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147 To Study or Not to Study I will first make my comments general. Then I will discuss more specific issues involved in this case. General Comments The question to ask is not “to study or not to study”; instead the questions should be: • Who should do the study? and • How should the study be conducted? I would assume that the study Dr AA has in mind is a community study that can identify risky sexual behaviour. It is wrong if Dr AA, regardless of his noble intentions, used the study as a cover for identifying paedophiles in the community. I will discuss this, later. Allowing that it is a community study that Dr AA intends, there are benefits from doing a community study on sexual knowledge, beliefs and practices. Such a study could provide reliable baseline data that can be used in evaluating the impact of an intervention; serve as a baseline for designing the appropriate intervention (e.g. education, information; community organising); and if the intervention is effective, it can reduce the risk to the boys (the main concern of Dr AA) contracting STIs (sexually transmitted infections) and change sexually risky behaviour of some community members. Thus, the study can eventually benefit the boys in particular and the community (including the mothers) in general. A further benefit of the study will be a reduction of incidence of STIs as well as providing learning material for students. Asian Bioethics Review June 2009 Volume 1, Issue 2 147–149 C A S E C O M M E N T A R Y To S t u d y o r N o t t o S t u d y F a t i m a C a s t i l l o A s i a n B i o e t h i c s R e v i e w J u n e 2 0 0 9 Vo l u m e 1 , I s s u e 2 148 Given this premise, the next point to address is: who should conduct the study? Before we answer this question, we should first identify some salient features of this study, which would also suggest the answer to the question: how should the study be conducted? In the first instance, the subject matter is very sensitive and some data could be stigmatising. Secondly, the study could expose research participants to police action (e.g. the paedophiles or the boys who engage in commercial sex work). Thirdly, the study is intrusive and there is a high risk of violation of privacy; and finally, some data would be difficult to collect through the traditional survey method. Given these difficulties, we should address the competencies required of the researchers. They should be adept in using qualitative methods that can uncover sensitive and “secret” data; able to gain the trust of the community; and should be knowledgeable of community dynamics that are not easily observable (e.g. networks of sexual service providers and users). Dr AA and other medical doctors may not be the best persons to conduct the study, even if they have the trust of the community, having provided medical services to these people for some time. Furthermore, they may not have research competence in using the qualitative methods required. It appears that Dr AA does not really have an indepth knowledge of community dynamics. His colleague, therefore, was right in suggesting that perhaps an NGO that has been working in the community for some time would be in a better position to conduct the study. A study team that is multidisciplinary with expertise in community work will be most appropriate for this study. The researchers could learn from the experiences and methods of other researchers who have also studied sensitive issues such as drug addiction and abortion. Specific Issues I will now discuss specific issues implied by this case. The first of these is stigmatisation. If limiting the study to this community (and any eventual intervention) may result in the community being stigmatised, why single out this community to be studied? It might be more prudent to study more than one community and to conduct any intervention...

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