred to hire people like themselves, usually from their extended networks. When women were hired, they were usually hired to less lucrative positions. In terms of grooming, Tobias Neely identifies how older and more senior men in the industry who have power and status will select one or several younger men as their protégés, to include in their own elite networks. Finally, in terms of her concept of seeding, Tobias Neely describes how older men who are hedge fund managers provide the seed money (often in the hundreds of millions of dollars) for a hedge fund to men, often their own sons (but not their daughters). These interviews provided an in-depth look into gendered and racialized mechanisms that allow white men to flourish in this industry.

Research by Rao draws on dozens of interviews with men and women who had lost their jobs, some of the participants’ spouses and follow-up interviews with about half the sample approximately 6 months after the initial interview 34 . Rao used interviews to understand the gendered experience and understanding of unemployment. Through these interviews, she found that the very process of losing their jobs meant different things for men and women. Women often saw job loss as being a personal indictment of their professional capabilities. The women interviewed often referenced how years of devaluation in the workplace coloured their interpretation of their job loss. Men, by contrast, were also saddened by their job loss, but they saw it as part and parcel of a weak economy rather than a personal failing. How these varied interpretations occurred was tied to men’s and women’s very different experiences in the workplace. Further, through her analysis of these interviews, Rao also showed how these gendered interpretations had implications for the kinds of jobs men and women sought to pursue after job loss. Whereas men remained tied to participating in full-time paid work, job loss appeared to be a catalyst pushing some of the women to re-evaluate their ties to the labour force.

In a study of workers in the tech industry, Hart used interviews to explain how individuals respond to unwanted and ambiguously sexual interactions 35 . Here, the researcher used interviews to allow participants to describe how these interactions made them feel and act and the logics of how they interpreted, classified and made sense of them 35 . Through her analysis of these interviews, Hart showed that participants engaged in a process she termed “trajectory guarding”, whereby they sought to monitor unwanted and ambiguously sexual interactions to avoid them from escalating. Yet, as Hart’s analysis proficiently demonstrates, these very strategies — which protect these workers sexually — also undermined their workplace advancement.

Drawing on interviews, these studies have helped us to understand better how gendered mechanisms, gendered interpretations and gendered interactions foster gender inequality when it comes to paid work. Methodologically, these studies illuminate the power of interviews to reveal important aspects of social life.

Nationalism and ethnicity

Traditionally, nationalism has been studied from a top-down perspective, through the lens of the state or using historical methods; in other words, in-depth interviews have not been a common way of collecting data to study nationalism. The methodological turn towards everyday nationalism has encouraged more scholars to go to the field and use interviews (and ethnography) to understand nationalism from the bottom up: how people talk about, give meaning, understand, navigate and contest their relation to nation, national identification and nationalism 36 , 37 , 38 , 39 . This turn has also addressed the gap left by those studying national and ethnic identification via quantitative methods, such as surveys.

Surveys can enumerate how individuals ascribe to categorical forms of identification 40 . However, interviews can question the usefulness of such categories and ask whether these categories are reflected, or resisted, by participants in terms of the meanings they give to identification 41 , 42 . Categories often pitch identification as a mutually exclusive choice; but identification might be more complex than such categories allow. For example, some might hybridize these categories or see themselves as moving between and across categories 43 . Hearing how people talk about themselves and their relation to nations, states and ethnicities, therefore, contributes substantially to the study of nationalism and national and ethnic forms of identification.

One particular approach to studying these topics, whether via everyday nationalism or alternatives, is that of using interviews to capture both articulations and narratives of identification, relations to nationalism and the boundaries people construct. For example, interviews can be used to gather self–other narratives by studying how individuals construct I–we–them boundaries 44 , including how participants talk about themselves, who participants include in their various ‘we’ groupings and which and how participants create ‘them’ groupings of others, inserting boundaries between ‘I/we’ and ‘them’. Overall, interviews hold great potential for listening to participants and understanding the nuances of identification and the construction of boundaries from their point of view.

Education and inequality

Scholars of social stratification have long noted that the school system often reproduces existing social inequalities. Carter explains that all schools have both material and sociocultural resources 45 . When children from different backgrounds attend schools with different material resources, their educational and occupational outcomes are likely to vary. Such material resources are relatively easy to measure. They are operationalized as teacher-to-student ratios, access to computers and textbooks and the physical infrastructure of classrooms and playgrounds.

Drawing on Bourdieusian theory 46 , Carter conceptualizes the sociocultural context as the norms, values and dispositions privileged within a social space 45 . Scholars have drawn on interviews with students and teachers (as well as ethnographic observations) to show how schools confer advantages on students from middle-class families, for example, by rewarding their help-seeking behaviours 47 . Focusing on race, researchers have revealed how schools can remain socioculturally white even as they enrol a racially diverse student population. In such contexts, for example, teachers often misrecognize the aesthetic choices made by students of colour, wrongly inferring that these students’ tastes in clothing and music reflect negative orientations to schooling 48 , 49 , 50 . These assessments can result in disparate forms of discipline and may ultimately shape educators’ assessments of students’ academic potential 51 .

Further, teachers and administrators tend to view the appropriate relationship between home and school in ways that resonate with white middle-class parents 52 . These parents are then able to advocate effectively for their children in ways that non-white parents are not 53 . In-depth interviews are particularly good at tapping into these understandings, revealing the mechanisms that confer privilege on certain groups of students and thereby reproduce inequality.

In addition, interviews can shed light on the unequal experiences that young people have within educational institutions, as the views of dominant groups are affirmed while those from disadvantaged backgrounds are delegitimized. For example, Teeger’s interviews with South African high schoolers showed how — because racially charged incidents are often framed as jokes in the broader school culture — Black students often feel compelled to ignore and keep silent about the racism they experience 54 . Interviews revealed that Black students who objected to these supposed jokes were coded by other students as serious or angry. In trying to avoid such labels, these students found themselves unable to challenge the racism they experienced. Interviews give us insight into these dynamics and help us see how young people understand and interpret the messages transmitted in schools — including those that speak to issues of inequality in their local school contexts as well as in society more broadly 24 , 55 .

The welfare state

In-depth interviews have also proved to be an important method for studying various aspects of the welfare state. By welfare state, we mean the social institutions relating to the economic and social wellbeing of a state’s citizens. Notably, using interviews has been useful to look at how policy design features are experienced and play out on the ground. Interviews have often been paired with large-scale surveys to produce mixed-methods study designs, therefore achieving both breadth and depth of insights.

In-depth interviews provide the opportunity to look behind policy assumptions or how policies are designed from the top down, to examine how these play out in the lives of those affected by the policies and whose experiences might otherwise be obscured or ignored. For example, the Welfare Conditionality project used interviews to critique the assumptions that conditionality (such as, the withdrawal of social security benefits if recipients did not perform or meet certain criteria) improved employment outcomes and instead showed that conditionality was harmful to mental health, living standards and had many other negative consequences 56 . Meanwhile, combining datasets from two small-scale interview studies with recipients allowed Summers and Young to critique assumptions around the simplicity that underpinned the design of Universal Credit in 2020, for example, showing that the apparently simple monthly payment design instead burdened recipients with additional money management decisions and responsibilities 57 .

Similarly, the Welfare at a (Social) Distance project used a mixed-methods approach in a large-scale study that combined national surveys with case studies and in-depth interviews to investigate the experience of claiming social security benefits during the COVID-19 pandemic. The interviews allowed researchers to understand in detail any issues experienced by recipients of benefits, such as delays in the process of claiming, managing on a very tight budget and navigating stigma and claiming 58 .

These applications demonstrate the multi-faceted topics and questions for which interviews can be a relevant method for data collection. These applications highlight not only the relevance of interviews, but also emphasize the key added value of interviews, which might be missed by other methods (surveys, in particular). Interviews can expose and question what is taken for granted and directly engage with communities and participants that might otherwise be ignored, obscured or marginalized.

Reproducibility and data deposition

There is a robust, ongoing debate about reproducibility in qualitative research, including interview studies. In some research paradigms, reproducibility can be a way of interrogating the rigour and robustness of research claims, by seeing whether these hold up when the research process is repeated. Some scholars have suggested that although reproducibility may be challenging, researchers can facilitate it by naming the place where the research was conducted, naming participants, sharing interview and fieldwork transcripts (anonymized and de-identified in cases where researchers are not naming people or places) and employing fact-checkers for accuracy 11 , 59 , 60 .

In addition to the ethical concerns of whether de-anonymization is ever feasible or desirable, it is also important to address whether the replicability of interview studies is meaningful. For example, the flexibility of interviews allows for the unexpected and the unforeseen to be incorporated into the scope of the research 61 . However, this flexibility means that we cannot expect reproducibility in the conventional sense, given that different researchers will elicit different types of data from participants. Sharing interview transcripts with other researchers, for instance, downplays the contextual nature of an interview.

Drawing on Bauer and Gaskell, we propose several measures to enhance rigour in qualitative research: transparency, grounding interpretations and aiming for theoretical transferability and significance 62 .

Researchers should be transparent when describing their methodological choices. Transparency means documenting who was interviewed, where and when (without requiring de-anonymization, for example, by documenting their characteristics), as well as the questions they were asked. It means carefully considering who was left out of the interviews and what that could mean for the researcher’s findings. It also means carefully considering who the researcher is and how their identity shaped the research process (integrating and articulating reflexivity into whatever is written up).

Second, researchers should ground their interpretations in the data. Grounding means presenting the evidence upon which the interpretation relies. Quotes and extracts should be extensive enough to allow the reader to evaluate whether the researcher’s interpretations are grounded in the data. At each step, researchers should carefully compare their own explanations and interpretations with alternative explanations. Doing so systematically and frequently allows researchers to become more confident in their claims. Here, researchers should justify the link between data and analysis by using quotes to justify and demonstrate the analytical point, while making sure the analytical point offers an interpretation of quotes (Box 4 ).

An important step in considering alternative explanations is to seek out disconfirming evidence 4 , 63 . This involves looking for instances where participants deviate from what the majority are saying and thus bring into question the theory (or explanation) that the researcher is developing. Careful analysis of such examples can often demonstrate the salience and meaning of what appears to be the norm (see Table 2 for examples) 54 . Considering alternative explanations and paying attention to disconfirming evidence allows the researcher to refine their own theories in respect of the data.

Finally, researchers should aim for theoretical transferability and significance in their discussions of findings. One way to think about this is to imagine someone who is not interested in the empirical study. Articulating theoretical transferability and significance usually takes the form of broadening out from the specific findings to consider explicitly how the research has refined or altered prior theoretical approaches. This process also means considering under what other conditions, aside from those of the study, the researcher thinks their theoretical revision would be supported by and why. Importantly, it also includes thinking about the limitations of one’s own approach and where the theoretical implications of the study might not hold.

Box 4 An example of grounding interpretations in data (from Rao 34 )

In an article explaining how unemployed men frame their job loss as a pervasive experience, Rao writes the following: “Unemployed men in this study understood unemployment to be an expected aspect of paid work in the contemporary United States. Robert, a white unemployed communications professional, compared the economic landscape after the Great Recession with the tragic events of September 11, 2001:

Part of your post-9/11 world was knowing people that died as a result of terrorism. The same thing is true with the [Great] Recession, right? … After the Recession you know somebody who was unemployed … People that really should be working.

The pervasiveness of unemployment rendered it normal, as Robert indicates.”

Here, the link between the quote presented and the analytical point Rao is making is clear: the analytical point is grounded in a quote and an interpretation of the quote is offered 34 .

Limitations and optimizations

When deciding which research method to use, the key question is whether the method provides a good fit for the research questions posed. In other words, researchers should consider whether interviews will allow them to successfully access the social phenomena necessary to answer their question(s) and whether the interviews will do so more effectively than other methods. Table 3 summarizes the major strengths and limitations of interviews. However, the accompanying text below is organized around some key issues, where relative strengths and weaknesses are presented alongside each other, the aim being that readers should think about how these can be balanced and optimized in relation to their own research.

Breadth versus depth of insight

Achieving an overall breadth of insight, in a statistically representative sense, is not something that is possible or indeed desirable when conducting in-depth interviews. Instead, the strength of conducting interviews lies in their ability to generate various sorts of depth of insight. The experiences or views of participants that can be accessed by conducting interviews help us to understand participants’ subjective realities. The challenge, therefore, is for researchers to be clear about why depth of insight is the focus and what we should aim to glean from these types of insight.

Naturalistic or artificial interviews

Interviews make use of a form of interaction with which people are familiar 64 . By replicating a naturalistic form of interaction as a tool to gather social science data, researchers can capitalize on people’s familiarity and expectations of what happens in a conversation. This familiarity can also be a challenge, as people come to the interview with preconceived ideas about what this conversation might be for or about. People may draw on experiences of other similar conversations when taking part in a research interview (for example, job interviews, therapy sessions, confessional conversations, chats with friends). Researchers should be aware of such potential overlaps and think through their implications both in how the aims and purposes of the research interview are communicated to participants and in how interview data are interpreted.

Further, some argue that a limitation of interviews is that they are an artificial form of data collection. By taking people out of their daily lives and asking them to stand back and pass comment, we are creating a distance that makes it difficult to use such data to say something meaningful about people’s actions, experiences and views. Other approaches, such as ethnography, might be more suitable for tapping into what people actually do, as opposed to what they say they do 65 .

Dynamism and replicability

Interviews following a semi-structured format offer flexibility both to the researcher and the participant. As the conversation develops, the interlocutors can explore the topics raised in much more detail, if desired, or pass over ones that are not relevant. This flexibility allows for the unexpected and the unforeseen to be incorporated into the scope of the research.

However, this flexibility has a related challenge of replicability. Interviews cannot be reproduced because they are contingent upon the interaction between the researcher and the participant in that given moment of interaction. In some research paradigms, replicability can be a way of interrogating the robustness of research claims, by seeing whether they hold when they are repeated. This is not a useful framework to bring to in-depth interviews and instead quality criteria (such as transparency) tend to be employed as criteria of rigour.

Accessing the private and personal

Interviews have been recognized for their strength in accessing private, personal issues, which participants may feel more comfortable talking about in a one-to-one conversation. Furthermore, interviews are likely to take a more personable form with their extended questions and answers, perhaps making a participant feel more at ease when discussing sensitive topics in such a context. There is a similar, but separate, argument made about accessing what are sometimes referred to as vulnerable groups, who may be difficult to make contact with using other research methods.

There is an associated challenge of anonymity. There can be types of in-depth interview that make it particularly challenging to protect the identities of participants, such as interviewing within a small community, or multiple members of the same household. The challenge to ensure anonymity in such contexts is even more important and difficult when the topic of research is of a sensitive nature or participants are vulnerable.

Increasingly, researchers are collaborating in large-scale interview-based studies and integrating interviews into broader mixed-methods designs. At the same time, interviews can be seen as an old-fashioned (and perhaps outdated) mode of data collection. We review these debates and discussions and point to innovations in interview-based studies. These include the shift from face-to-face interviews to the use of online platforms, as well as integrating and adapting interviews towards more inclusive methodologies.

Collaborating and mixing

Qualitative researchers have long worked alone 66 . Increasingly, however, researchers are collaborating with others for reasons such as efficiency, institutional incentives (for example, funding for collaborative research) and a desire to pool expertise (for example, studying similar phenomena in different contexts 67 or via different methods). Collaboration can occur across disciplines and methods, cases and contexts and between industry/business, practitioners and researchers. In many settings and contexts, collaboration has become an imperative 68 .

Cheek notes how collaboration provides both advantages and disadvantages 68 . For example, collaboration can be advantageous, saving time and building on the divergent knowledge, skills and resources of different researchers. Scholars with different theoretical or case-based knowledge (or contacts) can work together to build research that is comparative and/or more than the sum of its parts. But such endeavours also carry with them practical and political challenges in terms of how resources might actually be pooled, shared or accounted for. When undertaking such projects, as Morse notes, it is worth thinking about the nature of the collaboration and being explicit about such a choice, its advantages and its disadvantages 66 .

A further tension, but also a motivation for collaboration, stems from integrating interviews as a method in a mixed-methods project, whether with other qualitative researchers (to combine with, for example, focus groups, document analysis or ethnography) or with quantitative researchers (to combine with, for example, surveys, social media analysis or big data analysis). Cheek and Morse both note the pitfalls of collaboration with quantitative researchers: that quality of research may be sacrificed, qualitative interpretations watered down or not taken seriously, or tensions experienced over the pace and different assumptions that come with different methods and approaches of research 66 , 68 .

At the same time, there can be real benefits of such mixed-methods collaboration, such as reaching different and more diverse audiences or testing assumptions and theories between research components in the same project (for example, testing insights from prior quantitative research via interviews, or vice versa), as long as the skillsets of collaborators are seen as equally beneficial to the project. Cheek provides a set of questions that, as a starting point, can be useful for guiding collaboration, whether mixed methods or otherwise. First, Cheek advises asking all collaborators about their assumptions and understandings concerning collaboration. Second, Cheek recommends discussing what each perspective highlights and focuses on (and conversely ignores or sidelines) 68 .

A different way to engage with the idea of collaboration and mixed methods research is by fostering greater collaboration between researchers in the Global South and Global North, thus reversing trends of researchers from the Global North extracting knowledge from the Global South 69 . Such forms of collaboration also align with interview innovations, discussed below, that seek to transform traditional interview approaches into more participatory and inclusive (as part of participatory methodologies).

Digital innovations and challenges

The ongoing COVID-19 pandemic has centred the question of technology within interview-based fieldwork. Although conducting synchronous oral interviews online — for example, via Zoom, Skype or other such platforms — has been a method used by a small constituency of researchers for many years, it became (and remains) a necessity for many researchers wanting to continue or start interview-based projects while COVID-19 prevents face-to-face data collection.

In the past, online interviews were often framed as an inferior form of data collection for not providing the kinds of (often necessary) insights and forms of immersion face-to-face interviews allow 70 , 71 . Online interviews do tend to be more decontextualized than interviews conducted face-to-face 72 . For example, it is harder to recognize, engage with and respond to non-verbal cues 71 . At the same time, they broaden participation to those who might not have been able to access or travel to sites where interviews would have been conducted otherwise, for example people with disabilities. Online interviews also offer more flexibility in terms of scheduling and time requirements. For example, they provide more flexibility around precarious employment or caring responsibilities without having to travel and be away from home. In addition, online interviews might also reduce discomfort between researchers and participants, compared with face-to-face interviews, enabling more discussion of sensitive material 71 . They can also provide participants with more control, enabling them to turn on and off the microphone and video as they choose, for example, to provide more time to reflect and disconnect if they so wish 72 .

That said, online interviews can also introduce new biases based on access to technology 72 . For example, in the Global South, there are often urban/rural and gender gaps between who has access to mobile phones and who does not, meaning that some population groups might be overlooked unless researchers sample mindfully 71 . There are also important ethical considerations when deciding between online and face-to-face interviews. Online interviews might seem to imply lower ethical risks than face-to-face interviews (for example, they lower the chances of identification of participants or researchers), but they also offer more barriers to building trust between researchers and participants 72 . Interacting only online with participants might not provide the information needed to assess risk, for example, participants’ access to a private space to speak 71 . Just because online interviews might be more likely to be conducted in private spaces does not mean that private spaces are safe, for example, for victims of domestic violence. Finally, online interviews prompt further questions about decolonizing research and engaging with participants if research is conducted from afar 72 , such as how to include participants meaningfully and challenge dominant assumptions while doing so remotely.

A further digital innovation, modulating how researchers conduct interviews and the kinds of data collected and analysed, stems from the use and integration of (new) technology, such as WhatsApp text or voice notes to conduct synchronous or asynchronous oral or written interviews 73 . Such methods can provide more privacy, comfort and control to participants and make recruitment easier, allowing participants to share what they want when they want to, using technology that already forms a part of their daily lives, especially for young people 74 , 75 . Such technology is also emerging in other qualitative methods, such as focus groups, with similar arguments around greater inclusivity versus traditional offline modes. Here, the digital challenge might be higher for researchers than for participants if they are less used to such technology 75 . And while there might be concerns about the richness, depth and quality of written messages as a form of interview data, Gibson reports that the reams of transcripts that resulted from a study using written messaging were dense with meaning to be analysed 75 .

Like with online and face-to-face interviews, it is important also to consider the ethical questions and challenges of using such technology, from gaining consent to ensuring participant safety and attending to their distress, without cues, like crying, that might be more obvious in a face-to-face setting 75 , 76 . Attention to the platform used for such interviews is also important and researchers should be attuned to the local and national context. For example, in China, many platforms are neither legal nor available 76 . There, more popular platforms — like WeChat — can be highly monitored by the government, posing potential risks to participants depending on the topic of the interview. Ultimately, researchers should consider trade-offs between online and offline interview modalities, being attentive to the social context and power dynamics involved.

The next 5–10 years

Continuing to integrate (ethically) this technology will be among the major persisting developments in interview-based research, whether to offer more flexibility to researchers or participants, or to diversify who can participate and on what terms.

Pushing the idea of inclusion even further is the potential for integrating interview-based studies within participatory methods, which are also innovating via integrating technology. There is no hard and fast line between researchers using in-depth interviews and participatory methods; many who employ participatory methods will use interviews at the beginning, middle or end phases of a research project to capture insights, perspectives and reflections from participants 77 , 78 . Participatory methods emphasize the need to resist existing power and knowledge structures. They broaden who has the right and ability to contribute to academic knowledge by including and incorporating participants not only as subjects of data collection, but as crucial voices in research design and data analysis 77 . Participatory methods also seek to facilitate local change and to produce research materials, whether for academic or non-academic audiences, including films and documentaries, in collaboration with participants.

In responding to the challenges of COVID-19, capturing the fraught situation wrought by the pandemic and the momentum to integrate technology, participatory researchers have sought to continue data collection from afar. For example, Marzi has adapted an existing project to co-produce participatory videos, via participants’ smartphones in Medellin, Colombia, alongside regular check-in conversations/meetings/interviews with participants 79 . Integrating participatory methods into interview studies offers a route by which researchers can respond to the challenge of diversifying knowledge, challenging assumptions and power hierarchies and creating more inclusive and collaborative partnerships between participants and researchers in the Global North and South.

Brinkmann, S. & Kvale, S. Doing Interviews Vol. 2 (Sage, 2018). This book offers a good general introduction to the practice and design of interview-based studies.

Silverman, D. A Very Short, Fairly Interesting And Reasonably Cheap Book About Qualitative Research (Sage, 2017).

Yin, R. K. Case Study Research And Applications: Design And Methods (Sage, 2018).

Small, M. L. How many cases do I need?’ On science and the logic of case selection in field-based research. Ethnography 10 , 5–38 (2009). This article convincingly demonstrates how the logic of qualitative research differs from quantitative research and its goal of representativeness.

Google Scholar

Gerson, K. & Damaske, S. The Science and Art of Interviewing (Oxford Univ. Press, 2020).

Glaser, B. G. & Strauss, A. L. The Discovery Of Grounded Theory: Strategies For Qualitative Research (Aldine, 1967).

Braun, V. & Clarke, V. To saturate or not to saturate? Questioning data saturation as a useful concept for thematic analysis and sample-size rationales. Qual. Res. Sport Exerc. Health 13 , 201–216 (2021).

Guest, G., Bunce, A. & Johnson, L. How many interviews are enough? An experiment with data saturation and variability. Field Methods 18 , 59–82 (2006).

Vasileiou, K., Barnett, J., Thorpe, S. & Young, T. Characterising and justifying sample size sufficiency in interview-based studies: systematic analysis of qualitative health research over a 15-year period. BMC Med. Res. Methodol. 18 , 148 (2018).

Silverman, D. How was it for you? The Interview Society and the irresistible rise of the (poorly analyzed) interview. Qual. Res. 17 , 144–158 (2017).

Jerolmack, C. & Murphy, A. The ethical dilemmas and social scientific tradeoffs of masking in ethnography. Sociol. Methods Res. 48 , 801–827 (2019).

MathSciNet Google Scholar

Reyes, V. Ethnographic toolkit: strategic positionality and researchers’ visible and invisible tools in field research. Ethnography 21 , 220–240 (2020).

Guillemin, M. & Gillam, L. Ethics, reflexivity and “ethically important moments” in research. Qual. Inq. 10 , 261–280 (2004).

Summers, K. For the greater good? Ethical reflections on interviewing the ‘rich’ and ‘poor’ in qualitative research. Int. J. Soc. Res. Methodol. 23 , 593–602 (2020). This article argues that, in qualitative interview research, a clearer distinction needs to be drawn between ethical commitments to individual research participants and the group(s) to which they belong, a distinction that is often elided in existing ethics guidelines.

Yusupova, G. Exploring sensitive topics in an authoritarian context: an insider perspective. Soc. Sci. Q. 100 , 1459–1478 (2019).

Hemming, J. in Surviving Field Research: Working In Violent And Difficult Situations 21–37 (Routledge, 2009).

Murphy, E. & Dingwall, R. Informed consent, anticipatory regulation and ethnographic practice. Soc. Sci. Med. 65 , 2223–2234 (2007).

Kostovicova, D. & Knott, E. Harm, change and unpredictability: the ethics of interviews in conflict research. Qual. Res. 22 , 56–73 (2022). This article highlights how interviews need to be considered as ethically unpredictable moments where engaging with change among participants can itself be ethical.

Andersson, R. Illegality, Inc.: Clandestine Migration And The Business Of Bordering Europe (Univ. California Press, 2014).

Ellis, R. What do we mean by a “hard-to-reach” population? Legitimacy versus precarity as barriers to access. Sociol. Methods Res. https://doi.org/10.1177/0049124121995536 (2021).

Article Google Scholar

Braun, V. & Clarke, V. Thematic Analysis: A Practical Guide (Sage, 2022).

Alejandro, A. & Knott, E. How to pay attention to the words we use: the reflexive review as a method for linguistic reflexivity. Int. Stud. Rev. https://doi.org/10.1093/isr/viac025 (2022).

Alejandro, A., Laurence, M. & Maertens, L. in International Organisations and Research Methods: An Introduction (eds Badache, F., Kimber, L. R. & Maertens, L.) (Michigan Univ. Press, in the press).

Teeger, C. “Both sides of the story” history education in post-apartheid South Africa. Am. Sociol. Rev. 80 , 1175–1200 (2015).

Crotty, M. The Foundations Of Social Research: Meaning And Perspective In The Research Process (Routledge, 2020).

Potter, J. & Hepburn, A. Qualitative interviews in psychology: problems and possibilities. Qual. Res. Psychol. 2 , 281–307 (2005).

Taylor, S. What is Discourse Analysis? (Bloomsbury Publishing, 2013).

Riessman, C. K. Narrative Analysis (Sage, 1993).

Corbin, J. M. & Strauss, A. Grounded theory research: Procedures, canons and evaluative criteria. Qual. Sociol. 13 , 3–21 (1990).

Timmermans, S. & Tavory, I. Theory construction in qualitative research: from grounded theory to abductive analysis. Sociol. Theory 30 , 167–186 (2012).

Fereday, J. & Muir-Cochrane, E. Demonstrating rigor using thematic analysis: a hybrid approach of inductive and deductive coding and theme development. Int. J. Qual. Meth. 5 , 80–92 (2006).

Potter, J. & Hepburn, A. Eight challenges for interview researchers. Handb. Interview Res. 2 , 541–570 (2012).

Tobias Neely, M. Fit to be king: how patrimonialism on Wall Street leads to inequality. Socioecon. Rev. 16 , 365–385 (2018).

Rao, A. H. Gendered interpretations of job loss and subsequent professional pathways. Gend. Soc. 35 , 884–909 (2021). This article used interview data from unemployed men and women to illuminate how job loss becomes a pivotal moment shaping men’s and women’s orientation to paid work, especially in terms of curtailing women’s participation in paid work.

Hart, C. G. Trajectory guarding: managing unwanted, ambiguously sexual interactions at work. Am. Sociol. Rev. 86 , 256–278 (2021).

Goode, J. P. & Stroup, D. R. Everyday nationalism: constructivism for the masses. Soc. Sci. Q. 96 , 717–739 (2015).

Antonsich, M. The ‘everyday’ of banal nationalism — ordinary people’s views on Italy and Italian. Polit. Geogr. 54 , 32–42 (2016).

Fox, J. E. & Miller-Idriss, C. Everyday nationhood. Ethnicities 8 , 536–563 (2008).

Yusupova, G. Cultural nationalism and everyday resistance in an illiberal nationalising state: ethnic minority nationalism in Russia. Nations National. 24 , 624–647 (2018).

Kiely, R., Bechhofer, F. & McCrone, D. Birth, blood and belonging: identity claims in post-devolution Scotland. Sociol. Rev. 53 , 150–171 (2005).

Brubaker, R. & Cooper, F. Beyond ‘identity’. Theory Soc. 29 , 1–47 (2000).

Brubaker, R. Ethnicity Without Groups (Harvard Univ. Press, 2004).

Knott, E. Kin Majorities: Identity And Citizenship In Crimea And Moldova From The Bottom-Up (McGill Univ. Press, 2022).

Bucher, B. & Jasper, U. Revisiting ‘identity’ in international relations: from identity as substance to identifications in action. Eur. J. Int. Relat. 23 , 391–415 (2016).

Carter, P. L. Stubborn Roots: Race, Culture And Inequality In US And South African Schools (Oxford Univ. Press, 2012).

Bourdieu, P. in Cultural Theory: An Anthology Vol. 1, 81–93 (eds Szeman, I. & Kaposy, T.) (Wiley-Blackwell, 2011).

Calarco, J. M. Negotiating Opportunities: How The Middle Class Secures Advantages In School (Oxford Univ. Press, 2018).

Carter, P. L. Keepin’ It Real: School Success Beyond Black And White (Oxford Univ. Press, 2005).

Carter, P. L. ‘Black’ cultural capital, status positioning and schooling conflicts for low-income African American youth. Soc. Probl. 50 , 136–155 (2003).

Warikoo, N. K. The Diversity Bargain Balancing Acts: Youth Culture in the Global City (Univ. California Press, 2011).

Morris, E. W. “Tuck in that shirt!” Race, class, gender and discipline in an urban school. Sociol. Perspect. 48 , 25–48 (2005).

Lareau, A. Social class differences in family–school relationships: the importance of cultural capital. Sociol. Educ. 60 , 73–85 (1987).

Warikoo, N. Addressing emotional health while protecting status: Asian American and white parents in suburban America. Am. J. Sociol. 126 , 545–576 (2020).

Teeger, C. Ruptures in the rainbow nation: how desegregated South African schools deal with interpersonal and structural racism. Sociol. Educ. 88 , 226–243 (2015). This article leverages ‘ deviant ’ cases in an interview study with South African high schoolers to understand why the majority of participants were reluctant to code racially charged incidents at school as racist.

Ispa-Landa, S. & Conwell, J. “Once you go to a white school, you kind of adapt” black adolescents and the racial classification of schools. Sociol. Educ. 88 , 1–19 (2015).

Dwyer, P. J. Punitive and ineffective: benefit sanctions within social security. J. Soc. Secur. Law 25 , 142–157 (2018).

Summers, K. & Young, D. Universal simplicity? The alleged simplicity of Universal Credit from administrative and claimant perspectives. J. Poverty Soc. Justice 28 , 169–186 (2020).

Summers, K. et al. Claimants’ Experiences Of The Social Security System During The First Wave Of COVID-19 . https://www.distantwelfare.co.uk/winter-report (2021).

Desmond, M. Evicted: Poverty And Profit In The American City (Crown Books, 2016).

Reyes, V. Three models of transparency in ethnographic research: naming places, naming people and sharing data. Ethnography 19 , 204–226 (2018).

Robson, C. & McCartan, K. Real World Research (Wiley, 2016).

Bauer, M. W. & Gaskell, G. Qualitative Researching With Text, Image And Sound: A Practical Handbook (SAGE, 2000).

Lareau, A. Listening To People: A Practical Guide To Interviewing, Participant Observation, Data Analysis And Writing It All Up (Univ. Chicago Press, 2021).

Lincoln, Y. S. & Guba, E. G. Naturalistic Inquiry (Sage, 1985).

Jerolmack, C. & Khan, S. Talk is cheap. Sociol. Methods Res. 43 , 178–209 (2014).

Morse, J. M. Styles of collaboration in qualitative inquiry. Qual. Health Res. 18 , 3–4 (2008).

ADS Google Scholar

Lamont, M. et al. Getting Respect: Responding To Stigma And Discrimination In The United States, Brazil And Israel (Princeton Univ. Press, 2016).

Cheek, J. Researching collaboratively: implications for qualitative research and researchers. Qual. Health Res. 18 , 1599–1603 (2008).

Botha, L. Mixing methods as a process towards indigenous methodologies. Int. J. Soc. Res. Methodol. 14 , 313–325 (2011).

Howlett, M. Looking at the ‘field’ through a zoom lens: methodological reflections on conducting online research during a global pandemic. Qual. Res. https://doi.org/10.1177/1468794120985691 (2021).

Reñosa, M. D. C. et al. Selfie consents, remote rapport and Zoom debriefings: collecting qualitative data amid a pandemic in four resource-constrained settings. BMJ Glob. Health 6 , e004193 (2021).

Mwambari, D., Purdeková, A. & Bisoka, A. N. Covid-19 and research in conflict-affected contexts: distanced methods and the digitalisation of suffering. Qual. Res. https://doi.org/10.1177/1468794121999014 (2021).

Colom, A. Using WhatsApp for focus group discussions: ecological validity, inclusion and deliberation. Qual. Res. https://doi.org/10.1177/1468794120986074 (2021).

Kaufmann, K. & Peil, C. The mobile instant messaging interview (MIMI): using WhatsApp to enhance self-reporting and explore media usage in situ. Mob. Media Commun. 8 , 229–246 (2020).

Gibson, K. Bridging the digital divide: reflections on using WhatsApp instant messenger interviews in youth research. Qual. Res. Psychol. 19 , 611–631 (2020).

Lawrence, L. Conducting cross-cultural qualitative interviews with mainland Chinese participants during COVID: lessons from the field. Qual. Res. https://doi.org/10.1177/1468794120974157 (2020).

Ponzoni, E. Windows of understanding: broadening access to knowledge production through participatory action research. Qual. Res. 16 , 557–574 (2016).

Kong, T. S. Gay and grey: participatory action research in Hong Kong. Qual. Res. 18 , 257–272 (2018).

Marzi, S. Participatory video from a distance: co-producing knowledge during the COVID-19 pandemic using smartphones. Qual. Res. https://doi.org/10.1177/14687941211038171 (2021).

Kvale, S. & Brinkmann, S. InterViews: Learning The Craft Of Qualitative Research Interviewing (Sage, 2008).

Rao, A. H. The ideal job-seeker norm: unemployment and marital privileges in the professional middle-class. J. Marriage Fam. 83 , 1038–1057 (2021).

Rivera, L. A. Ivies, extracurriculars and exclusion: elite employers’ use of educational credentials. Res. Soc. Stratif. Mobil. 29 , 71–90 (2011).

Download references

Acknowledgements

The authors are grateful to the MY421 team and students for prompting how best to frame and communicate issues pertinent to in-depth interview studies.

Author information

Authors and affiliations.

Department of Methodology, London School of Economics, London, UK

Eleanor Knott, Aliya Hamid Rao, Kate Summers & Chana Teeger

You can also search for this author in PubMed Google Scholar

Contributions

The authors contributed equally to all aspects of the article.

Corresponding author

Correspondence to Eleanor Knott .

Ethics declarations

Competing interests.

The authors declare no competing interests.

Peer review

Peer review information.

Nature Reviews Methods Primers thanks Jonathan Potter and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

A pre-written interview outline for a semi-structured interview that provides both a topic structure and the ability to adapt flexibly to the content and context of the interview and the interaction between the interviewer and participant. Others may refer to the topic guide as an interview protocol.

Here we refer to the participants that take part in the study as the sample. Other researchers may refer to the participants as a participant group or dataset.

This involves dividing a population into smaller groups based on particular characteristics, for example, age or gender, and then sampling randomly within each group.

A sampling method where the guiding logic when deciding who to recruit is to achieve the most relevant participants for the research topic, in terms of being rich in information or insights.

Researchers ask participants to introduce the researcher to others who meet the study’s inclusion criteria.

Similar to stratified sampling, but participants are not necessarily randomly selected. Instead, the researcher determines how many people from each category of participants should be recruited. Recruitment can happen via snowball or purposive sampling.

A method for developing, analysing and interpreting patterns across data by coding in order to develop themes.

An approach that interrogates the explicit, implicit and taken-for-granted dimensions of language as well as the contexts in which it is articulated to unpack its purposes and effects.

A form of transcription that simplifies what has been said by removing certain verbal and non-verbal details that add no further meaning, such as ‘ums and ahs’ and false starts.

The analytic framework, theoretical approach and often hypotheses, are developed prior to examining the data and then applied to the dataset.

The analytic framework and theoretical approach is developed from analysing the data.

An approach that combines deductive and inductive components to work recursively by going back and forth between data and existing theoretical frameworks (also described as an iterative approach). This approach is increasingly recognized not only as a more realistic but also more desirable third alternative to the more traditional inductive versus deductive binary choice.

A theoretical apparatus that emphasizes the role of cultural processes and capital in (intergenerational) social reproduction.

Rights and permissions

Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Cite this article.

Knott, E., Rao, A.H., Summers, K. et al. Interviews in the social sciences. Nat Rev Methods Primers 2 , 73 (2022). https://doi.org/10.1038/s43586-022-00150-6

Download citation

Accepted : 14 July 2022

Published : 15 September 2022

DOI : https://doi.org/10.1038/s43586-022-00150-6

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

This article is cited by

Development of a digital intervention for psychedelic preparation (dipp).

Rosalind G. McAlpine
Matthew D. Sacchet
Sunjeev K. Kamboj

Scientific Reports (2024)

Between the dog and the wolf: an interpretative phenomenological analysis of bicultural, sexual minority people’s lived experiences

Emelie Louise Miller
Ingrid Zakrisson

Discover Psychology (2024)

Acknowledging that Men are Moral and Harmed by Gender Stereotypes Increases Men’s Willingness to Engage in Collective Action on Behalf of Women

Alexandra Vázquez
Lucía López-Rodríguez
Marco Brambilla

Sex Roles (2024)

Quick links

Explore articles by subject
Guide to authors
Editorial policies

Ethical consideration dilemma: systematic review of ethics in qualitative data collection through interviews

Journal of Ethics in Entrepreneurship and Technology

ISSN : 2633-7436

Article publication date: 11 August 2023

Issue publication date: 14 December 2023

Qualitative research that involves the use of human participants calls for the need to protect those participants to give their honest view during data collection. This is an important part of every primary data collection in qualitative studies using interviews. This paper aims to investigate all available ethical considerations that need to be observed by the researcher when conducting primary data collection through interview and to explore the theories that underpin the ethics in qualitative studies.

Design/methodology/approach

This paper systemically reviewed existing qualitative data on ethics and gathered information that were analysed and presented on the topic area.

The findings show that ethical considerations deal with the various approaches adopted by the researcher to make the participants feel safe to participate in any given researcher. During an interview process in qualitative research, the findings show that anonymity, voluntary participation, privacy, confidentiality, option to opt out and avoiding misuse of findings are ethical considerations that must be observed by the researcher. The outcome of the investigation also shows that deontology and utilitarianism, rights and virtue are the main theories that underpin ethical considerations in research.

Originality/value

The rights of the research participants need to be respected in qualitative research to assist in gathering accurate information to achieve the objectives of study. This and other ethical principles such as anonymity, privacy, confidentiality, voluntary participation and option to opt out guide the researcher to systematically adhere to data collection approaches that yield valid results in qualitative data collection using interviews.

Primary data
Qualitative research
Ethical theory
Informed consent
Data collection
Ethical approval

Nii Laryeafio, M. and Ogbewe, O.C. (2023), "Ethical consideration dilemma: systematic review of ethics in qualitative data collection through interviews", Journal of Ethics in Entrepreneurship and Technology , Vol. 3 No. 2, pp. 94-110. https://doi.org/10.1108/JEET-09-2022-0014

Emerald Publishing Limited

Published by Emerald Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/legalcode

1. Introduction

Qualitative research that involves human subjects should focus on using the best form of interaction to gather accurate information. The researcher is vested with the main ideas and the approach to interact with the participants during data collection. However, these human subjects have the choice of what kinds of information they provide to researchers based on the treatment that are shown to them by the researchers. Researchers such as Collis and Hussey (2014) and Smith et al. (2009) proposed that researchers must have a policy of respecting the rights and privileges given to human participants in any given qualitative studies to allow the freedom of expression and the option to opt out at any point during the data collection.

These and other privileges given to the human participants in a research aid in gathering information without fear or pressure from the participants. Saunders et al. (2016) also affirmed by saying that the accuracy of information gathered using interviews largely depends on the honesty of the participants, and this is caused by outlining the ethical considerations that needs to be observed by the researcher. Ethical considerations are fundamental in any kind of research, this provides the opportunity for the researcher to gather the most important information without causing any harm to the participants in the research ( Orb et al. , 2000 ). The aim of this paper is to present a systematic and comprehensive literature review on ethical considerations in qualitative data collection using interviews and highlighting the various theories that underpin the ethical issues in qualitative research.

2. Literature review

Research ethics considers the act of doing good and protecting the rights of participants in research, as well as avoiding any possible harm to any participants ( Kara and Pickering, 2017 ; UK Statistics Authority, 2022 ). Kara and Pickering (2017) further noted in their research study that research ethics often considers the elements which concerns primary data collection than secondary data. For example, in their research that analysed 29 published articles between 2000 and 2015, majority of the article (22) addressed ethical consideration such as anonymity, privacy, confidentiality, informed consent and formal ethical regulations that concerns primary data collection, and the rest consisted of other topics such as ethics and secondary data, ethics and data analysis, theory and life-writing. This became evident that though ethical considerations are associated with other kinds of data, it particularly concerns primary data collection than secondary data. This was also confirmed by Colnerud (2015) who also expressed that ethical considerations help in preventing or reducing any harm that could happen to the human participants during primary data collection. Thus, it becomes very important for the protection of human rights in any kind of research ( Cilliers and Viljieon, 2021 ). In the current trend of research investigation, it is illegal to violate human right under the pretence of research studies. The nature of ethical issues in qualitative research is so delicate as compared to quantitative research ( Drolet et al. , 2022 ). Researchers have the highest accountability to ensure that they notice or identify and foreseeable harm and safeguard the wellbeing of the participants ( Williams-Jones et al. , 2013 ). As such, the actions of researchers, especially those that engage in qualitative studies, have been under high scrutiny due to the likelihood of mistreating the human participants, to gain deeper findings and clarity of information generated.

As noted by Van Burg et al. (2022) , qualitative research has been vital in the development of theories on emerging techniques that helped the existence of men in recent times, such as crowdfunding ( Short et al. , 2017 ), digital technologies ( Nambisan et al. , 2019 ) and lean start-up approach ( Shepherd and Gruber, 2020 ). The relevance of qualitative research has called for the need to ensure internal coherence as noted by Howard-Grenville et al. (2021) where they pointed out that a perfect fit must exist in qualitative studies which helps to link the research question to data collection, data analysis, as well as findings and development of theory.

However, researchers that engage in qualitative studies are faced with three major challenges that raises the issue of ethics in data collection: the researcher–participants relationship, the subjective interpretation of data and findings by the researcher and the research design adopted ( Beauchemin et al. , 2021 ). There is the possibility of disclosing some damaging information under deception. The literature provides an example of researcher’s deception through Humphrey’s study of homosexuals ( Punch, 1994 ). Humphrey used participants’ observation as his data collection technique through the act of deception, and this raised major concerns and shocked American scholars who wanted to have his doctorate degree revoked. Humphrey engaged in controversial research where he observed homosexuals in a public bathroom, and under the disguise of working under a different investigation follows same homosexuals to their various homes. Though this contradicts the ethical principle, Clark (1996) expressed that deception allows the researcher to gather “uncontaminated” data. This approach of “deception” was adopted by Clark (1996) in her forensic unit research. While conducting research over a period of six weeks, Clarke pretended to be working as a nursing auxiliary to observe participants and later take notes. In other words, Clarke did not disclose her identify as a researcher, rather pretended to be a worker at the facility. Clark (1996 , p. 38) justified her approach by expressing that when “dealing with sensitive aspect of subject’s behaviour”, some degree of deception should be permitted. However, Kang and Hwang (2021) pointed out that the act of deception violates human right and exposes the participants to harm and danger.

Misconduct in research studies deeply affects the results of any investigation. While Bruhn et al. (2002) believed that the authenticity of research findings depends on data collection techniques, Davison (2004) also expressed that human participants can give their honest opinion on an investigation when they are given “convenient” environment to operate. Participants should not be manipulated under no circumstance to give any to be involved in a research data collection. Throughout the research life cycle, it is very important for researchers to consider any possible ethical challenges that could occur ( Giorgini et al. , 2016 ). Due to the difficulties associated with identifying any possible ethical issues, ethical committee acts as experts who access the research documents prior to the investigation to make sure all ethical “checklists” are met by the researcher ( Lynöe et al. , 1999 ).

3. Historical background to research ethics

There has been different school of thoughts when a historical account of the birth of ethics in research is being narrated. This approach to rightfully engage human participants in research started when people started to reflect on the best way to interact and live. To recall, history has it that the birth of research ethics in modern studies started when investigators had to protect the human participants in any kind of investigation. To this school of thought, the Doctors Trial of 1946–1947 gave way for a starting point to document regulations that should have been followed by investigators for the Nuremberg Trials for war criminals by the Nazis ( Annas and Grodin, 1992 ). To further expand on the scenario, there were a total of 23 physicians from Germany who wanted to conduct research with human subjects as the main participants in view of uncovering a scientific knowledge regarding limits of the human body as a result exposed those human participants involved in the research to high temperatures and altitudes ( Grodin, 1992 ).

The accused 23 German physicians ended up brutalising and torturing the human subjects involved, as well crippling most of them which led to the death of thousands of the research victims. During the Nazi racial purification policies, these physicians were also exploring ways to racially kill innocent people in a relatively painless manner for reasons of mercy. This was to relieve the foreigners of the racial discrimination met out to them by the Nazis, without their consent. These acts were the most destructive and gruesome experiments that led to the murder of thousands of victims in Germany by the Nazi party in 1942 ( Nuremberg Code, 1947 ).

Research participants must voluntarily consent to research participation.

Research aims should contribute to the good of society.

Research must be based on sound theory and prior animal testing.

Research must avoid unnecessary physical and mental suffering.

No research projects can go forward where serious injury and/or death are potential outcomes.

The degree of risk taken with research participants cannot exceed anticipated benefits of results.

Proper environment and protection for participants is necessary.

Experiments can be conducted only by scientifically qualified persons.

Human subjects must be allowed to discontinue their participation at any time.

Scientists must be prepared to terminate the experiment if there is cause to believe that continuation will be harmful or result in injury or death.

Clinical research must conform to the moral and scientific principles that justify medical research and should be based on laboratory and animal experiments or other scientifically established facts.

Clinical research should be conducted only by scientifically qualified persons and under the supervision of a qualified medical man.

Clinical research cannot legitimately be carried out unless the importance of the objective is in proportion to the inherent risk to the subject.

Every clinical research project should be preceded by careful assessment of inherent risks in comparison to foreseeable benefits to the subject or to others.

Special caution should be exercised by the doctor in performing clinical research in which the personality of the subject is liable to be altered by drugs or experimental procedure.

Following the DoH in 1964, the development of the “Belmont Report” in 1979 became the next set of ethical guidelines that was proposed by the National Commission for the maximum protection of human participants on Biomedical and Behavioural Research. The Belmont Report reviewed and reaffirmed three key ethical guidelines that researchers must follow when dealing with human participants in research, and these are respect for persons, beneficence and justice. The Nuremberg code, DoH and Belmont Report paved way for modern approaches to research ethics in research.

4. Ethical theories

There have been several attempts by scholars in the field of ethics to provide justifications for the need to oblige to some form of principles when engaging human participants in research ( Koski, 2009 ). In essence, it is common and appropriate to consider different ethical theories that underpin the principles of a researcher to clarify what is wrong or right during data collection that involves human participants. The following are four key ethical theories that form the philosophical position of researchers during data collection.

4.1 Deontology

This ethical theory is often associated with the works of Immanuel Kant who expressed that the rightness or wrongness of an action should not be dependent on the consequences of that action, rather on whether that action is right under a series of rules ( Beauchamp, 1991 ). This is mostly regarded as obligation or duty and thus referred to as the rule-based ethics. Under this theory, people must follow their rules and do their duty. Salzman (1995) also pointed out that deontology ethical theory exists within the domain of morality which helps to guide our choice of what is right and wrong. For example, when a computer scientist who has much knowledge in hacking systems learn that there is going to be a nuclear weapon launch that could kill lots of people. Under this circumstance, the computer scientist can hack and cancel the launch of the nuclear weapon, to avoid killing of people ( Olson, 1967 ). However, the deontic view is that it is unprofessional to break into the system of the nuclear weapon without consent or permission. Deontologist advises not to breach the professional code of conduct as a computer scientist ( Waller, 2005 ).

4.2 Utilitarianism

Unlike deontology, this theory mainly focusses on the rightness or wrongness of an action based on the outcome of that action. This is born out of consequentialism which holds that utilitarianism deals with taking actions that produces the greatest benefits to the greatest number of related people ( Shaw, 1998 ). This is a moral principle that holds that the best ethical choice is the actions that produces the best benefits to the greatest number. For example, a healthy person has a good liver, kidney, heart and lungs. Imagine there are four people at the hospital who needs organ transplant each. In this instance, a healthy person can save four people with his/her organs. Utilitarianism theory suggests that the life of one healthy person can save four people at the hospital (greatest number) and that is arguably the best choice to make ( McCloskey, 1957 ). The consequence of taking the life of just one person is saving the lives of four people, though other scholars suggest that taking the life of any person is unethical.

This is a duty-based ethical theory which explains the rights of every person, and it is the duty of another person to respect those rights, thus owing up the duty to respect the rights of another. As Traer (2009 p. 103) explains:

[…] the most widely accepted justification for moral rights relies on Kant's deontological argument that we have a duty to treat every person as an end, and not to our ends, because every person is autonomous and rational, and thus has intrinsic worth.

This theory highly judges a person based on his or her character, rather than the action or outcome of event. This deals with the moral reputation of a person that determines any ethical behaviour (Annas, 1993). As the name suggest, virtue can be expressed as a morally good tendency to act well in some aspects of life ( Hursthouse and Pettigrove, 2018 ). This mainly portrays the character traits and become central to the personality of a person.

When researchers are faced with decision-making situation or data collection when there is the need to adhere to ethical considerations, there are several ethical theories that gives the guidelines to reach a decision that is ethically correct. To reach the right decision when dealing with human participants, each ethical theory helps to adhere to the best practices that lead to taking the best decision.

5. Qualitative research

The choice of this type of research largely depends on the philosophical position of the researcher. This type of research relies on the information supplied by the human subjects in the research. They hold the idea that human subjects under any given piece of research should be given the chance to bring out their views about the topic area in the research. This should be devoid of any predetermined set of questions that gives participants less chance to express themselves. As expressed by Merriam (2009) , qualitative researchers are interested in understanding the meaning people have constructed, that is, how people make sense of their world and the experiences they have in the world. This was affirmed by Parkinson and Drislane (2011) who also expressed that qualitative research use research techniques such as case studies and participants which helps in narrative and descriptive nature of practice. The most common idea from both authors concludes that qualitative research investigates events in their natural settings and successfully attempts to make meaning to the research based on the meanings the human subjects attach to them. Simply put, qualitative research deals with the gathering and analysing of non-numerical data to explore views, experiences or opinions of others.

6. Current and emerging trends in qualitative research

The community of research in qualitative studies has gone through several changes from where the human participants are harmed to the stage where the rights of participants are highly respected and protected ( Roth and von Unger, 2018 ). Qualitative researchers tend to treat ethics as the main characteristics between the researcher and what is researched. To move further, the advancement in technology has led to the transformation of many fields of research and qualitative research is no exception. As a result, qualitative research is going through tremendous and rapid changes and any researcher interested in such investigation should know the state of development in qualitative research ( Costa and Moreira, 2019 ). These changes and other emerging trends could be seen in three main areas ( ESOMAR, 2010 ): sources of data, data collection and analysis of data.

The traditional data sources under qualitative research were mainly through interviews, observation, focus groups and recordings ( Gill et al. , 2008 ). Currently, these methods have been heavily complemented by virtual, textual, visual and other data that is gathered from social media. The introduction of Web 2.0 technologies (interactive contents) has led to the development of social media platforms that enables people all over the world to share their lives and other private information online which is accessed by people all over the world ( Sykora, 2017 ). With creativity and innovation, qualitative researchers have found ways to leverage on this trend to conduct high quality research. As such, as many people around the world creates accounts on Instagram, Facebook, Twitter and other social media platforms, there are vast amount of qualitative data streams that could be accessed by the qualitative researcher. In a nutshell, social media platforms have become an additional source of data for researchers.

The consequence of data available on social media platforms has brought about other emerging data collection tools such as data mining and web crawling techniques used in recent times. For example, software programmes such as Ncapture have been integrated into NVivo which helps to capture social media contents for fast qualitative data analysis. Ncapture is a free web-browser extension created for internet explorer and Google chrome which helps the researcher to collect contents from the web to effectively import into NVivo for qualitative data analysis ( Tom and Richards, 2003 ; Zamawe, 2015 ). This has led to the introduction of “netnography” (the combination of network and ethnography) as a new form of qualitative social media research. Netnography is a specific type of qualitative social media research that relates to data collection, analysis, representation and research ethics that is deeply rooted in research participant’s observation ( Kozinets, 2017 ). Kozinets (2002) further explained that netnography uses an interpretative research philosophy which helps to adapt participants’ observation approach of anthropology to the detail investigation of involvement and experiences which manifest through digital communications.

The traditional qualitative data analysis consists of using humans to code texts manually ( Saunders et al. , 2016 ); however, the introduction of social media research has turned efforts to using automated content analysis (ACA). This consists of techniques that are used to automatically analyse social media contents. Scholars such as Stockwell et al. (2009) and Sievert and Shirley (2014) added that ACA helps qualitative researchers to engage in large-scale data analysis and helps to produce efficient results.

7. Qualitative data collection methods and procedure

7.1 methods.

Data collection is one of the most important parts of every research investigation. It is the systematic process of gathering and collecting information on the interested variables in research to answer the research question and evaluate the outcome of a research (Collis and Hussey, 2016; Saunders et al. , 2016 ). In a qualitative research where human participants are involved, data collection translates into the various processes of gathering and collection data from the targeted participants about the topic area, through, for example, interviews. There are several methods of qualitative data collection, and it is up to the researcher to justify the methods used. The choice of data collection methods for qualitative research is highly influenced by the research philosophical positioning of the researcher ( Saunders et al. , 2016 ). The most common method of collecting qualitative data is through, interviews, group discussions or focus group, observations, surveys and note taking. It is worth mentioning that the interview could take place via telephone, online (through Skype, Zoom and Teams) or face-to-face, and be recorded for analysis. The focus of the research investigation is interviews as the main qualitative data collection methods.

7.2 Interviews

This is the most common form of data collection for qualitative research investigation (Collis and Hussey, 2016). This presents the great opportunity for researchers to fully interact with the participants to solicit for data about a topic area. There are several forms of interviews that are available to the researcher such as unstructured, semi-structured and structured interviews (Oats, 2016). Researchers can choose any form of interviews for the data collection based on the depth of data to be collected to answer the research questions.

7.3 Procedures

A long-standing process of conducting interviews to solicit for information from participants suggests that the researcher must have four main documents ready and to be sent to the participants (interviewee) before conducting the interview ( Denzin and Lincoln, 2011 ). These documents are as follows: consent form, information sheet, interview guide and introduction letter (when the researcher is seeking to involve organisations or institutions).

7.4 Information sheet

It is mostly called participant’s information sheet ( Creswell and Plano Clark, 2007 ). This is a written document that gives the summary of the research project and detailed out how the participants will be affected by their involvement in the data collection for the study ( Saunders et al. , 2016 ). Areas that are clearly detailed out in the information sheet are: (1) What is the study about? (2) How do I join? (3) What happens to the information? (4) Do I have to take part in the research? (5) Will I benefit from the research? and (6) What if I change my mind. These and many other information are provided on the information sheet to give the interviewee an awareness of the research investigation and how he or she will be protected.

7.5 Consent form

Having read the information sheet and become aware of the project, interviewees are given the consent form to sign to show their willingness to take part in the research. This is therefore a signed document that outlines the informed consent of an individual to partake in a research study (Collis and Hussey, 2016). In most cases, the consent form has some information with a tick box against it, asking individual to tick to agree to some key information that will take place in the research before finally signing the document. Some key information that requires a “tick” by the individual (interviewee) are (1) I confirm that I have read and understand the information sheet dated for the above study, (2) I understand that my participation is voluntary and that I am free to withdraw at any time, without giving any reason and (3) I understand that my name will not appear in any reports, articles or presentations.

7.6 Interview guide

Usually limited to a one-page document ( Menzies et al. , 2016 ), the interview guide simply lists the high-level topics that the researcher plans to cover in the interview with the high-level questions that the researcher wants the interviewee to answer under each topic. The topics and questions written on this document is guided by the research questions ( Lazar et al. , 2017 ) that is necessary and sufficient to achieve the aim of the research.

7.7 Introduction letter

This is a letter that is written to an organisation to allow members of its staff members to be involved in data collection ( Saunders et al. , 2016 ) or to seek permission to retrieve data from archives of the organisation, thus often called organisational letter.

All these documents mentioned above must be made ready to commence an interview by the researcher. The researcher through a sampling technique, selects and sends an invitation to the participants and records the number who has agreed to be interviewed. The interview is then recorded and transcribed for analysis.

8. Ethical considerations in conducting interviews

When the information sheet, consent form and interview guide has been designed by the researcher, it now time for the researcher to commence the interview process. This is the time where ethical considerations become very relevant. The following are some of the ethical considerations that must be observed by the researcher during the interview process.

8.1 Anonymity

Providing anonymity to the interviewees means that all the information collected is devoid of personal details of the interviewee such as address, email, name and other key information that could lead to the identification of the interviewee ( Crow and Wiles, 2008 ). Ensuring anonymity of information collected gives protection to the interviewees and allows them to give out key information which ensures reliability of findings ( Saunders et al. , 2015 ). This helps to protect the privacy of voluntary participants in the research investigation.

8.2 Privacy and confidentiality

The interviewer must ensure that any information collected from the interviewee must remain private and confidential; thus, ensuring that no third party has access to the raw data unless otherwise stated by the interviewee for exposure.

8.3 Voluntary participation

To gain reliable information from the interviewee, none must be forced or induced to participate in the research investigation. Forcing participant will mean that they are not willing to give out any information but for material compensation, they will take part which could lead to the collection of false information. Allowing for voluntary participation will ensure that participants understand the research area and accept to engage in the data collection ( Mumford et al. , 2021 ).

8.4 Option to opt out

The researcher must respect the rights of interviews at any point during the data collection to opt out. When this happens any already collected data about the participants must be discarded. This ensures that no interviewee is forced to engage in the research if some questions go against their virtues ( Mumford et al. , 2021 ). The researcher owes it a responsibility to respect the rights of the interviewees.

8.5 Non-maleficence/Beneficence

The ethical principle of non-maleficence and beneficence describes the researcher’s obligation to fully avoid causing any harm to the participant intentionally or be able to identify and eliminate any source of harm to the participant ( Guillemin and Gillam, 2004 ). The researcher in this instance should not over-burden the participant with more questions or create a situation where the participant feels uncomfortable. Any deliberate attempt by the researcher to cause an unwelcome environment will impact negatively to the responses that will be gathered ( Wilson et al. , 2008 ). This was initially a concern in the nursing research where a patient places full trust in the hands of a nurse or health officer, and therefore suffers a deliberate harm by the health officer which could be avoided ( Alderson, 2000 ). For example, where patients handle sensitive and private information to the health officer due to trust. Table 1 below gives a typology of ethical concerns faced by interviewers.

9. Key ethical concerns in entrepreneurship and technology

Technology and entrepreneurship are constantly developing fields that provide numerous benefits to society. However, they also bring up a few ethical concerns. The following are some of the most important ethical issues in technology and entrepreneurship:

Privacy: Personal data collection, storage and use are now easier than ever thanks to technology ( Reynolds, 2019 ). This raises concerns regarding who has access to that data and how it is being used. Technologists and entrepreneurs must respect the privacy of individuals and be open about their data practices.

Security: Cyberattacks and data breaches are becoming increasingly common as technology usage rises ( Reynolds, 2019 ). Business owners and technologists should do whatever it takes to safeguard client information.

Intellectual property: New concepts and inventions are frequently developed through technology. Intellectual property rights must be respected by technologists and entrepreneurs alike, and they must avoid violating the rights of others ( Reynolds, 2019 ).

Bias and discrimination: If technology is not designed and implemented in a way that is fair and inclusive, bias and discrimination can continue ( Van Burg et al. , 2022 ). Technologists and entrepreneurs need to be aware of the possibility of bias and discrimination and take steps to reduce it.

Social obligation: Technologists and entrepreneurs have a responsibility to think about how their products and services will affect society ( Van Burg et al. , 2022 ). They should guarantee that their developments are not unsafe to society and that they are adding to everyone's benefit.

Labour issues: Entrepreneurs and technologists must consider the effects on workers as technology alters the nature of work. They should guarantee that their advancements do not prompt work dislodging or double-dealing ( Van Burg et al. , 2022 ).

Business and innovation present numerous moral difficulties that should be tended to. It is essential for technologists and entrepreneurs to be aware of these issues and to take steps to guarantee that their innovations are socially responsible and beneficial.

10. Gaining ethical approval

Research that involves the use of human participants needs to seek for ethical approval from an ethics committee. Saunders et al. (2016) further expressed that all research that involves human tissues requires that ethical approval must be sought by the university’s research ethics committee. Obtaining ethical approval means that the researcher has adhered to the acceptable ethical standards of a reliable and genuine research study ( Bickman and Rog, 2009 ).

For the application process, the researcher must make available the research proposal, together with the data collection instrument, participants’ information sheet, consent form and then apply for ethics from the university’s ethics committee by filling the ethics form online and attaching the proposal for submission. The ethics committee has been named differently by many universities based on the country or university of application, for example, it is called the “Institutional Review Board” (IRB) in the USA. Section 9 below gives a detail overview of IRB and its composition. The ethics committee (or IRS) reviews the application and examines the proposal to meet all requirements per the ethics standards. Once all requirements are met by the applicant (researcher), ethical approval is granted for the research to commence.

11. Institutional review board

The IRB is also referred to as an independent ethics committee ( Mohamadi et al. , 2014 ) with the sole mandate of reviewing the proposed research methods by researchers to ensure that the methodological pathway is ethical. This is an officially constituted group under the FDA in the USA. This committee is called “Research Ethics Committees” in Spain. This committee assumes the central role in research by approving (or rejecting), monitoring, reviewing social science research involving human participants. The primary aim of the IRB is to conduct a high-level risk-benefit analysis to determine whether research involving humans should be allowed and thus brings no harm and other related risk to the human participants involved ( McNeil, 2014 ).

The purpose of the IRB is to ensure that various steps are taken by the committee to assist in protecting the rights and welfare of the human elements in the research. This means that by the review of the research protocols and other related materials by the IRB, any psychological or physical harm are eliminated ( Alicia, 2009 ). The review process takes the form of assessing the research methods and fully promoting informed consent and voluntary participation by all participants who can make such decisions. The composition of IRB varies among countries; however, it consists of academic scholars and other non-academic scholars which helps to bring a greater scope of understanding and helps to ensure sense of ethics in human-related research. It important to note that the IRB is often applied in health and other social science research which includes sociology, psychology and anthropology. This research often relates to social behaviour, attitude or opinions, as well as research on the quality of health care provided and means of improving the health-care practices.

The growth of research in ethical considerations and debates among qualitative researchers to adapt the IRB reviews to social science research necessitated the formation of specialised ethics committees (as called in the UK) to exclusively oversee social science research investigations. For a better review by the IRB, the specialised ethics committee tries to adequately understand research conducted by social scientists.

It is a usual practice that universities around the world publish all ethical concerns that must be addressed in respective research on their official websites. Students are expected to carefully review such principles and apply to their research. Due to differences or constant changes in culture, all ethical committee members must be subjected to constant training programme to be able to incorporate new and updated cultural changes into the ethical principles for students to be aware. This will help to improve the ethical committee processes. In addition, these ethicists must train teachers or supervisors who oversee the work of research students so that they can acquire the updated and most relevant ethical issues in qualitative research. These supervisors will also teach and explain to students how to apply all needed concerns in ethics. Because ethical concerns are mostly general in most qualitative research, through training programme organised for the students, they become aware to a more narrowed and focused ethical concerns regarding the specific human participants in research. In a cycle of approach, well knowledgeable students on specific ethical issues in qualitative research are more likely to address all ethical concerns before applying for ethical approval. This situation improves the process of the ethics committee and makes their role more effective by responding to students’ applications promptly, because of rightfully responding to all specific ethical concerns. This is illustrated in the framework below ( Figure 1 ).

12. Conclusion

Human beings are at the centre of qualitative research, and the rights of these human participants need to be respected to give out valid information. Researchers conducting a qualitative research investigation must adhere to ethical considerations such as anonymity, voluntary participation, privacy and confidentiality and freedom to walk out in a researcher. Researchers must also make sure consent forms and information sheet are given to the participants to read and agree to take part in a research investigation before conducting interviews. Adhering to ethical considerations in research demonstrate that the research investigation meets the standard of ensuring reliability and validity of findings.

13. Limitations and suggestions for future research

One limitation of this research is it focused on ensuring that the research participants are safe and can give out the right information through tape-recorded interviews. The security nature of the recording device (technology used) can however, exposed the interviewee through device hacking and other cyber-attacks. Further research is therefore recommended to examine the kinds of recording device to use during interview recording to provide data protection from the public and other cyber criminals. The study was also limited to giving a general consent form to the interviewee to sign before the researcher commences the interview. Further research is therefore suggested to explore the content of the consent form to clearly state the most relevant parts that seeks to protect the interviewee. There should also be further research to fully examine the retention and use of recording by the researcher for future studies. This will help to give a measure on how long any interview data recorded should be kept by the researcher before been discarded. In addition, the researcher relied heavily on secondary data that has been collated by other past researchers, and due to the current trends in qualitative research, it is highly suggested that future researcher should adopt the interpretative philosophy using semi-structured interview to fully interact with scholars in qualitative research to uncover any new knowledge about ethics in qualitative research. Research in qualitative studies often overlooks the cultural diversity among participants that helps to understand the worldview of participants. Future research studies should be directed towards exploring how research design in qualitative research should focus on addressing cultural issues in data recoding. This is because there are some tribes or cultures that frowns on recordings and the taking and retention of information after the person’s death. In addition, future research should focus on the effect of training programmes that are organised for the ethics committee and its effects on ethical approval process. In the words, are there any given forums or developmental programmes that are made available to the ethics committee in view of improving knowledge on current ethical concerns and how it has made their role more effective.

A typology of ethical issues in an interview

Source: Authors’ own work

Alderson , P. ( 2000 ), Qualitative Research: A Vital Resource for Ethical Healthcare , The Welcome Trust , London .

Alicia , M. ( 2009 ), “ Coast IRB, caught in sting, to close ”, The Wall Street Journal .

Annas , G.J. and Grodin , M.A. ( 1992 ), The Nazi Doctors and the Nuremberg Code , Oxford University Press , New York, NY .

Beauchamp , T.L. ( 1991 ), Philosophical Ethics: An Introduction to Moral Philosophy , 2nd ed. , McGraw Hill , New York, NY .

Beauchemin , É. , Côté , L.P. , Drolet , M.J. and Williams-Jones , B. ( 2021 ), “ Conceptualizing ethical issues in the conduct of research: results from a critical and systematic literature review ”, Journal of Academic Ethics , Vol. 20 No. 3 , pp. 335 - 358 , doi: 10.1007/s10805-021-09411-7 .

Bickman , L. and Rog , D. ( 2009 ), “ Applied research design: a practical approach ”, in Bickman , L. and Rog , D. (Eds), Handbook of Applied Social Research Methods , 2nd ed. , Sage , Thousand Oaks, CA , pp. 3 - 43 .

Bruhn , J.G. , Zajac , G. , Al-Kazemi , A.A. and Prescott , L.D. ( 2002 ), “ Moral positions and academic conduct: parameters of tolerance for ethics failure ”, The Journal of Higher Education , Vol. 73 No. 4 , pp. 461 - 493 , doi: 10.1353/jhe.2002.0033 .

Cilliers , L. and Viljieon , K. ( 2021 ), “ A framework of ethical issues to consider when conducting internet-based research ”, South African Journal of Information Management , ISSN: 1560-63x, 2078-1865 .

Clark , H.H. ( 1996 ), Using Language , Cambridge University Press , Cambridge .

Collis , J. and Hussey , R. ( 2014 ), Business Research: A Practical Guide for Undergraduate and Postgraduate Students , 4th ed. , Macmillan education; Palgrave .

Colnerud , G. ( 2015 ), “ Ethical dilemmas in research in relation to ethical review: an empirical study ”, Research Ethics , Vol. 10 No. 4 , pp. 238 - 253 , doi: 10.1177/1747016114552339 .

Costa , A.P. and Moreira , A. ( 2019 ), “ Technology ethics in qualitative research: how to be ”, The Qualitative Report , Vol. 24 No. 13 , pp. 1 - 4 .

Creswell , J. and Plano Clark , V. ( 2007 ), Designing and Conducting Mixed Methods Research , Sage , Thousand Oaks, CA .

Crow , G. and Wiles , R. ( 2008 ), “ Managing anonymity and confidentiality in social research: the case of visual data in community research ”, ESRC National centre for research methods .

Davison , J. ( 2004 ), “ Dilemmas in research: issues of vulnerability and disempowerment for the social workers/researcher ”, Journal of Social Work Practice , Vol. 18 No. 3 , pp. 379 - 393 , doi: 10.1080/0265053042000314447 .

Denzin , N. and Lincoln , Y. ( 2011 ), Handbook of Qualitative Research , 4th ed. , Sage , Thousand Oaks, CA .

Drolet , M. , Rose-Derouin , E. , Leblanc , J. , Ruest , M. and Williams-Jones , B. ( 2022 ), “ Ethical issues in research: perceptions of researchers, research ethics board members and research ethics experts ”, Journal of Academic Ethics , Vol. 21 No. 2 , pp. 269 - 292 , doi: 10.1007/s10805-022-09455-3 .

ESOMAR ( 2010 ), “ Current and emerging trends in qualitative research ”, Athens, Greece in combination with congress-Odyssey , Retrieved from: Current And Emerging Trends In Qualitative Research – WebSM (accessed 18 December 2022 ).

Gill , P. , Stewart , K. , Treasure , E. and Chadwick , B. ( 2008 ), “ Methods of data collection in qualitative research: interviews and focus groups ”, British Dental Journal , Vol. 204 No. 6 , pp. 291 - 295 .

Giorgini , V. , Mecca , J.T. , Gibson , C. , Medeiros , K. , Mumford , M.D. , Connelly , S. and Devenport , L.D. ( 2016 ), “ Researcher perceptions of ethical guidelines and codes of conduct ”, Accountability in Research , Vol. 22 No. 3 , pp. 123 - 138 , doi: 10.1080/08989621.2014.955607 .

Grodin , M.A. ( 1992 ), “ Historical origins of the Nuremberg code ”, in Annas , G.J. and Grodin , M.A. (Eds), The Nazi Doctors and the Nuremberg Code: Human Rights in Human Experimentation , Oxford University Press , Oxford .

Guillemin , M. and Gillam , L. ( 2004 ), “ Ethics, reflexivity and ‘ethically important moments’ in research ”, Qualitative Inquiry , Vol. 10 No. 2 , pp. 261 - 280 .

Howard-Grenville , J. , Nelson , A. , Vough , H. and Zilber , T. ( 2021 ), “ From the editors – achieving fit and avoiding misfit in qualitative research ”, Academy of Management Journal , Vol. 64 No. 5 , pp. 1313 - 1323 .

Hursthouse , R. and Pettigrove , G. ( 2018 ), “ Virtue ethics ”, in Zalta , E.N. (Ed.), Stanford Encyclopedia of Philosophy (Winter 2018 ed.) , Metaphysics Research Lab, Stanford University , Retrieved 2021-02-19 .

Kang , E. and Hwang , H. ( 2021 ), “ Ethical conducts in qualitative research methodology; participants observation and interview process ”, Journal of Research and Publication Ethics , Vol. 2 No. 2 , pp. 5 - 10 .

Kara , H. and Pickering , L. ( 2017 ), “ New directions in qualitative research ethics ”, International Journal of Social Research Methodology , Vol. 20 No. 3 , pp. 239 - 241 .

Koski , G. ( 2009 ), “ Ethical issues in translational research and clinical investigation ”, Clinical and Translational Science , Academic Press .

Kozinets , R.V. ( 2002 ), “ The field behind the screen: using netnography for marketing research in online communities ”, Journal of Marketing Research , Vol. 39 No. 1 , pp. 61 - 72 .

Kozinets , R.V. ( 2017 ), “ Management netnography: axiological and methodological developments in online cultural business research ”, The SAGE Handbook of Qualitative Business and Management Research Methods , Sage , London .

Lazar , J. , Feng , J. and Hochheiser , H. ( 2017 ), Research Methods in Human-Computer Interaction , 2nd ed. , Morgan Kaufmann Publishers , Cambridge, MA .

Lynöe , N. , Sandlund , M. and Jacobsson , L. ( 1999 ), “ Research ethics committees: a comparative study of assessment of ethical dilemmas ”, Scandinavian Journal of Public Health , Vol. 27 No. 2 , pp. 152 - 159 .

McCloskey , H.J. ( 1957 ), “ An examination of restricted utilitarianism ”, The Philosophical Review , Vol. 66 No. 4 , pp. 466 - 485 , doi: 10.2307/2182745 .

McNeil , C. ( 2014 ), “ Debate over institutional review boards continues as alternative options emerge ”, JNCI Journal of the National Cancer Institute , Vol. 99 No. 7 , pp. 502 - 503 .

Menzies , T. , Williams , L. and Zimmerman , T. ( 2016 ), Perspectives on Data Science for Software Engineering , Elsevier .

Merriam , S. ( 2009 ), Qualitative Research: A Guide to Design and Implementation , Jossey-Bass , San Francisco, CA .

Mohamadi , A. , Asghari , F. and Rashidian , A. ( 2014 ), “ Continuing review of ethics in clinical trials: a surveillance study in Iran ”, Journal of Medical Ethics and History of Medicine , PMC 4648212. PMID 26587202 , Vol. 7 , p. 22

Mumford , M.D. , Higgs , C. and Gujar , Y. ( 2021 ), “ Ethics in coercive environments: ensuring voluntary participation in research ”, in Panicker , S. and Stanley , B. (Eds), Handbook of Research Ethics in Psychological Science , American Psychological Association , pp. 113 - 123 .

Nambisan , S. , Wright , M. and Feldman , M. ( 2019 ), “ The digital transformation of innovation and entrepreneurship: progress, challenges and key themes ”, Research Policy , Vol. 48 No. 8 , p. 103773 , doi: 10.1016/j.respol.2019.03.018 .

Nuremberg Code ( 1947 ), “ The doctor's trial: the medical case of the subsequent Nuremberg proceedings ”, United States Holocaust Memorial Museum Online Exhibitions , Retrieved from: Nuremberg Code – United States Holocaust Memorial Museum (ushmm.org) (accessed 2 April 2022 ).

Olson , R.G. ( 1967 ), “ Deontological ethics ”, in Edwards , P. (Ed.), The Encyclopedia of Philosophy , Collier Macmillan , London .

Orb , A. , Eisenhauer , L. and Wynaden , D. ( 2000 ), “ Ethics in qualitative research ”, Journal of Nursing Scholarship , Vol. 33 No. 1 , pp. 93 - 96 .

Parkinson , G. and Drislane , R. ( 2011 ), “ Qualitative research. In online dictionary of the social sciences ”, available at: http://bitbucket.icaap.org/dict.pl

Punch , M. ( 1994 ), Politics and Ethics in Qualitative Research. Handbook of Qualitative Research , Sage , Newbery Park, CA .

Reynolds , G.W. ( 2019 ), Ethics in Information Technology , 6th ed. , Cengage Learning .

Roth , W. and von Unger , H. ( 2018 ), “ Current perspectives on research ethics in qualitative research ”, Qualitative Social Research , Vol. 19 No. 3 , pp. 798 - 809 .

Salzman , T.A. ( 1995 ), Deontology and Teleology: An Investigation of the Normative Debate in Roman Catholic Moral Theology , University Press .

Saunders , B. , Kitzinger , J. and Kitzinger , C. ( 2015 ), “ Anonymising interview data: challenges and compromise in practice ”, Qualitative Research , Vol. 15 No. 5 , pp. 616 - 632 .

Saunders , M. , Lewis , P. and Thornhill , A. ( 2016 ), Research Methods for Business Students , 6th ed. , Pearson .

Shaw , W. ( 1998 ), Contemporary Ethics: Taking Account of Utilitarianism , Wiley-Blackwell , ISBN 978-0-631-20294-3 .

Shepherd , D.A. and Gruber , M. ( 2020 ), “ The lean startup framework: closing the academic–practitioner divide ”, Entrepreneurship Theory and Practice , Vol. 45 No. 5 , p. 104225871989941 , doi: 10.1177/1042258719899415 .

Short , J.C. , Ketchen , D.J. , McKenny , A.F. , Allison , T.H. and Ireland , R.D. ( 2017 ), “ Research on crowdfunding: reviewing the (very recent) past and celebrating the present ”, Entrepreneurship Theory and Practice , Vol. 41 No. 2 , pp. 149 - 160 , doi: 10.1111/etap.12270 .

Sievert , C. and Shirley , K.E. ( 2014 ), “ A method for visualizing and interpreting topics ”, Proceedings of the Workshop on Interactive Language Learning, Visualization, and Interfaces , Association for Computational Linguistics , Baltimore, MD , pp. 63 - 70 .

Smith , J. , Flowers , P. and Larkin , M. ( 2009 ), Interpretive Phenomenological Analysis: Theory, Method and Research , Sage , Thousand Oaks, CA .

Stockwell , P. , Colomb , R.M. , Smith , A.E. and Wiles , J. ( 2009 ), “ Use of an automatic content analysis tool: a technique for seeing both local and global scope ”, International Journal of Human-Computer Studies , Vol. 67 No. 5 , pp. 424 - 436 .

Sykora , M. ( 2017 ), “ Web 1.0 to web 2.0: an observational study and empirical evidence for the historical r(evolution) of the social web ”, International Journal of Web Engineering and Technology , Vol. 12 No. 1 , pp. 70 - 94 .

Tom , R. and Richards , L. ( 2003 ), “ The way ahead in qualitative research ”, Journal of Modern Applied Statistical Methods , Vol. 2 No. 1 .

Traer , R. ( 2009 ), Doing Environmental Ethics , Routledge, Taylor and Francis Group .

UK Statistics Authority ( 2022 ), “ Ethical considerations associated with qualitative research methods ”, available at: https://uksa.statisticsauthority.gov.uk/publication/ethical-considerations-associated-with-qualitative-research-methods/pages/2/ ( accessed 24 April 2023 ).

Van Burg , E. , Cornelissen , J. , Stam , W. and Jack , S. ( 2022 ), “ Advancing qualitative entrepreneurship research: leveraging methodological plurality for achieving scholarly impact ”, Entrepreneurship Theory and Practice , Vol. 46 No. 1 , pp. 3 - 20 .

Waller , B.N. ( 2005 ), Consider Ethics: Theory, Readings, and Contemporary Issues , Pearson Longman , New York, NY .

Williams-Jones , B. , Potvin , M.J. , Mathieu , G. and Smith , E. ( 2013 ), “ Barriers to research on research ethics review and conflicts of interest ”, IRB: Ethics and Human Research , Vol. 35 No. 5 , pp. 14 - 20 .

Wilson , S. , Draper , H. and Ives , J. ( 2008 ), “ Ethical issues regarding recruitment to research studies within the primary care consultation ”, Family Practice , Vol. 25 No. 6 , pp. 456 - 461 .

Zamawe , F.C. ( 2015 ), “ The implication of using NVivo software in qualitative data analysis: evidence-based reflections ”, Malawi Medical Journal , Vol. 27 No. 1 , pp. 13 - 15 .

Corresponding author

Related articles, we’re listening — tell us what you think, something didn’t work….

Report bugs here

All feedback is valuable

Please share your general feedback

Join us on our journey

Platform update page.

Visit emeraldpublishing.com/platformupdate to discover the latest news and updates

Questions & More Information

Answers to the most commonly asked questions here

No internet connection.

All search filters on the page have been cleared., your search has been saved..

All content
Dictionaries
Encyclopedias
Expert Insights
Foundations
How-to Guides
Journal Articles
Little Blue Books
Little Green Books
Project Planner
Tools Directory
Sign in to my profile My Profile

Sign in Signed in
My profile My Profile

Offline Playback link

Have you created a personal profile? sign in or create a profile so that you can create alerts, save clips, playlists and searches.

Research Ethics for Qualitative Interviewing

Watching now: Chapter 1: Bethany Morgan Brett Discusses the Ethical Principle of Do No Harm Start time: 00:00:00 End time: 00:01:24
Chapter 2: Bethany Morgan Brett Discusses the Ethical Principle of Informed Consent Start time: 00:01:25 End time: 00:10:18
Chapter 3: Bethany Morgan Brett Discusses the Ethical Principle of Confidentiality and Anonymity Start time: 00:10:19 End time: 00:13:39

Video Type: Tutorial

Morgan Brett, B. (Academic). (2022). Research ethics for qualitative interviewing [Video]. Sage Research Methods. https:// doi. org/10.4135/9781529792034

Morgan Brett, Bethany. "Research Ethics for Qualitative Interviewing." In Sage Video . : SAGE Publications, Ltd., 2022. Video, 00:13:39. https:// doi. org/10.4135/9781529792034.

Morgan Brett, B., 2022. Research Ethics for Qualitative Interviewing , Sage Video. [Streaming Video] London: Sage Publications Ltd. Available at: <https:// doi. org/10.4135/9781529792034 & gt; [Accessed 2 Apr 2024].

Morgan Brett, Bethany. Research Ethics for Qualitative Interviewing . Online video clip. SAGE Video. London: SAGE Publications, Ltd., 5 Aug 2021. doi: https:// doi. org/10.4135/9781529792034. 2 Apr 2024.

Research Ethics for Qualitative Interviewing [Streaming video]. 2022. doi:10.4135/9781529792034. Accessed 04/02/2024

Please log in from an authenticated institution or log into your member profile to access the email feature.

Add this content to your learning management system or webpage by copying the code below into the HTML editor on the page. Look for the words HTML or </>. Learn More about Embedding Video icon link (opens in new window)

Sample View:

This is an image of a Sage Research Methods video on a Learning Management System

Download PDF opens in new window
icon/tools/download-video icon/tools/video-downloaded Download video Downloading... Video downloaded

Supplementary material

Dr. Bethany Morgan Brett, PhD, Lecturer in Psychosocial and Psychoanalytic Studies at the University of Essex, discusses research ethics for qualitative interviews, including the principles: do no harm, informed consent (forms, written, and verbal), and confidentiality and anonymity.

Chapter 1: Bethany Morgan Brett Discusses the Ethical Principle of Do No Harm

Start time: 00:00:00
End time: 00:01:24

Chapter 2: Bethany Morgan Brett Discusses the Ethical Principle of Informed Consent

Start time: 00:01:25
End time: 00:10:18

Chapter 3: Bethany Morgan Brett Discusses the Ethical Principle of Confidentiality and Anonymity

Start time: 00:10:19
End time: 00:13:39
Product: Sage Research Methods Video: Research Ethics and Integrity
Type of Content: Tutorial
Title: Research Ethics for Qualitative Interviewing
Publisher: SAGE Publications, Ltd.
Publication year: 2022
Online pub date: August 05, 2021
Discipline: Psychology
Methods: Research ethics , Qualitative interviewing , Informed consent , Consent , Vulnerable groups , Anonymity
Duration: 00:13:39
DOI: https:// doi. org/10.4135/9781529792034
Keywords: anonymity , beneficence , confidentiality , consent forms , data collection , data mining , data protection , ethical considerations , harm reduction , informed consent , informed consent by minors , participatory research , qualitative interview , research ethics , verbal communication , vulnerable populations , written communication Show all Show less

Academic: Bethany Morgan Brett

Further Reading ( 2017 ). Statement of Ethical Practice . British Sociological Association , https://www.britsoc.co.uk/media/24310/bsa_statement_of_ethical_practice.pdf

Further Reading Research data management . UK Data Service , https://ukdataservice.ac.uk/learning-hub/research-data-management/

Sign in to access this content

Get a 30 day free trial, more like this, sage recommends.

We found other relevant content for you on other Sage platforms.

Have you created a personal profile? Login or create a profile so that you can save clips, playlists and searches

Navigating away from this page will delete your results

Please save your results to "My Self-Assessments" in your profile before navigating away from this page.

You must have a valid academic email address to sign up.

Get off-campus access

View or download all content my institution has access to.

view my profile
view my lists

Have a language expert improve your writing

Run a free plagiarism check in 10 minutes, generate accurate citations for free.

Knowledge Base

Methodology

Types of Interviews in Research | Guide & Examples

Types of Interviews in Research | Guide & Examples

Published on March 10, 2022 by Tegan George . Revised on June 22, 2023.

An interview is a qualitative research method that relies on asking questions in order to collect data . Interviews involve two or more people, one of whom is the interviewer asking the questions.

There are several types of interviews, often differentiated by their level of structure.

Structured interviews have predetermined questions asked in a predetermined order.
Unstructured interviews are more free-flowing.
Semi-structured interviews fall in between.

Interviews are commonly used in market research, social science, and ethnographic research .

What is a structured interview, what is a semi-structured interview, what is an unstructured interview, what is a focus group, examples of interview questions, advantages and disadvantages of interviews, other interesting articles, frequently asked questions about types of interviews.

Structured interviews have predetermined questions in a set order. They are often closed-ended, featuring dichotomous (yes/no) or multiple-choice questions. While open-ended structured interviews exist, they are much less common. The types of questions asked make structured interviews a predominantly quantitative tool.

Asking set questions in a set order can help you see patterns among responses, and it allows you to easily compare responses between participants while keeping other factors constant. This can mitigate research biases and lead to higher reliability and validity. However, structured interviews can be overly formal, as well as limited in scope and flexibility.

You feel very comfortable with your topic. This will help you formulate your questions most effectively.
You have limited time or resources. Structured interviews are a bit more straightforward to analyze because of their closed-ended nature, and can be a doable undertaking for an individual.
Your research question depends on holding environmental conditions between participants constant.

Prevent plagiarism. Run a free check.

Semi-structured interviews are a blend of structured and unstructured interviews. While the interviewer has a general plan for what they want to ask, the questions do not have to follow a particular phrasing or order.

Semi-structured interviews are often open-ended, allowing for flexibility, but follow a predetermined thematic framework, giving a sense of order. For this reason, they are often considered “the best of both worlds.”

However, if the questions differ substantially between participants, it can be challenging to look for patterns, lessening the generalizability and validity of your results.

You have prior interview experience. It’s easier than you think to accidentally ask a leading question when coming up with questions on the fly. Overall, spontaneous questions are much more difficult than they may seem.
Your research question is exploratory in nature. The answers you receive can help guide your future research.

An unstructured interview is the most flexible type of interview. The questions and the order in which they are asked are not set. Instead, the interview can proceed more spontaneously, based on the participant’s previous answers.

Unstructured interviews are by definition open-ended. This flexibility can help you gather detailed information on your topic, while still allowing you to observe patterns between participants.

However, so much flexibility means that they can be very challenging to conduct properly. You must be very careful not to ask leading questions, as biased responses can lead to lower reliability or even invalidate your research.

You have a solid background in your research topic and have conducted interviews before.
Your research question is exploratory in nature, and you are seeking descriptive data that will deepen and contextualize your initial hypotheses.
Your research necessitates forming a deeper connection with your participants, encouraging them to feel comfortable revealing their true opinions and emotions.

A focus group brings together a group of participants to answer questions on a topic of interest in a moderated setting. Focus groups are qualitative in nature and often study the group’s dynamic and body language in addition to their answers. Responses can guide future research on consumer products and services, human behavior, or controversial topics.

Focus groups can provide more nuanced and unfiltered feedback than individual interviews and are easier to organize than experiments or large surveys . However, their small size leads to low external validity and the temptation as a researcher to “cherry-pick” responses that fit your hypotheses.

Your research focuses on the dynamics of group discussion or real-time responses to your topic.
Your questions are complex and rooted in feelings, opinions, and perceptions that cannot be answered with a “yes” or “no.”
Your topic is exploratory in nature, and you are seeking information that will help you uncover new questions or future research ideas.

Receive feedback on language, structure, and formatting

Professional editors proofread and edit your paper by focusing on:

Academic style
Vague sentences
Style consistency

See an example

Depending on the type of interview you are conducting, your questions will differ in style, phrasing, and intention. Structured interview questions are set and precise, while the other types of interviews allow for more open-endedness and flexibility.

Here are some examples.

Semi-structured
Unstructured
Focus group
Do you like dogs? Yes/No
Do you associate dogs with feeling: happy; somewhat happy; neutral; somewhat unhappy; unhappy
If yes, name one attribute of dogs that you like.
If no, name one attribute of dogs that you don’t like.
What feelings do dogs bring out in you?
When you think more deeply about this, what experiences would you say your feelings are rooted in?

Interviews are a great research tool. They allow you to gather rich information and draw more detailed conclusions than other research methods, taking into consideration nonverbal cues, off-the-cuff reactions, and emotional responses.

However, they can also be time-consuming and deceptively challenging to conduct properly. Smaller sample sizes can cause their validity and reliability to suffer, and there is an inherent risk of interviewer effect arising from accidentally leading questions.

Here are some advantages and disadvantages of each type of interview that can help you decide if you’d like to utilize this research method.

If you want to know more about statistics , methodology , or research bias , make sure to check out some of our other articles with explanations and examples.

Student’s t -distribution
Normal distribution
Null and Alternative Hypotheses
Chi square tests
Confidence interval
Quartiles & Quantiles
Cluster sampling
Stratified sampling
Data cleansing
Reproducibility vs Replicability
Peer review
Prospective cohort study

Research bias

Implicit bias
Cognitive bias
Placebo effect
Hawthorne effect
Hindsight bias
Affect heuristic
Social desirability bias

The four most common types of interviews are:

Structured interviews : The questions are predetermined in both topic and order.
Semi-structured interviews : A few questions are predetermined, but other questions aren’t planned.
Unstructured interviews : None of the questions are predetermined.
Focus group interviews : The questions are presented to a group instead of one individual.

The interviewer effect is a type of bias that emerges when a characteristic of an interviewer (race, age, gender identity, etc.) influences the responses given by the interviewee.

There is a risk of an interviewer effect in all types of interviews , but it can be mitigated by writing really high-quality interview questions.

Social desirability bias is the tendency for interview participants to give responses that will be viewed favorably by the interviewer or other participants. It occurs in all types of interviews and surveys , but is most common in semi-structured interviews , unstructured interviews , and focus groups .

Social desirability bias can be mitigated by ensuring participants feel at ease and comfortable sharing their views. Make sure to pay attention to your own body language and any physical or verbal cues, such as nodding or widening your eyes.

This type of bias can also occur in observations if the participants know they’re being observed. They might alter their behavior accordingly.

A focus group is a research method that brings together a small group of people to answer questions in a moderated setting. The group is chosen due to predefined demographic traits, and the questions are designed to shed light on a topic of interest. It is one of 4 types of interviews .

Quantitative research deals with numbers and statistics, while qualitative research deals with words and meanings.

Quantitative methods allow you to systematically measure variables and test hypotheses . Qualitative methods allow you to explore concepts and experiences in more detail.

Cite this Scribbr article

If you want to cite this source, you can copy and paste the citation or click the “Cite this Scribbr article” button to automatically add the citation to our free Citation Generator.

George, T. (2023, June 22). Types of Interviews in Research | Guide & Examples. Scribbr. Retrieved April 2, 2024, from https://www.scribbr.com/methodology/interviews-research/

Is this article helpful?

Tegan George

Other students also liked, unstructured interview | definition, guide & examples, structured interview | definition, guide & examples, semi-structured interview | definition, guide & examples, unlimited academic ai-proofreading.

✔ Document error-free in 5minutes ✔ Unlimited document corrections ✔ Specialized in correcting academic texts

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Publications
Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

Advanced Search
Journal List
Afr J Emerg Med
v.10(Suppl 2); 2020

Principles of research ethics: A research primer for low- and middle-income countries

Cindy c. bitter.

a Saint Louis University School of Medicine, Division of Emergency Medicine, St. Louis MO, USA

Annet Alenyo Ngabirano

b Aga Khan University, Kampala, Uganda

e Makerere University College of Health Sciences, Kampala, Uganda

Erin L. Simon

c Cleveland Clinic Akron General, Department of Emergency Medicine, Akron, OH, USA

f Northeast Ohio Medical University, Rootstown, OH, USA

David McD. Taylor

d University of Melbourne, Department of Medicine, Parkville, Victoria, Australia

g Austin Health, Heidelburg, Victoria, Australia

Ethical oversight in the form of review boards and research ethics committees provide protection for research subjects as well as guidance for safe conduct of studies. As the number of collaborative emergency care research studies carried out in low- and middle-income countries increases, it is crucial to have a shared understanding of how ethics should inform choice of study topic, study design, methods of obtaining consent, data management, and access to treatment after closure of the study. This paper describes the basic principles of Western research ethics – respect for persons, beneficence, and justice - and how the principles may be contextualized in different settings, by researchers of various backgrounds with different funding streams. Examples of lapses in ethical practice of research are used to highlight best practices.

African relevance

• Low and middle income countries (LMICs) have a high burden of acute illness, but insufficient research on emergency care
• Ethical barriers and lack of oversight impede emergency care research in LMICs
• Ethical clinical research in LMICs builds capacity and contributes to the evidence base for emergency care

The International Federation for Emergency Medicine global health research primer

This paper forms part 7 of a series of how to papers, commissioned by the International Federation for Emergency Medicine. This primer discusses ways to ensure that research is carried out ethically. It discusses principles for researchers from the global north involved in emergency care research projects in LMICs and provides guidance for LMIC researchers who may not have experience for navigating ethical issues in research. We have also included additional tips and pitfalls that are relevant to emergency medicine researchers.

Despite a disproportionally high burden of acute illnesses in low-and middle-income countries (LMICs), there is insufficient emergency care research. In a survey carried out through the African Federation for Emergency Medicine (AFEM), 67.3% of respondents agreed with this statement [ 1 ]. Research that targets local health challenges, such as context-specific health service delivery and drug development for diseases prevalent in LMIC, has the potential to improve population health in host countries [ [2] , [3] , [4] ].

Ethical barriers and oversight have been cited as an important barrier to research in LMIC [ 5 ]. Emanuel et al. provided a framework for conducting ethical research that stressed collaborative partnerships, social value, scientific validity, fair selection of study populations, favourable risk-benefit ratio, independent review, informed consent, and respect for recruited participants and study communities [ 6 ]. In their review of the framework, Tsoka-Gwegweni and colleagues concluded that most recurring ethical issues relating to research in LMICs were informed consent, scientific validity, fair participant selection and on-going respect for participants [ 7 ]. Research priorities are often determined outside the host country, raising concerns of outsourcing risk and exploitation of uninformed populations [ 8 ].

The value of building ethical clinical research in LMICs goes beyond the specific information collected in a study. Conducting research has substantial positive impact in a community by raising local scholarly standards and encouraging independent thinking and creativity as many LMICs work towards building evidence-based emergency care systems. Each project builds confidence and skills which allows local researchers to participate fully in the scientific process which impacts the care of their local community. This may lead to intellectual and financial resources for the community which in turn encourages local empowerment and self-sufficiency for additional research.

Bioethical principles

Review of research protocols by experts not involved with the study is one way of ensuring protection for human research subjects. In the United States of America (US), such review committees are called Institutional Review Boards (IRBs). In other countries, these committees may be called Human Research Ethics Committees (HREC) or have other titles. Several articles discuss the evolution of HRECs in sub Saharan Africa [ 9 , 10 ].

Most Western scholars agree on the main principles of autonomy, beneficence, and justice for clinical ethics, with some adjustments in how these principles are applied in the research setting. However, these principles are not universally acknowledged. Some authors argue that these principles are less relevant in populations where community rather than individual values are stressed. Others argue that local development of research ethics is crucial to ensuring buy-in and avoiding bioethical imperialism [ 11 , 12 ]. Acknowledging the past abuses that took place under the guise of research, Western ethical thought now insists on voluntary consent, with special protections for traditionally vulnerable populations such as children, women, and ethnic minorities. Emergency care research, however, introduces a unique type of vulnerability in unconscious or other otherwise mentally altered patients who do not meet criteria for giving informed consent. In some Western countries like the US and the United Kingdom (UK), such patients may still be enrolled in studies through a different process called an exemption from informed consent or waiver of consent [ [13] , [14] , [15] ]. The same principle may be applied in LMICs, however, a detailed assessment of the research components necessary to guide HRECs in order to reach decisions that protect this vulnerable group from harm or unnecessary risk.

International standards

In 1964, the World Medical Association adopted the Declaration of Helsinki. This document and subsequent revisions lay out the principles of minimizing risks, informed consent, privacy, special protections for vulnerable groups, access to beneficial treatment after trial, and dissemination [ 16 ]. The first Declaration was adopted largely in response to the unethical experiments carried out by Nazi researchers during the Holocaust, in which prisoners were exposed to infectious disease, extremes of temperature, and experimental drugs without their consent, often resulting in death [ 17 ].

The Declaration is a guideline of research ethics but is not legally binding. Individual countries are responsible for implementing legislation that reflects the principles. In the United States, discovery of ongoing research abuses such as the Tuskegee syphilis study in the 1970's led to adoption of the Belmont Report [ 18 ]. The Belmont Report requires that researchers uphold three basic principles: respect for persons, beneficence, and justice. Researchers in the US must have the protocol approved by an IRB prior to enrolling subjects. IRBs are charged with operationalizing the principles outlined in the Belmont Report and subsequent regulations specified in the Common Rule [ 19 ]. Certain research may be exempted from IRB review and these typically include surveys, interviews, and research using existing specimens, records or data. The concept of “minimal risk to participants” plays a key role in allowing this exemption and should be considered when conducting research in LMIC's. “Minimal risk” is defined as that “ordinarily encountered in daily life or the performance of routine physical and psychological testing.”

These previous regulations, however, were written without consideration for Emergency Care research. Therefore in 1996, the US' Food and Drug Administration recommended procedures for enrolling patients in emergency situations into research studies through exemption of informed consent [ 20 ]. Similar procedures were adopted by the United Kingdom in 2006 [ 21 ]. This concept of “waiver of consent” in emergency care research should be considered in LMICs where contextualized processes are critical for development of sustainable emergency care systems.

Guidelines intended for global adoption often lack details required for context-specific implementation and can be slow to respond to emerging realities. Barugahare uses an analogy to jurisprudence to discuss how local HRECs can guide implementation of global ethical principles within their own contexts [ 22 ]. With that in mind, we will go through the guiding principles and discuss pitfalls in implementation.

Respect for persons

Respect for persons requires that research subjects freely participate in research after informed consent. Subjects should be counselled on the known risks of the drug or treatment being examined, the expected course of illness without intervention, and any compensation or benefit they may receive from participating. This must occur in the subjects' native language. If documents require translation from the researchers' language to the local language, the documents should be translated back to the original language and reviewed to ensure consistency with the originals. Only after the subject has shown comprehension and has had any questions answered can they be considered to have given informed consent. There is some disagreement about the need for a signature on a consent form, but researchers must treat consent as an ongoing process rather than a piece of paper. Subjects must also understand they are free to withdraw from the study at any time.

Research in the global context highlights challenges to the notion of consent. In the global north, the concept of respect for persons is often supplanted by the principle of autonomy. But many cultures outside the global north stress the importance of the family unit and communitarian values over individual decisions [ 23 ]. Community leaders and heads-of-household should be involved in the process, often before approaching individual subjects [ 24 ]. This is especially critical in emergency situations where “waiver of consent” protocols require involvement of family or communities of unconscious or otherwise incapacitated patients. Consent processes may also be challenging when approaching female subjects, who may require approval of a male head of household in addition to their own consent [ [25] , [26] , [27] ]. While 18 years is considered the age of adulthood in many Western countries, other cultures may consider younger persons to have reached maturity [ 28 , 29 ]. In one qualitative study of 15–19 year old participants in HIV research in Kenya, 50% thought parental consent should be sought, 25% felt this was not necessary, and 25% had mixed feelings [ 30 ].

Lack of education, limited health literacy, poor access to medical care, and the sense of urgency that accompanies disease outbreaks also call into question the notion of voluntary, informed consent. The Pfizer meningitis trial in Nigeria reported that 100% of patients approached were enrolled in the protocol, suggesting patients were desperate to access care [ 31 ]. All participants in a clinical trial for malaria believed procedures followed solely to meet research objectives were a required part of their individual curative treatment [ 32 ]. Some participants in an Ebola vaccine trial enrolled in hopes of accessing free healthcare for other conditions [ 33 ].

Beneficence

Beneficence requires that researchers obtain scientifically valid data with useful applications, while minimizing risks within the study protocol and protecting subjects during the trial.

Although several guidelines recommend research in LMIC focus on health conditions that contribute substantially to the local burden of disease, research objectives are set by funders and do not always meet this guideline. Research on cancer therapeutics focuses on lung and breast cancer, even when trials are performed in LMIC which have a large burden of cervical, liver and gastric cancers [ 34 ]. While some risk is unavoidable when testing new drugs, research subjects should expect benefits to accrue for their population.

Use of rigorous methodology with adequate power and appropriate control groups is essential to ethical research. Underpowered research, poorly designed studies, and falsified data will not yield valid results and are inherently unethical. The use of placebo controls has been an area of contention since early studies of maternal-fetal transmission of HIV [ 35 ]. While placebo-controlled trials are optimal from a methodological standpoint, patients should be treated with their standard local regimen if effective treatment is available. Cheah et al. provide a compelling rationale for a placebo arm in their malaria trial, as use of the placebo is equivalent to current clinical practice, thus the subjects do not incur additional risk [ 36 ]. Researchers should ensure that interventions proven successful will be sustainable in their study population [ 37 ].

Unproven interventions may be utilized during emergency and disaster situations. The World Health Organization convened a panel to help guide use of novel therapies during epidemics [ 38 ]. They stress the importance rigorous data collection to assess effectiveness and safety of such interventions, and transparency and fairness in decisions regarding access to investigational treatments.

Minimizing risk means building safety into the protocol and monitoring for adverse events throughout the trial. Adverse events may require unblinding, a report to the HREC, or cessation of the trial. Dissemination of all results, regardless of the success of the trial, is crucial to ensure future study participants are not exposed to risks of unsuccessful interventions and funding can be distributed to projects more likely to result in improved health [ 39 ].

Protection of privacy is another important principle of beneficence. Data should only be accessible to the research team. Surveys and other paper documents must be kept in a locked cabinet or drawer in a secure room. Files should be password protected. Study ID numbers should be substituted for individual identifiers. Master lists that could be used to link data back to participants should be destroyed after data is cleaned. Data must be de-identified before sharing data with anyone outside the original study team. Data-sharing is important for verification of results and avoidance of duplicate efforts, but regulations and guidelines have not kept pace with emerging technologies [ 40 , 41 ]. Privacy laws vary widely between countries, with the European Union having some of the strictest protections. Although it would seem that outside researchers would adhere to the standards they must uphold to in their own settings, this is not always the case. Medical students from the US are more likely to violate patients' privacy online during international electives than during rotations at home [ 42 ].

Justice requires that the costs and benefits of research are distributed fairly within the population. Even this statement is open to interpretation, as there are no global norms of fairness [ 43 ]. Justice is a key consideration in the research framework proposed by Pratt and Loff [ 44 ].

The global distribution of harms and benefits in research is particularly problematic in the setting of clinical trials. The cost of research is significantly lower in LMIC but there is concern that pharmaceutical companies are also benefitting from lax regulatory oversight to conduct high-risk research that would not be tolerated in the global north [ 45 ]. Millions of persons participate in clinical research each year, but the number of adverse events is difficult to determine and likely underreported [ 46 , 47 ]. Deaths in clinical trials are not distributed evenly across nations, with higher rates of morbidity and mortality in LMIC. While deaths in the global north tend to be rare and highly publicized, India had 2644 deaths during clinical trials in the years 2005–12 [ 48 ]. Laws regarding compensation for injuries sustained during research are markedly different between nations, adding another layer of disparities [ 49 ].

Compensation for participation in research is another potential pitfall. Western research ethics considers whether compensation for participation is enough to exert undue influence or coercion. Paradoxically, using this standard in LMIC research would decrease the value of compensation as smaller amounts would likely constitute a larger proportion of subjects' income [ 50 ]. Participation “gifts” of nominal value, such as soap or sugar, may carry hidden meanings in the local context and should be discussed with community leaders [ 51 ]. One proposed solution would be to consider participation as work, to be compensated according to local custom [ 52 ].

A final area of justice concerns authorship of manuscripts. There is an inherent imbalance of power when outsiders approach a community to do research. Researchers should strive to build capacity in local communities and ensure all members of the study team receive appropriate credit. The International Committee of Medical Journal Editors requires the following criteria be met to be listed as an author: contributions to study design, data acquisition, or data analysis, drafting or substantial revisions to the manuscript, final approval of submission, and agreement to be accountable for integrity of the work [ 53 ]. All persons who meet these criteria should be listed. Guest authorship has been reported as common and usually involves including superiors or subject experts that did not contribute substantially to the manuscript [ 54 ]. Some authors fear that the criteria to draft/substantially revise and approve the final document discriminates against researchers from LMIC whose native language is not commonly used for international publications [ 55 ]. Determination of authorship and order of authors may cause great angst, particularly if not done early in the process.

Emerging challenges

Data security.

Collection of genetic material, even blood samples, may jeopardize anonymity. Consensus is lacking on how best to use “big data” to improve public health while protecting individual privacy concerns.

Tips on this topic

• Research in LMICs, contextualized to their local health systems, is necessary to ensure patients receive the most appropriate care.
• Researchers should ensure sound methodology and data management practices in their studies.
• Community engagement is one way of ensuring patients' values are incorporated into setting research priorities, the consent process, risk assessment, and dissemination of results.
• HRECs have a responsibility to protect human subjects but also serve to protect researchers from allegations of improper behaviour. Ethical approval for a protocol is required before researchers approach participants and is required for publication by most journals.

Pitfalls to avoid

• Failure to consider local norms in obtaining informed consent
• Failure to execute the study in exact accordance with the approved study protocol and other documentation may undermine the ethical integrity of the project and violate the ethical principles of research. Any changes to approved study protocols must be reviewed and approved by the local HREC prior to adoption.
• Inadequate procedures for confidentiality and data security

Annotated bibliography

• Biruk [ 51 ] uses the example of soap as a gift for participation in surveys to discuss ethical compensation for participants and duties of researchers.
• Das et al. [ 32 ] discuss participants' limited understanding of the overlap of clinical care and research in malaria studies.
• Emanuel et al. [ 6 ] established benchmarks for ethical research in the global setting.
• The WHO advisory panel report [ 38 ] and Ezeome and Simon [ 31 ] discuss ways of minimizing ethical pitfalls when performing research during epidemics – these articles are applicable to the discussion of experimental treatments for the ongoing COVID-19 pandemic.
• Groves et al. [ 30 ] used qualitative methods to explore adolescents' views on research requirements for parental involvement in studies of HIV in youth.
• Ochieng et al. [ 10 ] describe the development of research ethics within Uganda, starting with early regulations on protection of human subjects, through revisions to applicable statues, and training of local experts.
• Tangwa [ 8 ] critiques the lack of inclusion of African researchers in the efforts surrounding HIV vaccine trials and the response to the Ebola outbreak of 2013–16.
• World Medical Association Declaration of Helsinki [ 16 ] describes the principles that should guide research. Most recent version available at https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/ .

Academic Life in Emergency Medicine: Society for Academic Emergency Medicine Research Learning Series provides helpful guidance for junior researchers in many stages of starting a research project. In particular, episode 3 deals with IRB pitfalls and episode 8 discusses waivers from informed consent.

University of Oxford Global Health podcast has an interview with Dr. Phaik Yeong Cheah on the ethics of research in vulnerable populations (Oct 5, 2015).

Authors' contribution

Authors contributed as follow to the conception or design of the work; the acquisition, analysis, or interpretation of data for the work; and drafting the work or revising it critically for important intellectual content: CB contributed 50%; AAN contributed 30%; and ES and DMT contributed 10% each. All authors approved the version to be published and agreed to be accountable for all aspects of the work.

Declaration of competing interest

The authors declared no conflicts of interest.

Research ethics guidance - ESRC

Our framework for research ethics helps you to consider ethics issues during the complete lifecycle of a project and includes information and guidelines on good research conduct and governance.

Our policy and guidelines for good research conduct

Find out about your responsibilities to carry out research to the highest scientific and ethical standards

Framework for research ethics

Find out about our principles, commitment, terms and conditions and when to contact us

Researchers and research teams

Our principles and expectations for research collaboration

What to expect as a research participant

Find out how researchers should treat you if you are participating in their research

Risk and benefit

Answers to commonly asked questions about risk and benefit

Answers to commonly asked questions about consent

Internet mediated research

Learn about the specific ethical considerations when using the internet and social media for research

Research with children and young people

Considerations when using children in research

Research with potentially vulnerable people

Considerations when using vulnerable people in research

International research

What should you consider if your research has an international dimension

Data requirements

Your responsibilities when gathering and sharing data

Research organisations and research ethics committees

Build and maintain appropriate structures and support for good practice

Ethics reviews

Ensure your ethical approach is properly reviewed

Ethics statement examples

Read ethics statements from successful applications

Useful resources

Useful links to ethical codes, forms and templates and guidance

This is the website for UKRI: our seven research councils, Research England and Innovate UK. Let us know if you have feedback or would like to help improve our online products and services .

Open access
Published: 27 March 2024

Exploring health and disease concepts in healthcare practice: an empirical philosophy of medicine study

Rik R. van der Linden ORCID: orcid.org/0000-0002-9642-3715 1 &
Maartje H.N. Schermer ORCID: orcid.org/0000-0003-4283-9659 1

BMC Medical Ethics volume 25 , Article number: 38 ( 2024 ) Cite this article

94 Accesses

Metrics details

In line with recent proposals for experimental philosophy and philosophy of science in practice, we propose that the philosophy of medicine could benefit from incorporating empirical research, just as bioethics has. In this paper, we therefore take first steps towards the development of an empirical philosophy of medicine, that includes investigating practical and moral dimensions. This qualitative study gives insight into the views and experiences of a group of various medical professionals and patient representatives regarding the conceptualization of health and disease concepts in practice and the possible problems that surround them. This includes clinical, epistemological, and ethical issues. We have conducted qualitative interviews with a broad range of participants ( n = 17), working in various health-related disciplines, fields and organizations. From the interviews, we highlight several different practical functions of definitions of health and disease. Furthermore, we discuss 5 types of problematic situations that emerged from the interviews and analyze the underlying conceptual issues. By providing theoretical frameworks and conceptual tools, and by suggesting conceptual changes or adaptations, philosophers might be able to help solve some of these problems. This empirical-philosophical study contributes to a more pragmatic way of understanding the relevance of conceptualizing health and disease by connecting the participants’ views and experiences to the theoretical debate. Going back and forth between theory and practice will likely result in a more complex but hopefully also better and more fruitful understanding of health and disease concepts.

Peer Review reports

In the philosophy of medicine, scholars have primarily addressed ‘health’ and ‘disease’ as theoretical concepts without exploring their actual use in practice all too much. Yet, it has been argued that the way we conceptualize health and disease also affects the practical and moral dimension of medicine [ 1 , 2 ]. While many philosophers recognize the practical consequences of defining health and disease in certain ways, most still tend to depart from theory to determine how health and disease should be defined. In the traditional analytical debate, only limited attention has been paid to the ways in which these concepts are embedded in the various practices they are deployed in. In the medical-philosophical literature, the conceptual, epistemic and bioethical issues associated with proposed disease-definitions, such as medicalization and overdiagnosis, have been primarily addressed as theoretical problems, often lacking contextualization and empirical foundation. Consequently, it is often not clear to what extent such conceptual issues are in fact experienced as problematic in practice and for whom exactly this is a problem. While it is increasingly recognized that the traditional method of conceptual analysis is ill-equipped to answer the various normative, ontological and epistemological questions surrounding the conceptualization of health and disease [ 2 , 3 , 4 ], new philosophical perspectives and research methods have to yet to be explored.

In recent contributions to the debate, several promising proposals have been made for a new direction, in which health and disease are viewed as plural concepts that need to be specified [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. Instead of formulating definitions on monistic grounds, it is proposed to continue the debate by philosophical explication [ 4 , 10 ], and by developing precising definitions [ 12 ]. This is important as concepts may serve various practical functions and are deployed in diverse contexts. As different practices may have different values, goals, and priorities, different types of definitions may be needed [ 7 ]. Moreover, we have recently suggested that we should assess the successfulness of concept definitions in relation to the function they serve in the context they are deployed in [ 5 ]. This shift towards a pragmatist stance requires scholars to look beyond theoretical arguments and to explore the various practical motivations of defining health and disease. Hence, when explicating concepts, it seems important to complement the theoretical debate by empirically studying the use of concepts in practice.

In contrast to the field of bioethics where empirical methods are commonly used to research attitudes, beliefs and perspectives of certain groups of people, empirical research is only seldomly conducted in philosophical studies on health, disease, and related concepts. Adding these methods to our philosophical toolbox enables us to investigate more closely how concepts of health and disease operate in medical practice and to explore what kind of problems occur in relation to them. We could use existing socio-empirical studies that, for example, investigate psychosocial and cultural aspects of certain diseases (e.g., see [ 13 ]), that review definitions and meanings of certain medical or bioethical concepts (e.g., see [ 14 , 15 ]), or that explore patients’ and professionals’ views towards certain research programs or medical developments (e.g., see [ 16 ]). Both quantative and qualitative methods can be useful, depending on the research question at stake. However, as we propose in this paper, besides making use of existing empirical literature, we can also conduct empirical philosophy of medicine studies that aim to explore philosophical questions head-on.

Referring to debates on empirical ethics, Seidlein & Salloch [ 17 ] recently argued that the reconciliation of perspectives in the philosophy of medicine and socio-empirical research will lead to a more nuanced discussion that includes experiences of patients. Drawing on Alexander Kon’s [ 18 ] pragmatic classification of empirical methods, they argue that this approach may be used to investigate current practices (‘Lay of the Land’), revealing differences between illness conceptions in different groups of people, or between notions of ‘disease’ and ‘illness’. Such studies may improve patient-centered and shared decision-making, as it becomes clearer ‘what’ should be treated (cf. [ 19 ]). In addition to this, we argue that studying the views, attitudes and beliefs of medical researchers, clinicians and other healthcare stakeholders, seems important for obtaining a better and wider understanding of how health and disease concepts are used in actual practice and why they are conceptualized in certain ways. This proposal for incorporating tools and methods of the social sciences in philosophical work on health and disease concepts resonates with calls for experimental philosophy of medicine Footnote 1 [ 20 , 21 ], and for more ‘philosophy of science in practice’ [ 22 , 23 ].

While there have not been many studies focused particularly on health and disease concepts in which empirical methods are used, some exceptions should be mentioned here. In Hofmann [ 24 ], physicians were presented a list of different conditions and were asked to classify them as disease or non-disease. Hofmann demonstrated that there are disparities between what physicians consider diseases. In Stronks et al. [ 25 ], lay people, randomly recruited on the streets, were asked to define what ‘health’ means to them. The study resulted in an extensive overview of different aspects of health and disease, categorized into multiple clusters, with interesting differences between socio-economic classes. In Kohne et al. [ 26 ], clinicians, patients, and clinicians who have been patients themselves, were interviewed to explore their ideas regarding the ontology of mental disorders. They observed that the ‘ontological palette’ is more diverse than is commonly perceived within the dominant scientific and educational discourse. In Van Heteren et al. [ 27 ], frontline professionals were interviewed to investigate their conceptions of health in clients with psychosocial problems. They observed that professionals define health in different ways but that they also accommodate for the views of their patients and to the broader context care is provided in.

As we understand health and disease concepts to be context-dependent, we believe it is important to investigate their function and problems arising in relation to them in various contexts. Regarding the methodology and the type of inquiry, our pragmatist approach encourages us to look for problematic situations . The term ‘problematic situations’ originates from the work of pragmatist John Dewey (see [ 28 ]), who argued that academic inquiry must always start with (solving) actual problems. Here, we will use the term problematic situation to describe as a situation in which current conceptions/definitions of health and disease are no longer sufficient for the continuation of a certain health care (related) practice, or the achievement of a goal of the specific practice that is at stake. Thus, besides mapping different health and disease conceptualizations, we primarily explore what kind of problematic situations are experienced in practice and investigate possible underlying conceptual issues. In doing so, we aim to further elucidate the philosophical debate on conceptualization of health and disease and give it more practical relevance. In this study we have therefore conducted qualitative interviews with a broad range of professionals and patient representatives, working in various health-related disciplines, fields and organizations. We chose qualitative methods because these are considered the most suitable for investigating new and underexplored areas.

Methodology

We have designed a qualitative interview study with professionals working in various fields and organizations. Interviews were conducted by RL. As the sample included a broad range of professionals and patient representatives, a one-size-fits-all approach was not considered to be useful. We used a semi-structured interview guide that could be adjusted and specified to each of the interviews. This structure allowed us to explore context specific problems in more detail and to respond more extensively to issues participants mentioned during the interviews. Examples of interview questions include (for the complete guide, see appendix): ‘How would you describe ‘health’ and ‘disease’ yourself?’; ‘Would colleagues in your field agree with your definitions?’; ‘Are there any specific problematic situations that you encounter in practice that are related to definitions of health and disease?’; ‘Do you see any solutions to such problematic situations or have there been solutions brought forward to solve these issues?’. From these broader, more abstract questions, the interview was subsequently narrowed down to more specific questions, in response to the answers given by the participants. The interviews were conducted digitally, via Microsoft Teams, and took 46 min on average (ranging from 37 to 57 min). Audio recordings of the interviews were transcribed verbatim.

Setting and recruitment

This study was conducted in The Netherlands. All participants were Dutch speaking and all were highly educated. All participants were selected following the principle of purposeful sampling. The reason for choosing for purposeful sampling was that we wanted to study definitions of disease and health in relation to actual problems arising in health-related practices. We recruited professionals who have spoken out in public or professionally about problems in relation to health and disease definitions and/or who work in fields/organizations that we considered to be interesting because we expected such issues to arise. Moreover, we aimed to cover a broad range of healthcare practices. The participants were recruited by e-mail.

Participants

The sample details a broad range of professionals ( n = 17), including doctors, policy makers, representatives of patient organizations, humanities experts, and medical professionals working in various advisory boards and governmental organizations (see appendix for a specified overview of participants their expertise). All participants were Dutch speaking, highly educated and experienced professionals. The representatives of the patient organizations that we included were interviewed in their professional role and not as patients (if applicable). One of the interviews had to be excluded from analysis because the recording was unusable due to a technological error, bringing down the total number of transcripts from 17 to 16.

Data analysis

The data was analyzed using NVivo software (11th edition). The first interview reports and transcripts were discussed among RL and MS. Based on these discussions, RL made a first coding-scheme and discussed this with MS, which resulted in some adaptations. To reduce ‘tunnel vision’, transcripts were then analyzed and coded by RL and MS separately and compared afterwards. The interviews were analyzed in a way that may be best described as a method in between ‘grounded theory’ [ 29 ] and ‘directed content analysis’ [ 30 ]. That is, we did not build a conceptual scheme completely bottom-up as one would do with grounded theory. However, it was also not the case that we already had a solid theoretical framework at the start of the analysis which we would use to frame the issues discussed in the interviews, as is common in directed content analysis. We have taken the answers given by participants as a point of departure, exploring what their views are regarding the function of health and disease concepts, and exploring what kind of problematic situations they experience in practice. Sometimes, participants would already refer to specific theories, approaches or models themselves However, for other parts of the analysis, we have made use of distinctions and concepts from the academic literature to make sense of the many issues that were brought forward by participants. For instance, some issues mentioned by participants could be viewed as being practical examples of what is called a ‘line-drawing problem’ in the theoretical debate [ 10 , 31 ]. Such categories appeared useful for analyzing and interpreting the data but where not selected prior to the analysis.

Defining health and disease

In the interviews, respondents have pointed to various important practical functions of health and disease concepts. In some interviews the influence of certain definitions/approaches was explicitly articulated by participants. Participants talked about practical problems that they experienced and were often able to link these with how health and disease are conceptualized in their fields. For instance, some participants described specific models or definitions, such as the biopsychosocial model [ 32 , 33 , 34 ] and Positive Health [ 35 , 36 ] and talked about their significance for their professional fields. In other interviews, however, the link between conceptualizations of health and disease and practical issues was more implicit. Participants would, for example, speak more broadly about ‘biomedical’ and ‘holistic’ approaches, or discussed how thinking in terms of ‘evidence based medicine’ (EBM) could (negatively) affect clinical practice.

While some of the respondents mentioned that it would be convenient to have general, all-encompassing definitions, none of them thought it would be possible to formulate them in a way that they are exhaustive and practically useful at the same time. Instead, in some interviews, viewing health and disease as plural concepts was discussed as being a possible alternative. HD01, says in this regard:

I’m not saying that one type of concept is primary or more legitimate than the other. But if you are talking about a health concept for the use in scientific research, then I would argue for a concept that is more clearly defined. If you’re talking about how people experience things or use, for example laymen, you could be talking about a simpler concept. And I think those things can coexist just fine.

At the same time, other participants were more hesitant when discussing the possibility of having multiple definitions of health and disease. Concerns were raised that such a situation may lead to problems of communication between institutions, (medical) disciplines, but possibly also between doctor and patient. As defining health and disease was viewed by many to be important to facilitate communication, for some participants it also seemed to be problematic to have a plurality of definitions. Furthermore, some participants would also critically question the endeavor of defining health and disease, questioning the goal of defining concepts itself. In several interviews, defining health and disease is described as a continuous process of reflection and adjustment, rather than a pursuit of finding ultimate answers. One participant, HD02, describes that how we define our concepts always have an effect on practice:

I think that every description is functional, in the sense that it always has an effect. Words aren’t neutral so it’s not- I don’t believe in that correspondence theory of there being something in reality that you just have to put the right term on. A word always does something. And I think that’s what it’s more about, so when use a certain view of health, for example, the absence of diagnosis. Then it is important to see, what effect does that have? Who or what is excluded? Or who benefits from this? Who gets worse from this?

Health and disease concepts in practice

One of the key aims of this study was to explore how health and disease are conceptualized, defined or approached, in actual practice. In particular, we were interested what kind of practical functions health and disease concepts have in various contexts. In our analysis of the interviews, we observed that respondents discuss different types of health and disease concepts, working on different levels and as used for various kinds of purposes. If we look at the different type of functions and contexts the concepts are deployed in, and the levels on which they ‘operate’, an interesting picture emerges. We have categorized them broadly into three types of practical functions: (1) a ‘strategic, political and policy-making function’, (2) an ‘institutional and social function’, and (3), ‘guiding clinical practice and medical research’.

Strategic, political and policy-making function

In the context of strategic development, political debates and higher-order policy-making, definitions of health and disease can stay relatively broad and vague. Their function is not, for example, to give clinicians clear thresholds for line-drawing between the normal and pathological. Rather, their function is to steer public health policy, to change current practice within a healthcare organization, or to facilitate cooperation between organizations and institutions. Within this context, health and disease concepts do not need to have the analytical or explanatory power as may be needed in, for example, medical research or clinical practice. The definitions at stake may be demanding and idealistic, as they are used for questioning and/or changing the current state of affairs. Participant HD09 says in this regard:

If you want to explain to a politician why we are going to deploy all kinds of healthcare resources that are not directly focused physically, somatically, then you have to be able to explain it in clearly defined goals, objectives, and health definitions. And in that sense, it is of course also very important for the WHO to adjust such a definition. Because that changes your entire health policy worldwide. For example, it has an effect on what you use for prevention, but it also has an effect on what you use for treatment.

Embedded in these (inter)national discussions on definitions, goals and policies, we may find related discussions in the context of policy on local or organizational levels. Participant HD03 explains why defining health and disease concepts are considered to be important for organizational strategy and policy-making within healthcare organizations:

In the academic hospitals, we are primarily using a biomedical approach towards disease. At the same time, we have the ambition to expand to preventive medicine and to strive for positive health, public health, global health, that are all approaches of health. However, as an academic hospital you are only specialized in thinking about disease in biomedical terms.’’ … “So that’s the problem. If you make a strategy, what are you going to focus on? And so, what I say is, the wish is to focus on prevention, public health, global health and to look more broadly at health and disease.

Although broad and vague definitions may be used successfully for the purpose of guiding or changing policy, more concrete definitions may be needed in other contexts and for other purposes.

Institutional and social function

Another practical function that participants ascribed to the disease concept, and more concretely, to medical diagnosis, is a ‘gatekeeper function’ for issues regarding assessing eligibility for reimbursement of treatment and other healthcare arrangements. Examples mentioned by participants include debates on the legitimacy of viewing clinical conditions such as myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and chronic pain disorders as ‘genuine diseases’. What we consider to be diseases may therefore also be viewed to be a social and political agreement, some argue. Participant HD05 explains why ‘disease’ could be viewed as an institutional concept:

Who will be reimbursed for their medical treatment? That is decided on a political level.’’ … ‘‘And you can say that, at some point you have to say that someone has a disease, within the framework of a certain law, because that is how it has been agreed upon. And that is an institutional fact, because that is what has been agreed upon by various authorities.

What our institutions acknowledge as ‘genuine diseases’ does not only have impact within the medical realm, but also plays an important role in societal and personal debates. What we define as disease has also a social function. It creates a situation in which others take care of you as a patient, but it can also excuse responsibility from social tasks and duties, for example. In this regard, HD09 says the following:

And no matter how you look at it, sickness creates privileges. Because if you’re sick, people will bring you breakfast in bed, or not if you’re vomiting. And then you get get-well cards, people send flowers and you get time off. Then you are very pathetic and that comes with all kinds of perks. And I’m not saying that people get sick on purpose because of the perks, but that is an automatic consequence. Because my demented patients don’t get get-well cards and flowers and breakfast in bed at all, they are looked at strangely in the supermarket. And patients with psychiatric disorders, well, let’s say… they are usually not the most popular. And that has to do with the fact that we, I think, as a society have determined that being sick has to do with physical ailments…. There’s a discrepancy there. Physically ill: pathetic, perks. Not visibly ill: poser, difficult, hassle, hassle, hassle. That stings.

Guiding clinical practice and medical research

In a clinical context, health and disease can be approached in different ways depending on the type and level of care that is provided. For example, in emergency situations a medical doctor needs to focus on the direct biological problem, but when the patient is in a recovery phase they may have to ‘switch’ and take psychological and social aspects more into account. When caring for a patient suffering from a chronic condition a medical doctor may want to focus on aspects such as resilience and adaptation, and supporting the patient in what they consider to be meaningful. By going through these levels of care, health and disease may be approached differently. Here, HD06 explains this process of ‘shifting’ between models:

Of course, healthcare is very broad. The trauma surgeon and the emergency room doctor who provide acute care for a trauma patient, they are mainly focused on the biomedical model, their A, B, C, D, E, breathing, blood pressure, circulation, you name it. But then you end up in a rehabilitation process in which the biopsychosocial model is used. And then you come to an occupational doctor and an insurance doctor where I think it is very important to also use that model of Positive Health. Because there- Well, we see that with trauma patients too. In our research, independent of the seriousness of the injury, impediments to the ability to function were actually caused by all sorts of personal factors. So, you have to support people in finding their own direction and adaptability.

While taking account for ‘personal’ factors such as adaptability (or resilience) and societal participation may be of relevance for the treatment and revalidation of patients, and thus could be considered as being part of ‘health’, in context of medical research such factors are usually separated from health and disease outcomes and viewed as determinants instead. This allows researchers to measure causal relations between factors such as societal participation and health in a better way. Taking all kinds of (intra)personal and societal factors as being part of the health concept may result in problems for causal explanations in scientific research. Participant HD01 says the following regarding this tension:

The moment you use a broad concept of health, in which all these things are lumped together, you risk that the causality is not actually clear. So, in that sense, I’d like to stick to defining health as biomedical and mental functioning. And I would like to keep those other factors in their own place. And then you can look much better at, what causes what? Or how are things connected?

Problematic situations in practice

A second key aim of this study was to ask participants if they did experience problematic situations in practice that are caused by or related to conceptual issues. In the interviews, a large variety of problematic situations were discussed, including various clinical, epistemological, and ethical issues. Some participants described more abstract problems such as ‘medicalization’ or ‘healthism’ in a broad sense, while others described more concrete issues, such as social or bureaucratic problems in case of patients with medically unexplained symptoms (MUS). Because of the diversity of participants included in our study (i.e., people working in different fields and organizations), the answers to our questions were also diverse and related to their particular context. We have clustered the problematic situations which were brought up in the interviews into 5 types:

1) Illness without identifiable pathology

2) Biomedical versus holistic approaches

3) Line-drawing and threshold problems

4) Problems with translational medicine: from research to the clinic

5) Communication problems

Illness without identifiable pathology

One issue that was discussed in several interviews is the problem of patients suffering from illness without identifiable pathology (or, ‘disease’). This includes patients suffering from ME/CFS, functional neurological disorders, chronic pain disorders, and other conditions that are often described under the umbrella term ‘medically unexplained symptoms’ (MUS). As illness is often viewed to be secondary to disease, and as it is commonplace to think that in order to overcome the illness, one has to cure the underlying disease, it seems only logical to search for the causing pathology. However, in many cases this search does not lead to a clearcut answer. As a result of this, unfortunately, the suffering of the patient is sometimes not taken seriously by medical professionals.

Besides being taken serious by medical professionals and getting the care they need, patients suffering from illness without known pathology may also encounter other type of problems. For example, for patients who cannot work due to illness a medical diagnosis is a necessary criterium to be met for being excused from work and to gain access to certain social and financial resources Footnote 2 . HD07 explains the institutional aspect of medical diagnosis:

Well, in this sense, we are dealing with legal frameworks. The law prescribes that to be able to claim a sickness benefit, one must be diagnosed with a disease. If it stops there, then we do not need to test those other two criteria. And sometimes you will find yourself in a gray area. Because yes, for example, I am also thinking about an example that I have. Social problems can also often lead to dysfunction. In the case of a social problem, there is not by definition disease, but can become one. And we often have to deal with those kinds of dilemmas, that if you see someone with informal care, with a financial problem, just to name a few- Those people who are walking on eggshells at a given moment when they come to us. We establish that, legally, there is no disease. But it might turn into disease.

In line with the situation sketched by HD07, HD15 argues that this problem of not getting recognized by our institutions as having a genuine disease, is a terrible experience for patients. HD15 explains that this in matter of fact urges their organization, a patient organization, to ‘medicalize’ the condition:

Then it will get very bad for them. Because people have a disease on the one hand, on the other hand, they always have to prove that they have it, and then there is also a financial need. So, that’s really the crux of the story. And, of course, we try with our work to make it clear as much as possible, that it is a progressive, biological condition, biomedical condition and that just needs research.

On the other hand, negative aspects of medicalization were also mentioned throughout the interviews. Participant HD14 mentions that including a condition in the ICD should be done with precaution:

The bottom line is that I’m a huge proponent of including pain in the ICD-11, the way as it is now. But I also see that there, I also see that in that balance of those arguments, there are, well, let’s just call it dangers. And that is that you do indeed have things that are normal part of life, which we are going to call disease. And that medical procedures are set up by people, who say, ‘hey, come to me, because I can solve it’. And that is, we have to be very careful about that, in communication, on the one hand to recognize that pain that is there, et cetera, and to take it seriously and with all the benefits that entails. But at the same time to ensure that we do not make it too medical where it is not desired.

In the interviews, many participants argue that, in clinical practice, the illness-experience of the patient is most important and deserves recognition. HD08 argues:

I think a disease is largely about the experience of the patient. And again, of course there is a biological construct underneath, but not always, eh. There are also people with a disease without a biological construct. And just to say, those people are not sick, I think that is far too short-sighted.’’ …. ‘‘We relatively often see people with a functional disorder, something that used to be called conversion or functional neurological symptoms. Those people can suffer a lot from this, but there is no biologically identifiable cause. And I think you shouldn’t dismiss those people as posers or say, you have nothing. No, they do have something and they do suffer from it and that leads to hindrance in daily life. So, I think you can speak of disease.

Biomedical versus holistic approaches

A broader issue that came up in many of the interviews is one that may be best described as problems that are due to biomedical versus holistic approaches towards health and disease. Participants discussed that focusing treatment primarily on a biomedical parameter while paying less attention to the experience of the patient as a whole can be problematic for providing good clinical care. That is, patients may be treated for their medical condition without taking sufficient account of their personal circumstances and/or life goals. Participant HD11 said in this regard:

Of course, you can approach disease in many different ways. If you approach it cell-chemically, so to speak, disease is what damages, or attacks, or if you will, the biochemical integrity of your cell. But if you look from a patient’s perspective, or from a doctor’s perspective, then a disease is something that hurts, bothers, hinders that patient. And the perspective of the patient, but also the approach of society, of course, plays a very important role in this.

In some cases, the emphasis on the biomedical paradigm may even lead to instances of ‘treating’ biomarkers that may not have a clear clinical significance. HD11, discussing the implications of the new drug (aducanumab) for Alzheimer’s Disease, explains that:

The bottom line is, there is a new drug that, if you look at the cellular level, biochemical level, it absolutely does something. It does something to the proteins in your brain, period. However, if you look at the clinical effect on the patient, and what it can do for the patient, it does nothing. Patients don’t improve, we have no improvement, cognition does not improve, general daily activities neither, nothing. The FDA has approved it on the grounds that, despite the fact that it doesn’t do anything clinically, biochemically the evidence is so clear that it does something, it’s bound to do something clinically. While it just doesn’t.

Yet, also in cases where a biomedical treatment has proven to be clinically effective, it could be nevertheless problematic to forget about the patient’s personal circumstances. Sometimes it may be more important to help people with psychosocial issues, for example, than to direct attention to the medical problem. Participant HD10 discusses person-centered care for diabetes patients and argues that taking care of the patient - improving their health - includes more than treating the disease biomedically:

That also touches on the need for person-centered care, - that the care providers really can actually see from the patient’s eyes which approach they should take. Do they really have to focus on that disorder or do they indeed have to focus on the social realm?

Another related problem that was mentioned in the interviews is that of prioritizing biomedical diagnosis over other holistic aspects when assessing the prognosis. Although the diagnosis may give important information regarding the development of a disease and about chances for successful treatment, other non-medical factors may have an underestimated influence on the prognosis as well. In some instances, psychosocial aspects may even show a stronger correlation with prognosis and treatment than the medical diagnosis does, participant HD04 says in this regard:

The classic assumption is very much like, if you know a diagnosis, then you know the prognosis and then you know whether or not you need to do something to influence that prognosis. Whether or not you can do something to influence that prognosis. And what we are gradually noticing is that that prognosis may well be determined by many other factors and that the diagnosis is only a small part of it and therefore only partly determines what the prognosis is. The prognosis is also determined by all kinds of other factors. other variables, to put it in scientific terms.

According to HD04, it is common for medical professionals to focus too much on biomedical diagnosis and to underestimate the influence of ‘non-medical’ variables on the prognosis and the well-being of patients – which, she beliefs, should be the ultimate aim. This does not only go for patients with medical unexplained symptoms, for which finding the right diagnosis is considered to be very difficult. Also for diseases that can be diagnosed straightforwardly there seems to exist a disparity between a biomedical view of disease and more holistic ones. HD04 gives the following example:

Examples abound. People with rheumatoid arthritis, we can diagnose rheumatoid arthritis fairly well with lab tests, with clinical tests, with imaging tests. We have criteria, you can always argue about that, but we generally agree on that. And then we also have a measure of the disease activity. So, if you have a very high sedimentation rate, then you have a high disease activity, for example. And if you then look at the severity of the complaints and the disability that people have and relate that to disease activity, then that is not a nice linear relationship. So, then there are people with, if you would look at it as a rheumatologist, as a doctor, if you look at it as a doctor, then well, that disease is just well under control, hardly swollen joints, no increased sedimentation rate, goes well, but in fact people suffer very much.

Line-drawing and treatment threshold problems

In the interviews, problems with drawing the lines between states of health, disease, or ‘being at-risk’, and problems with determining the right thresholds for starting medical interventions, were considered important reasons for having clear definitions. Having clear cut-offs for diagnosing disease and for starting treatment is seen as convenient for clinical practice. Participants expressed a desire to have objective measures to decide whether we are talking about disease, and when to start treatment. Yet, they were also highly doubtful if such clear lines could be drawn. On the one hand, they said diagnostic tests are used to examine if a patient deviates from the (objective, biomedical) norm. On the other hand, participants also argued that patients’ symptoms should be viewed as central to drawing the line. This also seems to be problematic, however, as patients may sometimes deviate from the norm but do not experience symptoms, or vice versa, patients may experience symptoms but test results do not show significant abnormalities. HD08 talks about the challenges of the line-drawing problem for clinical-decision making:

Of course, it is difficult, because doctors like to work neatly, like to work according to scientific evidence, like to work according to guidelines. And a guideline only works well if you can make hard statements, otherwise you have a guideline that says about everything: you ‘may consider this’. And yes, that is how guidelines end relatively often, but then it is not very useful in practice, because you want such a guideline to guide you. And the surgeon, just to name one, who wants to determine whether he should operate. And it’s easy if that just has a cut-off point that says, you have to operate above 23 and not below, just to name something. So, whenever there’s a big gray area, it’s complicated and leads to subjectivity and also different doctors making different decisions.

This was also discussed in relation to prevention, when patients are ‘treated’ with medication to prevent future disease(s) while they do not experience symptoms at that point of time. In particular, participants pointed to the lowering of diagnostic and treatment standards for risk-factors such as high blood pressure and high cholesterol as examples in which it is difficult to draw the line. Participant HD09, who reflect on this problem, says the following:

But you can get quit some muscle cramps from cholesterol lowering drugs. Yes, so it may be that he has one in twenty, one in thirty less chance of that stroke, but in the meantime, he is no longer able to walk down the stairs and do his own shopping because of those muscle complaints and perhaps even take a fall. Well, and it’s not the case that everyone has muscle problems, so for the people who don’t get this it might be the best treatment. That is the way you have to look at it. And also evaluate, eh, and that’s about when you start something, you have to follow up what it does to someone, even if someone has been using it for some time, because that can change.

When participants were asked if they could identify reasons for this trend of lowering diagnostic and treatment thresholds, some suggest that cultural values and norms play an important role. Not only there is an increasing societal pressure on living a healthy life, health is also increasingly viewed as a moral good. It is this normative shift, in combination with ever growing technological possibilities, that is suggested to lead medicine to focusing on early detection and treatment of health risks more and more – even if chances of developing actual diseases are expected to be low. Patients may desire more diagnostic testing or more frequent health check-ups and medical professionals may feel obliged to grant their requests, since the technology is available. This is not without consequences, however. HD11, for example, explains that excessive diagnostic testing may lead to overdiagnosis. In particular, ‘incidental findings’ Footnote 3 are considered to be a problematic situation:

And that is, I think, also an ethical dilemma that doctors have, because then you find something and what do I do now? They have no complaints at the moment, so I don’t really have to do something with it now. But imagine that it is cancer, and in four months they will come in with metastatic disease, and then I could have prevented that. That’s difficult. And then the technology renders it unlikely that such a patient says, never mind, we’ll see how things will go. Because everyone says oh, yes, if something can be done about it, then let’s do that scan, then do that biopsy, then do that incredibly complicated procedure.

Incidental findings may be clear instances of pathology, and in these cases, it may be regarded as fortunate that the patient can be treated for a disease that may otherwise have gone undetected until it was too late. However, in other cases incidental findings may be benign deviations or anomalies and it is questionable if the patient will benefit from further diagnostic testing and/or medical intervening, as it is not clear if the anomaly will ever lead to clinical symptoms. Again, this begs the question where to draw the line between normal and abnormal, between health and disease.

Problems with translational medicine: from research to the clinic, and beyond

In the interviews, some participants also discussed problems regarding translating medical scientific findings from a research context into clinical practice. One approach that was mentioned by participants as particularly problematic was ‘evidence-based medicine’ (EMB) Footnote 4 . While medical professionals may be aware of the different aims and goals of medical research versus clinical medicine, and of the problems surrounding EBM, they may feel bounded by institutional agreements and regulations. For example, insurers may only reimburse treatments that are proven to be effective according to standards of EBM and therefore may not sufficiently allow for tailoring treatment to the personal needs of the patient. HD09 explains how the broad implementation of the EBM style of reasoning, from research to the clinic and beyond, to institutional arrangements, is not without danger:

Evidence-based medicine, with its mono-focus thinking, traditionally, it’s fortunately changing, can also bring real dangers, because what you see is that politics and insurers are very much steering policy and reimbursing on the basis of guideline indicators.

HD13 goes even a step further by provocatively referring to EBM as ‘pharmaceutical-based medicine’. He argues that medical professionals are restricted by the rules and regulations of the healthcare institutions such as the National Healthcare Institute (‘Zorginstituut’), which require treatments to be ‘evidence-based’ before they can be considered eligible for reimbursement. As a result, HD13 claims, we end up with suboptimal medical treatments:

The entire ‘pharmaceutical-based medicine’ is currently ‘the’ steering element of the National Healthcare Institute and of affordable care in the Netherlands, of reimbursed care. And it’s not the best treatment that gets reimbursed, but the treatment that has been the most researched; not the one with the best outcomes.

Another problem that was particularly mentioned in the interviews was that of generalizing medical knowledge from the research context to the clinical context. As diseases and their treatments are commonly researched in study populations that do not represent patient populations in clinical practice - e.g., age range between 18 and 50, mostly Western, male subjects, having only one disease instead of several - a rather homogenous picture of specific disease entities with specific treatments is generated that often does not match the heterogeneous reality in clinical practice. Moreover, while medical research is often focused on curing a disease, or at least reducing its symptoms, patients may in fact have different goals and wishes that need a different approach. Participant HD09 argues that the goals of medical research do not always match the goals of clinical medicine:

So, the average patient in a trial is a middle-aged man. The average user, who is treated according to the guideline based on those trials, is an old woman or one who has more medical conditions and uses several medications. And then it is also the case that those trials are aimed at preventing a new event or surviving. And, for example, not having a second heart attack, not having a stroke. Well, those may be things that are important to someone, but I just said that is often not the most important thing. Those people are not all at about living longer, they care about function preservation. And then it can still be important to prevent that stroke, but then you really have to look at it in a different way.

Especially in case of (chronic) multimorbidity, in which patients suffer from multiple diseases at the same time and also use multiple medications, it can become questionable what is treated, exactly. A set of separate diseases, or the combined physiological effects and symptoms of a multitude of underlying pathologies, or even of the medications used? As a consequence, ‘evidence-based’ treatment protocols could potentially harm patient populations that do not fit the assumptions on which the treatment is found to be efficacious. Furthermore, diseases and also the medications that are used may interact, resulting in a clinical picture that is very different from what is expected. We might describe this situation as one that is epistemologically opaque : it seems to get very difficult, if not impossible, to distinguish cause and effect. HD09 explains:

And then the question is whether it will work the same way with that woman with all those old age conditions compared to what happened with that fifty-year-old man. So, it probably reacts differently as well. It reacts differently, because there are multiple diseases, interaction with disease. And it reacts differently because there are a whole lot more medications, interacting with medication. And it reacts differently because the body is different.

So, while medical research tries to reduce complexity and look into single homogenous diseases and patient groups, in clinical practice disease often manifests very differently.

Communication problems

While participants were generally doubtful about arriving at univocal and all-encompassing definitions of health and disease and favored the idea of conceptual pluralism, some participants also expressed concerns with regard to communication. If we all use different definitions or different health and disease concepts, how do we know we are still speaking of the same thing? As clear-cut definitions are often desired precisely for the purpose of solving ongoing problematic situations in medicine, it may seem paradoxical to accept conceptual pluralism. In practice, having multiple ways to understand a disease can lead to communication problems, participants fear. For example, when medical specialists’ views differ so significantly that they almost literally speak about different diseases, it is questionable if they are still able to sufficiently communicate with each other and their patients.

In an interview with HD08, opposing views on Alzheimer’s Disease among medical specialists were discussed. Alzheimer’s Disease was originally diagnosed on the basis of clinical signs and symptoms, but in recent years a part of the neurologist community has switched to prioritizing biomarker testing (i.e., primarily the presence of beta-amyloid) over clinical presentation. However, the problem is that the group of patients with positive biomarker tests do not completely match the group of patients who get symptoms. Therefore, changing the way of diagnosing Alzheimer’s disease in patients also seem to imply changing the definition of Alzheimer’s disease. Hence, it becomes unclear if medical specialists are still discussing the ‘same’ disease. HD08 says the following about the opposing views:

Well, I think there’s- You could almost say, it’s kind of a clash of civilizations. You have the people who just want a hardcore biological substrate and then have little regard for other aspects. And you have people who say yes, maybe it is not possible to classify it exactly into careful categories, let’s also take into account the less ‘hard’, less definable aspects that are important for the functioning of a patient.

While acknowledging the challenges and pitfalls that come with speaking different ‘medical languages’, at the same time, participants also see benefits of having different approaches towards health and disease. Some of them note that we already are using different languages, scientific explanations and medical classifications, and that this could be viewed as something valuable. In a combined interview with HD13 and HD14, HD14 discusses the different classification systems that are being used for chronic pain patients among different (para)medical professionals:

No, I think you should cherish that, because an anesthesiologist can do things that a rehabilitation doctor cannot do, and vice versa. So, you really have to use each other for that and that also applies to all those other medical specialists and paramedical specialists. So that in itself is not a big deal. What- Or rather, that’s very functional, that’s excellent. At the same time, we must speak each other’s language and that must be the same language with each other, but we must certainly not forget the patient. And, because the patient must also be at the center of our interprofessional communication. And, but also the wishes and needs of the patient. So, if HD13 says ‘I’m good at ICD’, and I’m good at ICF, to put it very bluntly, that’s not going to work. I need to know about ICD, enough to talk to HD13. And HD13 needs to know about ICF, enough to talk with me. But really, we should all be able to know enough to be able to talk to the patient properly.

Thus, interestingly, the suffering of one patient could be classified in several different ways, depending on the classification system that is used. While recognizing the challenges this brings for medical professionals, HD13 and HD14 also see the benefits of looking through different lenses – as long there is sufficient common ground to communicate with each other and the patient. So, concepts of health and disease seems to be approached differently at different levels of care (i.e., primary, secondary, and tertiary lines of healthcare) and between different types of (para)medical professionals. The situation as sketched by HD13 and HD14 seems evident for healthcare as arranged in The Netherlands, where various classification systems are indeed being used in different levels and types of healthcare practices Footnote 5 . Every classification system has its strengths and weaknesses. An ongoing challenge seems to lie in being able to sufficiently understand each other’s ‘medical language’.

Philosophers can contribute to medicine by exploring, analyzing and articulating conceptual issues. However, as we take health and disease concepts to be context-dependent, it is crucial to study their meaning in context. Building on recent proposals for a pragmatist understanding of health and disease that embraces conceptual pluralism, investigating different perspectives is very important. As Veit argues: “Questions such as how medical practitioners see, use, and evaluate concepts like health, pathology, and disease are important to the philosophy of medicine. Yet, these questions cannot be answered through introspection alone. They require investigative empirical methods” [ 21 ] (p.183). In similar vein, Seidlein & Salloch [ 17 ] argue that empirical methods can be used to gain better understanding of the complex relationship between illness and disease, by reflecting upon patient and professional perspectives. Including qualitative methods and other types of empirical research to our toolbox can bring theory and practice closer together and stimulate new medical-philosophical and bioethical explorations.

The current study differs from previous empirical studies [ 24 , 25 , 26 , 27 ], in that it was specifically focused on exploring how health and disease concepts have a function in practice and how they may lead to problematic situations . The existing studies have already shown a palette of different conceptualizations, but did not interpret these in terms of their practical function and role in problematic situations. In our interviews, various important practical functions of health and disease concepts were discussed and our participants suggest that different contexts and purposes may require different types of definitions. We agree with Veit that finding such a lack of consensus and a pluralism of concepts and functions, strengthens the case against conceptual monism, and favors positions that “relativise the concept to human interests and cultural dynamics’’ [ 21 ] (p.178). Indeed, our study reveals that “the notion [of disease] serves a variety of purposes that perhaps cannot be accomplished using a single concept” [ 21 ] (p.180).

However, the plurality of functions and the definitions that are used to serve them, may not always be compatible with each other. A broad concept definition of health may work, for example, to steer healthcare policy in a certain direction on a political or organizational level, but may cause problems when it must be implemented in a research setting. Of course, different functions and definitions do not exist in a vacuum but also interact. Moreover, as is evident from the interviews, although the plurality of definitions may sometimes be problematic for reasons of communication, it is also a reality. Therefore, it may be more fruitful to acknowledge this and to elucidate and explain the differences; this may actually enhance communication and understanding across domains.

In this article, we have highlighted 5 types of problematic situations that were discussed in the interviews and that can be related to the conceptualization of health and disease. Some problems are already recognized in the medical-philosophical literature, such as problem of line-drawing. Others may offer new starting points for medical-philosophical and bioethical inquiry. Philosophy of medicine might help to analyze and elucidate the conceptual components of these problems and come up with suggestions of how conceptual work might help to find solutions. For example, the work that has already been done by Rogers and Walker [ 12 , 31 ] regarding the line-drawing problem might be useful for medical practitioners and medical guideline developers. They propose using context specific précising definitions that serve to prevent overdiagnosis; such an approach may also be useful to help solve the line-drawing and treatment threshold problems, and the risks of over or undertreatment, that we encountered in this study.

Furthermore, tensions between biomedical and holistic approaches of health and disease – that have led to major debates in the philosophy of medicine and has important ethical implications – were also described by participants as problematic in practice. However, there was also a hint of a solution in the interviews. As one participant explained, different contexts may benefit from different approaches. Strictly biomedical definitions may be more useful for the emergency care doctor while during rehabilitation a holistic normative biopsychosocial model is considered more helpful. Footnote 6 This idea is in line with the proposal by Haverkamp et al. [ 7 ], to consider using concepts that fit best with the purposes and values of a specific healthcare practice. Some of the problematic situations described in the interviews may also give new input for investigating these purposes and values in different contexts. For example, the changing conceptualization of Alzheimer’s disease and the use of biomarker diagnostic testing, that was mentioned in the interviews, is a current topic of medical-philosophical and bioethical debate (e.g., see [ 43 , 44 , 45 ]).

Another role for philosophy can be to help healthcare professionals and policy makers to better understand how some of their problematic situations arise. For example, some of the issues we identified could be understood in terms of a disconnect between the three spheres of the conceptual triad of ‘disease, illness and sickness’, as originally presented by Twaddle [ 46 ] and as later updated by Hofmann [ 47 ]. As Hofmann already noted, cases of non-health are generally considered to be less controversial when two or three of the spheres align. However, when only one or two of the are deemed applicable to a certain condition, it becomes epistemically and normatively challenging [ 47 ]. This conceptual triad may help patients, healthcare professionals and policymakers to better understand issues around the problem of medically unexplained symptoms, also in relation to the institutional and social function of the disease concept. At this point, it may also be significant to note that in the Dutch language, in which the interviews were conducted, the distinction between disease, illness and sickness is not available. A single word, ‘ziek’ or ziekte’, is used to cover all three notions, making the conceptual confusion perhaps even more salient than in the English-speaking community.

Some of the problematic situations that we have described may, at first glance, be viewed as practical problems with only little conceptual basis. For example, when discussing disease as an institutional and social concept, and describing problems that patients who suffer from medically unexplained symptoms may face (e.g., problems with accessing certain healthcare resources, or social and financial arrangements), one might question to what extent this is a problem with the conceptualization of disease.

One might argue, as Hesslow [ 48 ] did, that we have been misled by the idea that we need a concept of disease to make normative decisions on clinical, moral or socially important issues. However, from a pragmatist perspective, the theoretical, practical and normative dimensions of concepts are inherently related. As De Vreese argues: ‘‘it seems undeniable that the health/disease distinctions made on the basis of tacit understandings of the disease notion do play an important role in the background of health care-related research and decision-making processes (clinical, moral, legal, social, or otherwise), which might have important consequences in practice’’ [ 6 ] (p.429). Starting from this observation, we might consider adapting our concepts to better fit the social and institutional arrangements (cf. [ 49 , 50 ]). or we might propose better concepts or criteria to base these decisions on (e.g., see [ 51 ]). Both seem to be pre-eminently tasks for philosophers and ethicists to pursue. Additionally, empirical studies may help to further explore these ‘tacit understandings of the disease notion’ and investigate what these ‘important consequences in practice’ entail, as starting points for further philosophical and ethical reflection.

Limitations

As is common for qualitative research, results cannot be generalized and results may not represent the views, attitudes and beliefs of the whole community of medical professionals or patient organizations. As the sample of this study is relatively small and consisted of a broad range of professionals, the findings should be viewed as starting points for further investigation, not definitive answers. Moreover, as indicated in the methods section, the sample consisted of a group of highly educated and experienced professionals. Although there were good reasons to select them, it is important to remark that as a consequence, we did not study the views and experiences of other, more ‘ordinary’ healthcare workers and patients. Also, we did not include the views of different nationalities, cultures, and/or for example less educated or marginalized people. Indeed, we should ask: ‘who are the rightful owners of the concepts disease, illness and sickness’ [ 9 ]? If we view health and disease as plural concepts then an empirical philosophy of medicine should do justice to this plurality by including the views and experiences of these groups as well. Future studies may focus on investigating more specific groups (e.g., a specific medical specialist field or certain group of patients) and/or institutional contexts.

Furthermore, as we have learned from discussions on the empirical turn in medical ethics [ 52 ], one should be careful and considerate when making normative claims on basis of empirical data. However, given the explorative character of this study, this is not deemed a significant problem. Our aim was to explore the range of views regarding health and disease concepts, and the existence of problematic situations related to health and disease concepts, not to give an exhaustive or quantitative overview of such concepts and situations. Furthermore, in qualitative research, it is generally acknowledged that the researcher is not merely a ‘neutral observer’ but also an actor who actively engages with participants in the research process, and thus, is part of the data that is generated [ 53 ]. In this study in particular, with its aim of exploring how health and disease concepts function in practice and examining whether they could lead to problems, the interview guide was drafted from a specific theoretical angle. Moreover, the interviews were analyzed with existing theoretical discussions and frameworks in the back of our minds. By being open and reflexive about this process, and by making our interpretations as transparent as possible, we hope to have gained sufficient rigor.

The traditional debate on health and disease concepts commonly departs from theory rather than from practice. In line with recent calls for experimental philosophy of medicine and empirical philosophy of science, we suggest that theoretical work could benefit from incorporating empirical research. In this qualitative interview study, we have examined the relevance and significance of health and disease concepts, as experienced by participants in various healthcare practices. We found that there are three types of functions that health and disease concepts serve in practice: (1) ‘Strategic development, politics and policy-making’, (2) ‘Institutional and social function’, and (3), ‘Guiding clinical practice and medical research’. Being aware of these different purposes may prevent bluntly using concepts beyond their functional scope. We also explored what kind of difficulties participants experienced in relation to the conceptualization of health and disease in practice, and found five main types of problematic situations: (1) Illness without identifiable pathology, (2) Biomedical versus holistic approaches, (3) Line-drawing and treatment threshold problems, (4) Problems with translational medicine: from research to the clinic, and beyond, and (5), Communication problems.

This study demonstrates how concepts of health and disease can influence different aspects of healthcare and healthcare-related practices and may sometimes contribute to complex problematic situations. By analyzing these influences, by making underlying implicit assumptions explicit, giving further interpretation to the problems observed in practice, providing theoretical frameworks and conceptual tools, and by suggesting conceptual changes or adaptations, we might be able to help solve some of these problems. To do this in a proper way, we need both theoretical and empirical work. If we want our philosophical definitions to be a part of the solution for real-world problems, it is important to consider the intuitions and ideas of people working in different types of medical fields, patients, researchers, and all other stakeholders [ 20 ]. Paraphrasing Immanuel Kant, we may conclude that philosophy of medicine without empirical research risks being empty, while empirical research without philosophical theorizing will still leave us blind. Going back and forth between theory and practice will probably result in a more complex but hopefully also in a better and more fruitful understanding of concepts of health and disease.

Data availability

The data that support the findings of this study are available from the Erasmus Medical Center but GDPR restrictions apply to the availability of these data and are therefore not publicly available.

The notion of experimental philosophy is relatively new and its definition is therefore not yet solidified. Sometimes it is used broadly, including various kinds of empirical research methods. In other instances, it refers specifically to philosophical studies with an experimental design, in which one variable is changed in isolation to measure changes in a philosophically relevant outcome (e.g., moral judgement). We believe that the latter, more narrow definition is useful to distinguish between experimental and other empirical studies. Therefore, in the title of our study, we explicitly use the term empirical philosophy instead of experimental philosophy.

This is, at least, how things are arranged in the Netherlands. Similar arrangements are in place in many other countries worldwide.

Incidental findings are anomalies that are detected in clinical tests that were in fact aimed on testing something else. As the clinical significance of these findings is often not clear, clinicians and/or clinical researchers are confronted with ethical dilemmas [ 37 , 38 , 39 ].

EBM can be described as an approach towards medicine that takes scientific evidence as a central point for guiding clinical decision-making. Typically, in EBM meta-analyses and randomized clinical trials (RCTs) are considered to be the highest forms of scientific evidence. While these methods can indeed have strong benefits over other types of medical research, there is ample discussion about its down sides as well [ 40 , 41 , 42 ].

For instance, general physicians, who provide primary care, use a different classification system (International Classification of Primary Care; ICPC) than a medical specialist in a hospital (International Statistical Classification of Diseases and Related Health Problems; ICD), who provides secondary and tertiary care, uses. Physiotherapists (International Classification of Functioning, Disability and Health; ICF), and psychologists (Diagnostic and Statistical Manual of Mental Disorders; DSM), in turn, also use different types of classification systems.

Another way to frame this would be to say that in emergency care, only ‘disease’ may be relevant to provide proper medical care, whereas in a rehabilitation setting the whole triad of disease, illness and sickness is being addressed.

Hofmann B. Managing the moral expansion of medicine. BMC Med Ethics. 2022;23(97). https://doi.org/10.1186/s12910-022-00836-2 .

Hofmann B. Does disease incite a stronger moral appeal than health? BMC Med. 2023;21(419). https://doi.org/10.1186/s12916-023-03110-3 .

Lemoine M. Defining disease beyond conceptual analysis: an analysis of conceptual analysis in philosophy of medicine. Theor Med Bioeth. 2013;34:309–25. https://doi.org/10.1007/s11017-013-9261-5 .

Article Google Scholar

Schwartz PH. Decision and discovery in defining ‘disease’. In: Kincaid H, McKitrick J, editors. Establishing medical reality. Dordrecht: Springer; 2007. pp. 47–63.

Chapter Google Scholar

Van der Linden R, Schermer M. Health and disease as practical concepts: exploring function in context-specific definitions. Med Health Care Philos. 2022;25:131–40. https://doi.org/10.1007/s11019-021-10058-9 .

De Vreese L. How to proceed in the disease concept debate? A pragmatic approach. J Med Philos. 2017;42(4):424–46. https://doi.org/10.1093/jmp/jhx011 .

Haverkamp B, Bovenkerk B, Verweij MA, Practice-Oriented. Review of Health concepts. J Med Philos. 2018;43(4):381–401. https://doi.org/10.1093/jmp/jhy011 .

Nordby H. The analytic-synthetic distinction and conceptual analysis of basic health concepts. Med Health Care Philos. 2006;9(2):169–80. https://doi.org/10.1007/s11019-006-0002-7 .

Nordby H. Who are the rightful owners of the concepts disease, illness and sickness? A pluralistic analysis of basic health concepts. Open J Philos. 2019;9:470–92. https://doi.org/10.4236/ojpp.2019.94029 .

Schwartz PH. Progress in defining disease: improved approaches and increased impact. J Med Philos. 2017;42:485–502. https://doi.org/10.1093/jmp/jhx012 .

Walker MJ, Rogers WA. A new approach to defining disease. J Med Philos. 2018;43(4):402–20. https://doi.org/10.1093/jmp/jhy014 .

Rogers WA, Walker MJ. Précising definitions as a way to combat overdiagnosis. J Eval Clin Pract. 2018;24:1019–25. https://doi.org/10.1111/jep.12909 .

Schulz S, Harzheim L, Hübner C, Lorke M, Jünger S, Woopen C. Patient-centered empirical research on ethically relevant psychosocial and cultural aspects of cochlear, glaucoma and cardiovascular implants – a scoping review. BMC Med Ethics. 2023;24(68). https://doi.org/10.1186/s12910-023-00945-6 .

Sanchini V, Sala R, Gastmans C. The concept of vulnerability in aged care: a systematic review of argument-based ethics literature. BMC Med Ethics. 2022;23(84). https://doi.org/10.1186/s12910-022-00819-3 .

Schleidgen S, Klingler C, Bertram T, Rogowski WH, Marckmann G. What is personalized medicine: sharpening a vague term based on a systematic literature review. BMC Med Ethics. 2013;14(55). https://doi.org/10.1186/1472-6939-14-55 .

Erdmann A, Rehmann-Sutter C, Bozzaro C. Patients’ and professionals’ views related to ethical issues in precision medicine: a mixed research synthesis. BMC Med Ethics. 2021;22:116. https://doi.org/10.1186/s12910-021-00682-8 .

Seidlein AH, Salloch S. Illness and disease: an empirical-ethical viewpoint. BMC Med Ethics. 2019;20(5). https://doi.org/10.1186/s12910-018-0341-y .

Kon AA. The role of empirical research in bioethics. Am J Bioeth. 2009;9:59–65. https://doi.org/10.1080/15265160902874320 .

Verberne WR, Stiggelbout AM, Bos WJW, van Delden JJM. Asking the right questions: towards a person-centered conception of shared decision-making regarding treatment of advanced chronic kidney disease in older patients. BMC Med Ethics. 2022;23(47). https://doi.org/10.1186/s12910-022-00784-x .

De Block A, Hens K. A plea for an experimental philosophy of medicine. Theor Med Bioeth. 2021;42:81–9. https://doi.org/10.1007/s11017-021-09551-2 .

Veit W. Experimental philosophy of medicine and the concepts of health and disease. Theor Med Bioeth. 2021;42:169–86. https://doi.org/10.1007/s11017-021-09550-3 .

Ankeny R, Chang H, Boumans M, Boon M. Introduction: philosophy of science in practice. Eur J Philos Sci. 2011;1:303. https://doi.org/10.1007/s13194-011-0036-4 .

Kampourakis K. Empirical philosophy of Science. Sci Educ. 2019;28:1–3. https://doi.org/10.1007/s11191-019-00035-3 .

Hofmann B. Do health professionals have a prototype concept of disease? The answer is no. Philos Ethics Humanit Med. 2017;12(6):1–7. https://doi.org/10.1186/s13010-017-0047-7 .

Stronks K, Hoeymans N, Haverkamp B, den Hertog FRJ, van Bon-Martens MJH, Galenkamp H, Verweij M, van Oers HAM. Do conceptualisations of health differ across social strata? A concept mapping study among lay people. BMJ Open. 2018;8:e020210. https://doi.org/10.1136/bmjopen-2017-020210 .

Kohne ACJ, De Graauw LP, Leenhouts-van der Maas R, van Os J. Clinician and patient perspectives on the ontology of mental disorder: a qualitative study. Front Psychiatry. 2023;14:1081925. https://doi.org/10.3389/fpsyt.2023.1081925 .

Van Heteren F, Raaphorst N, Groeneveld S, Bussemaker J. Professionals’ health conceptions of clients with psychosocial problems: an analysis based on an empirical exploration of semi-structured interviews. Int J Nurs Stud Adv. 2023;5:100120. https://doi.org/10.1016/j.ijnsa.2023.100120 .

Wright HG. John Dewey’s view of situations, problems, means and ends. In: Wright HG, editor. Means, ends and Medical Care. Dordrecht: Springer; 2007. p. 92. https://doi.org/10.1007/978-1-4020-5292-7_4 .

Corbin J, Strauss A. Basics of qualitative research: techniques and procedures for developing grounded theory. California: Sage; 2008.

Book Google Scholar

Hsieh H, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res. 2005;15:1277–88. https://doi.org/10.1177/1049732305276687 .

Rogers WA, Walker MJ. The line-drawing problem in disease definition. J Med Philos. 2017;42(4):405–23. https://doi.org/10.1093/jmp/jhx010 .

Engel GL. The need for a new medical model: a challenge for biomedicine. Science. 1977;196(4286):129–36. https://doi.org/10.1126/science.847460 .

Bolton D. Looking forward to a decade of the biopsychosocial model. BJPsych Bull. 2022;46(4):228–32. https://doi.org/10.1192/bjb.2022.34 .

Bolton D, Gillett G. The Biopsychosocial Model of Health and Disease: New Philosophical and Scientific developments. London: Palgrave Pivot Cham; 2019. https://doi.org/10.1007/978-3-030-11899-0_1 .

Huber M, Knottnerus JA, Green L, van der Horst H, Jadad AR, Kromhout D, Leonard B, et al. How should we Define Health? BMJ. 2011;343(7817):235–37. https://doi.org/10.1136/bmj.d4163 .

Huber M, van Vliet M, Giezenberg M, Winkens B, Heerkens Y, Dagnelie PC, Knottnerus JA. Towards a ‘patient-centred’ operationalisation of the new dynamic concept of health: a mixed methods study. BMJ Open. 2016;6(1):1–12. https://doi.org/10.1136/bmjopen-2015-010091 .

Bomhof C, van Bodegom L, Vernooij M, Pinxten W, de Beaufort I, Bunnik E. The impact of incidental findings detected during brain imaging on Research participants of the Rotterdam Study: an interview study. Camb Q Healthc Ethics. 2020;29(4):542–56. https://doi.org/10.1017/S0963180120000304 .

Wagner J, Aron DC. Incidentalomas – A ‘‘disease’’ of modern imaging technology. Best Pract Res Clin Endocrinol Metab. 2012;26(1):3–8. https://doi.org/10.1016/j.beem.2011.08.006 .

Wolf SM, Introduction. The challenge of incidental findings. J Law Med Ethics. 2008;26(2):216–8. https://doi.org/10.1111/j.1748-720X.2008.00265.x .

Bolt TC, Huisman F. Disease specificity and evidence-based medicine: a historical perspective. Eur J Person Cent Healthc. 2020;8:308–14. https://doi.org/10.5750/ejpch.v8i3.1795 .

Borck C. Negotiating Epistemic hierarchies in Biomedicine: the rise of evidence-based medicine. In: Epple M, Imhausen A, Müller F, editors. Weak knowledge: forms, functions, and Dynamics. Frankfurt: Campus; 2020. pp. 449–82.

Google Scholar

Parker M. Whither our art? Clinical wisdom and evidence-based medicine. Med Health Care Philos. 2002;5:273–80. https://doi.org/10.1023/A:1021116516342 .

Alpinar-Sencan Z, Schicktanz S. Addressing ethical challenges of disclosure in dementia prediction: limitations of current guidelines and suggestions to proceed. BMC Med Ethics. 2020;21(33). https://doi.org/10.1186/s12910-020-00476-4 .

Schermer MHN. Preclinical disease or risk factor? Alzheimer’s Disease as a case study of changing conceptualizations of Disease. J Med Philos. 2023;48(4):322–34. https://doi.org/10.1093/jmp/jhad009 .

Tromp K, Smedinga M, Richard E, Perry M, Schermer M. Views on early diagnosis of Alzheimer’s Disease among Dutch Physicians: a qualitative interview study. J Alzheimers Dis. 2021;79(2):917–27.

Twaddle A. ‘Disease, illness and sickness revisited’. In: Twaddle A, Nordenfelt L, editors. Disease, illness and sickness: three Central concepts in the theory of Health. Linköping: Linköping University; 1994. pp. 1–18.

Hofmann B. On the Triad Disease, illness and sickness. J Med Philos. 2002;27(6):651–73. https://doi.org/10.1076/jmep.27.6.651.13793 .

Hesslow G. Do we need a concept of disease? Theor Med. 1993;14:1–14. https://doi.org/10.1007/BF00993984 .

Kukla QR. What counts as disease, and why does it matter? J Philos Disabil. 2022;2:130–56. https://doi.org/10.5840/jpd20226613 .

Kukla R. Infertility, epistemic risk, and disease definitions. Synthese. 2019;196:4409–28. https://doi.org/10.1007/s112 .

Htut Maung H. Is infertility a disease and does it matter? Bioethics. 2019;33:43–53. https://doi.org/10.1111/bioe.12495 .

Davies R, Ives J, Dunn M. A systematic review of empirical bioethics methodologies. BMC Med Ethics. 2015;16(15). https://doi.org/10.1186/s12910-015-0010-3 .

Ives J, Dunn M. Who’s arguing? A call for reflexivity in bioethics. Bioethics. 2010;24(5):256–65. https://doi.org/10.1111/j.1467-8519.2010.01809.x .

Download references

Acknowledgements

The authors would like to thank all the participants of the interview study for their input.

This research is funded by the Dutch Scientific Organization (NWO), Project Number 406.18.FT.002. The funding body played no role in the design of the study and collection, analysis, interpretation of data, and in writing the manuscript.

Author information

Authors and affiliations.

department of Medical Ethics, Philosophy & History of Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands

Rik R. van der Linden & Maartje H.N. Schermer

You can also search for this author in PubMed Google Scholar

Contributions

RL and MS were both involved in conceptualizing and designing the qualitative study, and both wrote the main manuscript. RL conducted the interviews with the participants. Both authors analyzed and interpreted the qualitative data. MS has secured the funding. Both authors read and approved the final manuscript.

Corresponding author

Correspondence to Rik R. van der Linden .

Ethics declarations

Ethics approval and consent to participate.

The research proposal was submitted for review by the research ethics review committee of the Erasmus Medical Center. A waiver was granted (MEC-2021-0584), as the study did not fall within the scope of the WMO (Dutch Medical Research Involving Human Subject Act). This study was carried out in accordance with General Data Protection Regulation (GDPR), and the Privacy Regulation of Erasmus Medical Center. Written and oral informed consent was obtained before the start of the interviews.

Consent for publication

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Rights and permissions.

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ . The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article.

van der Linden, R.R., Schermer, M.H. Exploring health and disease concepts in healthcare practice: an empirical philosophy of medicine study. BMC Med Ethics 25 , 38 (2024). https://doi.org/10.1186/s12910-024-01037-9

Download citation

Received : 12 December 2023

Accepted : 13 March 2024

Published : 27 March 2024

DOI : https://doi.org/10.1186/s12910-024-01037-9

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Health and disease concepts
Empirical philosophy
Philosophy of medicine

BMC Medical Ethics

ISSN: 1472-6939

General enquiries: [email protected]

More From Forbes

Scientists tend to inflate how ethical they are in doing their research.

Share to Facebook
Share to Twitter
Share to Linkedin

We have known for a long time that people tend to paint a rosy picture of how good they are. Now we know that scientists are no exception, at least when it comes to conducting their own research. This is especially surprising since scientists are regularly thought to be objective.

Research and Ethics - clinical trial law and rules, Medical compliance.

This new discovery emerged from a massive survey of 11,050 scientific researchers in Sweden, conducted by Amanda M. Lindkvist, Lina Koppel, and Gustav Tinghög at Linköping University and published in the journal Scientific Reports. The survey was very simple, with only two questions. Here was the first:

Question One : In your role as a researcher, to what extent do you perceive yourself as following good research practices—compared to other researchers in your field?

Rather than allowing the survey participants to each define what ‘good research practice’ is, the researchers gave them these criteria:

(1) Tell the truth about one’s research.

(2) Consciously review and report the basic premises of one’s studies.

(3) Openly account for one’s methods and results.

(4) Openly account for one’s commercial interests and other associations.

One Of The Best Shows Ever Made Lands On Netflix Today For The Very First Time

This popular google app will stop working in 3 days how to migrate your data, google suddenly reveals surprise android update that beats iphone.

(5) Not make unauthorized use of the research results of others.

(6) Keep one’s research organized, for example through documentation and filing.

(7) Stive to conduct one’s research without doing harm to people, animals or the environment.

(8) Be fair in one’s judgement of others’ research.

Note that many of these criteria have to do with honesty, but there are also ones on conscientiousness, non-malevolence, and fairness.

What were the results? Participants used a scale to rate themselves from 1 to 7, with 1 = Much less than other researchers, 4 = As much as other researchers, and 7 = Much more than other researchers. This is what the responses revealed:

44% rated themselves as more ethical in their research practices than other researchers in their field.

55% rated themselves as the same as their peers.

Not even 1% rated themselves as less ethical than their peers.

Of course these results can’t reflect real life, since mathematically there have to be more than 1% of scientists who are less than average in this area of their lives.

The other question that Lindkvist and his colleagues asked these scientific researchers was this:

Question Two : To what extent do you perceive researchers within your field as following good research practices–compared to researchers within other fields?

Here too the results were very skewed. 29% said their field followed good research practices to a greater extent than did scientists in other fields. Only 8% said it was the other way around.

These results should surprise us for a couple of reasons. One is that they go against the popular narrative of scientists as objective and neutral. When it comes to their own ethical behavior in conducting their research, they appear as a whole to be biased and overconfident. Another reason these results are surprising is that many scientists are likely aware of the existence of scientific research on how people in general tend to have an inflated view of their own virtue . So you’d expect that they would be on guard against such a tendency in their own case.

There are dangers that come with scientists having an overly positive view of their own research ethics. Lindkvist helpfully explains one of them: it “may lead researchers to underestimate the ethical implications of the decisions they make and to sometimes be blind to their own ethical failures. For example, researchers may downplay their own questionable practices but exaggerate those of other researchers, perhaps especially researchers outside their field.” Another danger that Lindkvist notes is a greater tendency to ignore warnings and ethical safeguards, if they are dismissed by a scientist as applying to others but not to her since she thinks she is above average.

It would be interesting in future work to see if similar patterns emerge with researchers in other countries besides Sweden. It would also be interesting to look at researchers anonymously rating the research ethics of their colleagues in their own departments and schools.

If these results hold up, it will be important to find ways to encourage scientific researchers to correct their inflated perceptions. As Lindkvist urges, “To restore science’s credibility, we need to create incentive structures, institutions, and communities that foster ethical humility and encourage us to be our most ethical selves in an academic system that otherwise incentivizes us to be bad.”

Editorial Standards
Reprints & Permissions

Professor Wins Second National Accounting Ethics Award

An article written by Douglas M. Boyle, DBA, chair of The University of Scranton’s Accounting Department and director of the University’s Ph.D. in Accounting program, received the 2024 Curt Verschoor Ethics Feature of the Year Award from the Institute of Management Accountants’ Committee on Ethics and Strategic Finance. This is the second-time Dr. Boyle has received this national award.

An accounting professor at The University of Scranton won his second national award that annually recognizes one article “that focuses on the importance of ethics in business as a whole and finance and accounting in particular.”

Selected by the Institute of Management Accountants’ Committee on Ethics and Strategic Finance for the 2024 Curt Verschoor Ethics Feature of the Year Award, the article “The Fraud Prevention Pyramid” was written by Douglas M. Boyle, DBA, chair of The University of Scranton Accounting Department and director of the University’s Ph.D. in Accounting program, and Dana Hermanson, Ph.D., professor of accounting at Kennesaw State University and the Dinos Eminent Scholar of Private Enterprise. The article was published in Strategic Finance in March of 2024.

Accounting professors at Scranton have won this prestigious, national ethics award more than faculty at any other university in the nation. Dr. Boyle won the inaugural Curt Verschoor Ethics Feature of the Year Award in 2020 for an article written by him and Scranton accounting professors Amanda S. Marcy, Ph.D., James F. Boyle, DBA, and Daniel P. Mahoney, Ph.D. Dr. Marcy won the 2023 Curt Verschoor Ethics Feature of the Year Award for an article written with class of 2021 Scranton business doctoral student Ronald Douglas Parker, DBA, now an assistant professor of accounting at Western Carolina University.

In the article that won the 2024 Curt Verschoor Ethics Feature of the Year Award, Drs. Boyle and Hermanson introduce a five-stage Fraud Prevention Pyramid, which they write is “designed to assist financial professionals and others in building a career-long ability to shield themselves from fraud. It contains five increasingly advanced stages of anti-fraud preparation: developing fraud awareness and acumen; understanding fraud ingredients; avoiding common fraud pitfalls; mitigating dark triad traits and pressure; and mastering emotional intelligence.”

The article concludes with ways in which the Fraud Prevention Pyramid can be used to encourage ethical behavior by boards and executives and by organizations through continuing education programs, as well as by individuals for personal development.

Articles written by Dr. Boyle and doctoral students at Scranton and fellow professors have received numerous awards, including most recently a 2023 Institute of Management Accountants’ (IMA) Lybrand Silver Medal and Certificate of Merit .

With respect to authorships of individual accounting faculty in the area of accounting education, Dr. Boyle, was ranked No. 5 in the world for research publishing success by most-recent 2023 Brigham Young University Accounting Rankings, a listing considered to be the gold standard in accounting disciplines.

Dr. Boyle is a Certified Public Accountant and a Certified Management Accountant with more than 30 years of industry executive experience. He has served in executive roles in startup, middle market, and Fortune 500 companies, where he has held the positions of board chair, chief executive officer, president, chief operations officer and chief financial officer. An award-winning researcher and teacher, Dr. Boyle was selected as the IMA Research Foundation Distinguished Scholar in 2022, awarded the Outstanding Accounting Educator of the Year Award from the Pennsylvania Institute of Certified Public Accountants in 2015, and an Outstanding Lecturer Award from the Cultural Mission of the Royal Embassy of Saudi Arabia in 2012. At Scranton, Dr. Boyle earned Provost Excellence Awards for University Service and Leadership in 2021, the Scholarship of Teaching in 2014 and Scholarly Publication in 2012, and the Faculty Senate’s Excellence in Graduate Teaching Award in 2019. He was named the Kania School of Management’s (KSOM) Alperin Teaching Fellow for 2015 to 2018 and received the KSOM Advisory Board’s Award for Curriculum Innovation for 2017-2018. He received the KSOM Faculty Research Award for 2019 – 2020 and was twice recognized as the KSOM Teacher of the Year. He is the founder and director of the University’s Nonprofit Leadership Certificate Program .

Dr. Boyle earned a bachelor’s degree from The University of Scranton, an MBA from Columbia University and a doctorate from Kennesaw State University.

Interview with Gerd B. Müller on Theoretical Biology

Perspective
Published: 09 October 2023
Volume 16 , pages 381–394, ( 2023 )

Cite this article

Kalevi Kull 1

159 Accesses

Explore all metrics

The topics discussed in the interview cover the development and activities of the Konrad Lorenz Institute for Evolution and Cognition Research as one of the most important theoretical biology centers in the world, the reasons for its inspiring atmosphere, as well as the development of the interests and research work of its longtime president Gerd B. Müller. An important part of this is the work on a revised theoretical framework of evolution, the Extended Evolutionary Synthesis. We also talk about the place of biosemiotics in biology and about the situation and future perspectives of theoretical biology in general. With this interview we celebrate Gerd Müller’s 70th birthday.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price includes VAT (Russian Federation)

Instant access to the full article PDF.

Rent this article via DeepDyve

Institutional subscriptions

Can a Muslim be an Evolutionist?

An evolutionary perspective on Kohlberg’s theory of moral development

Eugene W. Mathes

Is Evolutionary Psychology a Scientific Revolution? A Bibliometric Analysis

Andrea Zagaria

See also his autobiographical sketch: Müller, 2011 .

About this important conference, see a review in Kull, 2016 .

See, for instance, an overview in Kull & Favareau, 2022 . In the context of the extended evolutionary synthesis, see also Kull, 2022 .

Acknowledgements

Many thanks to Gerd Müller for his excellent work in theoretical biology and congratulations on his 70th birthday.

Author information

Authors and affiliations.

Department of Semiotics, University of Tartu, Tartu, Estonia

Kalevi Kull

You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kalevi Kull .

Ethics declarations

Conflict of interests.

The author declares no conflict of interests.

Additional information

Publisher's note.

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Kull, K. Interview with Gerd B. Müller on Theoretical Biology. Biosemiotics 16 , 381–394 (2023). https://doi.org/10.1007/s12304-023-09543-w

Download citation

Received : 31 August 2023

Accepted : 11 September 2023

Published : 09 October 2023

Issue Date : December 2023

DOI : https://doi.org/10.1007/s12304-023-09543-w

Share this article

Anyone you share the following link with will be able to read this content:

Sorry, a shareable link is not currently available for this article.

Provided by the Springer Nature SharedIt content-sharing initiative

Austrian biology
Developmental biology
Extended evolutionary synthesis
History of biology
Konrad Lorenz Institute
Theoretical biology
Find a journal
Publish with us
Track your research

Watch CBS News

Supreme Court grapples with online First Amendment rights as social media teems with misinformation

By Lesley Stahl

March 24, 2024 / 7:30 PM EDT / CBS News

As big tech firms wrestle with how to keep false and harmful information off their social networks, the Supreme Court is wrestling with whether platforms like Facebook and Twitter, now called X, have the right to decide what users can say on their sites.

The dispute centers on a pair of laws passed in the red states of Florida and Texas over the question of First Amendment rights on the internet. The Supreme Court is considering whether the platforms are like newspapers, which have free speech rights to make their own editorial decisions, or if they're more like telephone companies, that merely transmit everyone's speech.

If the laws are upheld, the platforms could be forced to carry hate speech, and false medical information, the very content most big tech companies have spent years trying to remove through teams of content moderators. But in the process, conservatives claim that the companies have engaged in a conspiracy to suppress their speech.

As in this case: a tweet in 2022 from Congresswoman Marjorie Taylor Greene falsely claiming that there were… "Extremely high amounts of COVID vaccine deaths."

Twitter eventually banned Greene's personal account for "multiple violations" of its COVID policy.

Facebook and YouTube also removed or labeled posts they deemed "misinformation."

Confronted with criticisms from conservatives like Congressman Jim Jordan, that the social media companies were censoring their views, and because of cost-costing, platforms began downsizing their fact checking teams.

So today, social media is teeming with misinformation. Like these posts suggesting tanks are moving across the Texas-Mexico border. But it's actually footage from Chile.

These are AI-generated images of – well, see for yourself.

With social media moderation teams shrinking, a new target is misinformation academic researchers who began working closely with the platforms after evidence of Russian interference online in the 2016 election.

Lesley Stahl: Are researchers being chilled?

Kate Starbird: Absolutely.

Kate Starbird is a professor at the University of Washington, a former professional basketball player, and a leader of a misinformation research group created ahead of the 2020 election.

Kate Starbird: We were very specifically looking at misinformation about election processes, procedures, and election results. And if we saw something about that, we would pass it along to the platforms if we thought it violated their-- one of their policies.

Here's an example: a November 2020 tweet saying that election software in Michigan "switched 6,000 votes from Trump to Biden."

The researchers alerted Twitter that then decided to label it with a warning.

Lesley Stahl: I understand that some of the researchers, including you, have-- had some threats against them death threats.

Kate Starbird: I have received one. Sometimes they're threats with something behind them. And sometimes they are just there to make you nervous and uncomfortable. And it's hard to know the difference.

Lesley Stahl: This campaign against you is meant to discredit you. So we won't believe you.

Kate Starbird: Absolutely. It's interesting that the people that pushed voter fraud lies are some of the same people that are trying to discredit researchers that are trying to understand the problem.

Lesley Stahl: Did your research find that there was more misinformation spread by conservatives?

Kate Starbird: Absolutely. I think-- not just our research, research across the board, looking at the 2020 election found that there was more misinformation spread by people that were supporters of Donald Trump or conservatives. And the events of January 6th kind of underscore this.

Kate Starbird: The folks climbing up the Capitol Building were supporters-- of Donald Trump. And they were-- they were misinformed by these false claims. And-- and that motivated those actions.

Ohio Republican Congressman Jim Jordan is chairman of the House Judiciary Committee.

Lesley Stahl: So how big a problem is mis and disinformation on the web?

Rep. Jim Jordan: Well, I'm sure there's some. But I think, you know-- our concern is the bigger problem of the attack on First Amendment liberties.

Congressman Jordan's Judiciary Committee produced a report that concluded there's a "censorship industrial complex" where the federal government and tech companies colluded with academic researchers to disproportionately silence conservatives, which Kate Starbird vigorously denies.

But Congressman Jordan says her group unfairly flagged posts like this tweet by Newt Gingrich:

"Pennsylvania democrats are methodically changing the rules so they can steal the election"

He complains that government officials put pressure on social media companies directly –

Rep. Jim Jordan: A great example, 36 hours into the Biden administration, the-- the Biden White House sends-- a email to Twitter and says, "We think you should take down this tweet ASAP."

Just a call alone from the government, he says, can be unnerving.

Rep. Jim Jordan: You can't have the government say, "Hey, we want you to do X," government who has the ability to regulate these private companies, government which has the ability to tax these private companies.

He says that White House email to Twitter involved a tweet from…

Rep. Jim Jordan: Robert F. Kennedy Jr. and everything in the tweet was true.

That tweet implied falsely that baseball legend Hank Aaron's death was caused by the COVID vaccine.

Lesley Stahl: Did they take it down?

Rep. Jim Jordan: Turned out they didn't. Thank goodness.

And that post is still up.

Kate Starbird says the social media platforms also often ignored the researchers' suggestions.

Kate Starbird: The statistics I've seen are just for the Twitter platform. But I-- my understanding is-- is that they've responded to about 30% of the things that we sent them. And I think the-- on the majority of those, they put labels.

Lesley Stahl: But just a third.

Kate Starbird: Just a third, yeah.

Lesley Stahl: And do you suspect that Facebook was the same?

Kate Starbird: Oh, yeah.

Katie Harbath: These platforms have their own First Amendment rights.

Katie Harbath spent a decade at Facebook where she helped develop its policies around election misinformation. When she was there, she says it was not unusual for the government to ask Facebook to remove content, which is proper, as long as the government is not coercing.

Katie Harbath: Conservatives are alleging that the platforms were taking down content at the behest of the government which is not true. The platforms made their own decisions. And many times we were pushing back on the government.

Lesley Stahl: Can we talk about a specific case? It's of Nancy Pelosi. It's a doctored tape where she's-- she looks drunk.

This was the video of then-House Speaker Pelosi posted to Facebook in 2019, slowed down to make it seem that she was slurring her words.

Lesley Stahl: Did it come down?

Katie Harbath: It did not.

Lesley Stahl: Why?

Katie Harbath: Because it didn't violate the policies that they had.

Lesley Stahl: So did she put pressure on the company to take it down?

Katie Harbath: She was definitely not pleased.

Lesley Stahl: Is that a yes?

Katie Harbath: Yes. And it really damaged the relationship that the company had with her.

The conservatives' campaign faced a setback at the Supreme Court on Monday when a majority of the justices seemed poised to reject their effort to limit attempts by the government to influence social media.

The court is deciding, in separate cases, whether the platforms are like news organizations with a First Amendment right to control who and what information appears on their sites.

Congressman Jordan argues that the tech companies shouldn't remove most of what they call "misinformation."

Rep. Jim Jordan: I think you let the American people, respect the American people, their common sense, to figure out what's accurate, what isn't.

Lesley Stahl: Well, what about this idea that they-- the 2020 election was stolen? You think that these companies should allow people to say that and individuals can make up their own mind and that there should be--

Rep. Jim Jordan: I think the American people are smart. Look-- I've not said that. What I've said is there were concerns about the 2020 election. I think Americans agree with that.

Lesley Stahl: No they don't--

Rep. Jim Jordan: You don't think they think there were concerns with the 2020 election?

Lesley Stahl: Most people don't question the result. That's all I'm saying. They don't question whether--

Rep. Jim Jordan: Fair enough.

Lesley Stahl: Biden won or not. Right? Right? Most people don't question

Rep. Jim Jordan: Oh, OK. No--

Lesley Stahl: The outcome.

Rep. Jim Jordan: Right.

X basically did what Jordan proposes. After Elon Musk took over in 2022, most of its fact checkers were fired. Now the site is rife with trash talk and lies. Little would you know that this – said to be footage from Gaza -- is really from a video game. Eventually X users added a warning label.

In this post, pictures of real babies killed in Israeli strikes are falsely dismissed as dolls.

Darrell West: The toothpaste is out of the tube and we have to figure out how to deal with the resulting mess.

Darrell West, a senior fellow of technology innovation at the Brookings Institution, says the clash over "what is true" is fraying our institutions and threatening democracies around the world.

Darrell West: Half of the world is voting this year and the world could stick with democracy or move toward authoritarianism. The danger is disinformation could decide the elections in a number of different countries.

In the U.S., he says, the right wing has been flooding the internet with reams of misleading information in order to confuse the public. And he's alarmed by the campaign to silence the academic researchers, who have had to spend money and time on demands from Jim Jordan's Judiciary Committee.

Lesley Stahl: There are people who make the accusation that going after these researchers, misinformation researchers, is tantamount to harassment. And that your goal really is to chill the research.

Rep. Jim Jordan: I find it interesting that you use the word "chill," because in-- in effect, what they're doing is chilling First Amendment free speech rights. When, when they're working in an effort to censor Americans, that's a chilling impact on speech.

Lesley Stahl: They say what you're doing, they do, is a violation of their First Amendment right.

Rep. Jim Jordan: So us pointing out, us doing our constitutional duty of oversight of the executive branch-- and somehow w-- (LAUGH) we're censoring? That makes no sense.

Lesley Stahl: We Americans, we're looking at the same thing and seeing a different truth.

Rep. Jim Jordan: We might see different things, I don't-- I don't think you can see a different truth, because truth is truth.

Lesley Stahl: Okay. The-- the researchers say they're being chilled. That's their truth.

Rep. Jim Jordan: Yeah.

Lesley Stahl: You're saying they're not. So what's the truth?

Rep. Jim Jordan: They can do their research. God bless em', do all the research you want. Don't say we think this particular tweet is not true-- and-- or-- or--"

Lesley Stahl: Well, that's their First Amendment right to say that.

Rep. Jim Jordan: Well, they can say it, but they can't take it down.

Lesley Stahl: Well, they can't take it down and they don't. They just send their information to the companies.

Rep. Jim Jordan: But when they're coordinating with government, that's a different animal.

Lesley Stahl: Okay, well, of course, they deny they're coordinating.

We just went round and round.

Starbird says she and her team feel intimidated by the conservatives' campaign, so while they will continue releasing their research reports on misinformation, they will no longer send their findings to the social media platforms.

Produced by Ayesha Siddiqi. Associate producer, Kate Morris. Broadcast associates, Wren Woodson and Aria Een. Edited by Matthew Lev.

One of America's most recognized and experienced broadcast journalists, Lesley Stahl has been a "60 Minutes" correspondent since 1991.

More from CBS News

Indian Relay horse races have historic roots for Native American tribes

Hillary Clinton, Malala Yousafzai on producing Broadway musical "Suffs"

Indian Relay races connect Horse Nations tribes with "warriors of the past"

Gold prices hit a new high: Should you buy in now?

Ethics & Leadership
Fact-Checking
Media Literacy
The Craig Newmark Center
Reporting & Editing
Ethics & Trust
Tech & Tools
Business & Work
Educators & Students
Training Catalog
Custom Teaching
For ACES Members
All Categories
Broadcast & Visual Journalism
Fact-Checking & Media Literacy
In-newsroom
Memphis, Tenn.
Minneapolis, Minn.
St. Petersburg, Fla.
Washington, D.C.
Poynter ACES Introductory Certificate in Editing
Poynter ACES Intermediate Certificate in Editing
Ethics & Trust Articles
Get Ethics Advice
Fact-Checking Articles
International Fact-Checking Day
Teen Fact-Checking Network
International
Media Literacy Training
MediaWise Resources
Ambassadors
MediaWise in the News

Support responsible news and fact-based information today!

Baltimore’s mayor asked journalists to stop airing footage of the Key Bridge collapse. Should they?

What responsibilities do news organizations have when showing dramatic images of disasters.

The Francis Scott Key Bridge in Baltimore collapsed early Tuesday morning after it was struck by a cargo ship. As of Tuesday night, six construction workers who were working on the bridge at the time were still missing.

Baltimore Mayor Brandon Scott appeared on CNN on Tuesday, and while being interviewed, CNN showed dramatic video of the bridge collapsing over and over.

During the interview, Scott said , “I’m going to be the first to ask that CNN and everyone else stop showing the video. No one needs to see … a possibility of their family member being severely injured or otherwise, over and over and over again because it’s just traumatizing our community.”

To be clear, CNN wasn’t the only news outlet showing video of the bridge being hit by the ship and then collapsing. In fact, as far as I could tell, every major news network showed the video. And it was on the homepages of The New York Times and The Washington Post for most of Tuesday.

Often, accidents and tragedies are caught on video, and so a question arises: What responsibility do news organizations have when showing these kinds of videos?

When it comes to the Key Bridge collapse, I asked my colleague Kelly McBride, Poynter’s senior vice president and chair of Craig Newmark Center for Ethics and Leadership, to share her thoughts.

More from Poynter: What those covering the Key Bridge collapse can learn from reports about the 1980 Skyway disaster

She told me, “The image of the bridge collapsing isn’t particularly traumatic to the audience viewing it. The camera is quite distant, and it wasn’t a targeted act of violence meant to terrorize, the way that 9/11 was or the many mass shootings that we’ve experienced. It was an accident, like a volcano erupting or an avalanche tumbling down.”

McBride added, “It is likely traumatic to the loved ones of the missing workers, as is all coverage of this news story, including images of the rescue operation and images of the bridge the moment before impact. For that reason, I could see some newsrooms electing to use a still image or limit the use of the video. But given the widespread distribution of the video, that won’t make much of a difference in the overall use of it. I don’t think using the video is particularly insensitive as long as the news coverage is advancing the story, by bringing in new perspectives and information.”

I also wanted to point you to a piece by Axios’ Zachary Basu and Sara Fischer: “Misinformation runs rampant after Baltimore bridge collapse.” They note how a bunch of conspiracy theories ran wild following the accident. Authorities were clear when they said there was no evidence that this was a terrorist attack.

Basu and Fischer wrote, “Rampant misinformation during mass casualty events is not a new phenomenon. But under Elon Musk’s ownership of X, the platform has evolved from an essential real-time news source to a breeding ground for conspiracy theories.”

This piece originally appeared in The Poynter Report, our daily newsletter for everyone who cares about the media. Subscribe to The Poynter Report here .

Opinion | Journalism schools must move beyond reporting to prepare graduates for modern media roles

As journalism rapidly evolves, J-schools must think critically about curriculums and equip graduates with skills for emerging roles across media.

Do Jesse Watters’ claims about the federal budget, LGBTQ+ and DEI funding add up?

The Fox News host’s five-part claim about programs funded by the latest federal budget ranges from missing context to inaccurate

Opinion | Wall Street Journal marks one year of reporter’s detainment in Russian jail

Evan Gershkovich was arrested a year ago today in Russia while on a reporting assignment for the Journal

A Baltimore bridge collapsed in the middle of the night and two metro newsrooms leapt into action

Coverage from The Baltimore Sun and The Baltimore Banner had much in common but with some marked differences — especially in visuals.

Private equity reporting grants show good return

Projects in Hawaii, Milwaukee and south central Indiana knit news organizations into community life

You must be logged in to post a comment.

This site uses Akismet to reduce spam. Learn how your comment data is processed .

Start your day informed and inspired.

Get the Poynter newsletter that's right for you.

IMAGES

Research Ethics: Definition, Principles and Advantages
Research Ethics
Research Ethics The History of Research Ethics
Ethics in researchThere exists complexity of research ethics Free Essay
What Are Research Ethics?
Research Ethics

VIDEO

Research Ethics and Policy Series (REPS): Nanibaa' Garrison, PhD
TREATs Talk: "Ethics Issues in Design and Testing of Medical Technologies"
Ethical Considerations in Research
ETHICS IN RESEARCH AND METHODOLOGY
Why Research and Ethics Matter in Filmmaking
ETHICS IN RESEARCH METHODOLOGY

COMMENTS

Ethical Issues in the Use of In-Depth Interviews: Literature Review and
types of article: general discussion, issues in particular studies, and studies of interview-based research ethics. Whilst many of the issues discussed in these articles are generic to research ethics, such as confidentiality, they often had par-ticular manifestations in this type of research. For example, privacy was a significant problem as ...
PDF 10 Principles of Ethical Interviewing and Observing
Quick Guide to Interviews and Observations Page 1 of 2 10 Principles of Ethical Interviewing and Observing 1. Accuracy: Your job is to present factual—not fabricated—information. Do not misrepresent the intended ... interaction will help you answer your research question, but be open to new insights gained, new avenues to explore, etc.
Ethical Considerations in Research
Research ethics are a set of principles that guide your research designs and practices in both quantitative and qualitative research. In this article, you will learn about the types and examples of ethical considerations in research, such as informed consent, confidentiality, and avoiding plagiarism. You will also find out how to apply ethical principles to your own research projects with ...
Ethical Guidelines for Online Interviews
ifariyike June 25, 2020 Ethical Guidelines for Online Interviews Ethics No Comment. Preamble. In all research encounters, it is vital to keep in mind that the ethnographer's primary goal should be maintaining the wellbeing of interlocutors. This mission extends into virtual environments as well, including in the realm of online interviews.
BPG 10 Conducting research interviews
CONDUCTING RESEARCH INTERVIEWS. This document is intended to provide guidance on identifying and addressing ethical issues associated with conducting interviews for research. Ethics approval is needed, in advance, for research interviews if the information gained from the interview will be used as research data to evidence research findings. If ...
(PDF) Ethical Issues in the Use of In-Depth Interviews: Literature
Abstract. This paper reports a literature review on the topic of ethical issues in in-depth interviews. The review returned three types of article: general discussion, issues in particular studies ...
Methodological and Ethical Considerations when Conducting Qualitative
This may be especially important and valuable for longitudinal interview studies. Researchers, research supervisors and human subject ethics committees are urged to establish protocols to guide how research relationships are ended within the context of qualitative methods, with considerations given to the length of research relationships.
Harm, change and unpredictability: the ethics of interviews in conflict
As researchers, while we can prepare, we know to expect interviews to be unpredictable: we cannot foresee how the relationship will develop and how this will impact the knowledge we generate (Swauger, 2011: 498).While the latter is an issue of substance, in this article, we engage with ethical considerations that emerge from the unpredictability of research interviews, as relationships between ...
Interviews in the social sciences
This article argues that, in qualitative interview research, a clearer distinction needs to be drawn between ethical commitments to individual research participants and the group(s) to which they ...
Ethical consideration dilemma: systematic review of ethics in
Research ethics considers the act of doing good and protecting the rights of ... Zoom and Teams) or face-to-face, and be recorded for analysis. The focus of the research investigation is interviews as the main qualitative data collection methods. 7.2 Interviews. This is the most common form of data collection for qualitative research ...
Research Ethics for Qualitative Interviewing
Dr. Bethany Morgan Brett, PhD, Lecturer in Psychosocial and Psychoanalytic Studies at the University of Essex, discusses research ethics for qualitative interviews, including the principles: do no harm, informed consent (forms, written, and verbal), and confidentiality and anonymity.
PDF Conducting Effective and Ethical Interviews Contents Contacting
Interviews are a great way to gain insight into individuals and their communities, and they are very frequently used for research in several disciplines. Whether a simple homework assignment or an extensive project, an interview allows for direct communication between a researcher and a population. Although much emphasis is often placed on the ...
Research Ethics
Research ethics is a foundational principle of modern medical research across all disciplines. The overarching body, the IRB, is intentionally comprised of experts across a range of disciplines that can include ethicists, social workers, physicians, nurses, other scientific researchers, counselors and mental health professionals, and advocates ...
(PDF) Ethical Interviewing
Making a human connection involves psychologists balancing their professional duties and responsibilities by connecting with prisoners as human beings. This echoes the idea of ethical interviewing ...
Ethical Issues in Research
Definition. Ethics is a set of standards, a code, or value system, worked out from human reason and experience, by which free human actions are determined as ultimately right or wrong, good, or evil. If acting agrees with these standards, it is ethical, otherwise unethical. Scientific research refers to a persistent exercise towards producing ...
Ethical Issues in Research: Perceptions of Researchers, Research Ethics
Data collection involved socio-demographic questionnaires and individual semi-structured interviews. Following the triangulation of different perspectives (researchers, REB members and ethics experts), emerging ethical issues were synthesized in ten units of meaning: (1) research integrity, (2) conflicts of interest, (3) respect for research ...
Ethical Issues in the Use of In-Depth Interviews: Literature Review and
The review returned three types of article: general discussion, issues in particular studies, and studies of interview-based research ethics. Whilst many of the issues discussed in these articles are generic to research ethics, such as confidentiality, they often had particular manifestations in this type of research. For example, privacy was a ...
Types of Interviews in Research
There are several types of interviews, often differentiated by their level of structure. Structured interviews have predetermined questions asked in a predetermined order. Unstructured interviews are more free-flowing. Semi-structured interviews fall in between. Interviews are commonly used in market research, social science, and ethnographic ...
Understanding Research Ethics
Failure to adhere to the research ethics will lead to research misconduct with repercussions. The main ethical principles that a researcher needs to follow are: i. Honesty—reporting of honest data, methodology, results, publication status. Additionally, do not deceive research sponsors, colleagues, or the public. ii.
Principles of research ethics: A research primer for low- and middle
Certain research may be exempted from IRB review and these typically include surveys, interviews, and research using existing specimens, records or data. The concept of "minimal risk to participants" plays a key role in allowing this exemption and should be considered when conducting research in LMIC's. ... Western research ethics considers ...
Research ethics guidance
Useful resources. Useful links to ethical codes, forms and templates and guidance. Our framework for research ethics helps you to consider ethics issues during the complete lifecycle of a project and includes information and guidelines on good research conduct and governance.
Exploring health and disease concepts in healthcare practice: an
In line with recent proposals for experimental philosophy and philosophy of science in practice, we propose that the philosophy of medicine could benefit from incorporating empirical research, just as bioethics has. In this paper, we therefore take first steps towards the development of an empirical philosophy of medicine, that includes investigating practical and moral dimensions. This ...
Scientists Tend to Inflate How Ethical They Are in Doing Their Research
Research and Ethics - clinical trial law and rules, Medical compliance. getty. This new discovery emerged from a massive survey of 11,050 scientific researchers in Sweden, conducted by Amanda M. ...
Professor Wins Second National Accounting Ethics Award
Selected by the Institute of Management Accountants' Committee on Ethics and Strategic Finance for the 2024 Curt Verschoor Ethics Feature of the Year Award, the article "The Fraud Prevention Pyramid" was written by Douglas M. Boyle, DBA, chair of The University of Scranton Accounting Department and director of the University's Ph.D. in ...
PDF Deloitte US
Deloitte US | Audit, Consulting, Advisory, and Tax Services
Interview with Gerd B. Müller on Theoretical Biology
The topics discussed in the interview cover the development and activities of the Konrad Lorenz Institute for Evolution and Cognition Research as one of the most important theoretical biology centers in the world, the reasons for its inspiring atmosphere, as well as the development of the interests and research work of its longtime president Gerd B. Müller. An important part of this is the ...
Ethical Dilemmas in Qualitative Research: A Critical Literature Review
To discuss the challenges faced by qualitative researchers in research ethics boards: Case studies—projects submitted to ethics boards: Research ethics boards review process may threaten core foundational principles. It is necessary a proportionate representation of qualitative researchers on research ethics boards: McMurphy et al. Canada ...
Supreme Court grapples with online First Amendment rights as social
Misinformation is spreading on social media as some fight to stop what they call censorship. The Supreme Court is now grappling with how the First Amendment applies to the online world.
Baltimore's mayor asked journalists to stop airing footage of the Key
When it comes to the Key Bridge collapse, I asked my colleague Kelly McBride, Poynter's senior vice president and chair of Craig Newmark Center for Ethics and Leadership, to share her thoughts.
Qualitative health research and procedural ethics: An interview study
The obligation to obtain approval for medical research from an independent research ethics committee (REC) is enshrined in article 23 of the Declaration of Helsinki of the World Medical Association (2013).Legal and professional regulations and levels of implementation of this ethical requirement vary across the globe.

Ethical Guidelines for Online Interviews

No Comments Yet

Interviews in the social sciences

Similar content being viewed by others

The fundamental importance of method to theory

How ‘going online’ mediates the challenges of policy elite interviews

Participatory action research

Introduction

Experimentation

Research design

Study design

Data collection

Topic guide

Optimizing the interview

Ethics and reflexivity

Ethical considerations prior to interview

Box 1 Mapping potential forms of harm

Ethical considerations post-interview

Reflexivity and positionality

Box 2 Aspects to reflect on reflexively

Preparing data

Box 3 Excerpt of interview transcript (from Teeger 24 )

From data to codes

From coding to analysis and writing

Applications

Nationalism and ethnicity

Education and inequality

The welfare state

Reproducibility and data deposition

Box 4 An example of grounding interpretations in data (from Rao 34 )

Limitations and optimizations

Breadth versus depth of insight

Naturalistic or artificial interviews

Dynamism and replicability

Accessing the private and personal

Collaborating and mixing

Digital innovations and challenges

The next 5–10 years

Acknowledgements

Author information

Contributions

Corresponding author

Ethics declarations

Peer review

Additional information

Rights and permissions

About this article

Share this article

This article is cited by

Between the dog and the wolf: an interpretative phenomenological analysis of bicultural, sexual minority people’s lived experiences

Acknowledging that Men are Moral and Harmed by Gender Stereotypes Increases Men’s Willingness to Engage in Collective Action on Behalf of Women

Quick links

Ethical consideration dilemma: systematic review of ethics in qualitative data collection through interviews

Design/methodology/approach

Originality/value

1. Introduction

2. Literature review

3. Historical background to research ethics

4. Ethical theories

4.1 Deontology

4.2 Utilitarianism

5. Qualitative research

6. Current and emerging trends in qualitative research

7. Qualitative data collection methods and procedure

7.2 Interviews

7.3 Procedures

7.4 Information sheet

7.5 Consent form

7.6 Interview guide

7.7 Introduction letter

8. Ethical considerations in conducting interviews

8.1 Anonymity

8.2 Privacy and confidentiality

8.3 Voluntary participation

8.4 Option to opt out

8.5 Non-maleficence/Beneficence

9. Key ethical concerns in entrepreneurship and technology

10. Gaining ethical approval

11. Institutional review board

12. Conclusion