Accounts of consent: Orienting to self-other relations regarding motivations to participate in cancer bio-banking

Abstract

The motivations of those who give consent to bio-banking research have received a great deal of attention in recent years. Previous work draws upon the notion of altruism, though the self and/or family have been proposed as significant factors. Drawing on 11 interviews with staff responsible for seeking consent to cancer bio-banking and 13 observations of staff asking people to consent in routine clinical encounters, we investigate how potential participants are oriented to, and constructed as oriented to, self and other related concerns (Sarangi 2007). We adopt a rhetorical discourse analytic approach to the data and our perspective can be labelled as 'ethics-in-interaction'. Using analytic concepts such as repetition, extreme case formulation, typical case formulation and contrast structure, our observations are three-fold. Firstly, we demonstrate that orientation to 'general others' in altruistic accounts and to 'self' in minimising burden are foregrounded in constructions of motivation to participate in cancer bio-banking across the data corpus. Secondly, we identify complex relational accounts which involve the self as being more prominent in the consent encounter data where the staff have a nursing background, whereas 'general others' feature more when the staff have a scientific background. Finally, we suggest implications based on the disparities between how participants are oriented during interviews and consent encounters, which may have relevance for developing professional reflective practice.