ARTICLE IN PRESS

Social Science & Medicine 65 (2007) 2248–2259

www.elsevier.com/locate/socscimed

Ethnography/ethics
Michael Parker
Department of Public Health, The Ethox Centre, Gibson Building/Block 21, Radcliffe Infirmary Woodstock Road, Oxford OX2 6HE, UK
Available online 14 September 2007

Abstract

This paper situates discussion of the ethics of ethnographic research against the background of a theoretical and
methodological debate about the relationship between ethics and method, and about the relationships between research
methods and their objects. In particular, the paper investigates the implications of folding together the ethical and the
empirical in research and argues that this requires the development of new ethico-ethnographic methods for the
investigation of ethico-moral objects. The paper falls into three main parts. The first considers calls for what has come to
be known as empirical ethics, that is, for a more empirically informed bioethics, by way of an exploration of the integration
of ethnographic methods in bioethics, and concludes that approaches which see the ethical and the empirical as
‘complementary’ do not do justice to the methodological implications of enfolding the ethical and the ethnographic. The
second part juxtaposes this with calls for the integration of ethics in ethnography and, similarly, argues that the enfolding
of the ethical and the empirical in ethnography calls for the development of new methods. The paper goes on to
problematise the ‘negotiational’ approaches to informed consent preferred by many ethnographers, arguing that the
concept of negotiation, rather than offering a solution to the problem of consent, is itself ethically complex and in need of
analysis. The paper argues that, in the context of ethnographic research, the possibility of negotiational forms of consent
depends upon engagement between researchers and researched, with unavoidably ‘ethical’ concepts such as ‘respect’,
‘recognition’, ‘dignity’, ‘justice’ and so on, and that this poses methodological challenges to ethnography. The paper’s third
section explores the implications of these arguments for research practice, using The Genethics Club as an example.
r 2007 Elsevier Ltd. All rights reserved.

Keywords: Ethics; Ethnography; Methodology; Informed consent; Genetics; Bioethics; Empirical

Introduction ways in which ethical issues have arisen in their own

The papers in this Special Issue are all concerned,
in one way or another, with the relationship
between the ethical and the empirical. They are, in
particular, concerned with exploring the role of
ethical concepts such as informed consent, and of
ethical review by research ethics committees, in
empirical social science research in medicine. While
most of the other authors provide accounts of the
E-mail address: michael.parker@ethox.ox.ac.uk
empirical research, this paper aims to complement
these empirically oriented approaches with a theo-
retically driven consideration of the relationship
between ethical and empirical methods. The moti-
vation for this paper is nevertheless grounded in an
attempt to understand the relationship between the
ethical and the empirical in my own research, most
notably in an on-going ethico-ethnographic re-
search project, The Genethics Club, which investi-
gates the enactment of ethics in clinical genetics
practice. Whilst I shall not say much about this

0277-9536/$ - see front matter r 2007 Elsevier Ltd. All rights reserved.
doi:10.1016/j.socscimed.2007.08.003
 ARTICLE IN PRESS
M. Parker / Social Science & Medicine 65 (2007) 2248–2259
research here at the outset, I return to it in the latter
part of the paper and, in the light of the preceding
discussion, use it to illustrate the implications of my
arguments for research practice. The paper falls into
three main parts. In the first I consider calls for
what has come to be known as empirical ethics, that
is, for a more empirically informed bioethics, by
way of an exploration of the integration of
ethnographic methods in bioethics. In it I argue
that approaches which see the ethical and the
empirical as ‘complementary’ do not do justice to
the methodological implications of enfolding the
ethical and the ethnographic. In the second part I
consider calls for the integration of ethics in
ethnography and, similarly, argue that the enfolding
of the ethical and the empirical in ethnography calls
for the development of new methods. In the paper’s
third section I consider the implications of these
arguments for research practice.
Ethnography for bioethics
In recent years there have been increasing calls for
a more empirically informed bioethics (DeVries,
1995; Fox, 1976; Hoffmaster, 1992, 2001; Hope,
1999) and a greater emphasis on the importance of
the empirical in bioethical deliberation. These have
taken a number of different forms and have ranged
from pleas for empirical evidence to enrich philo-
sophical medical ethics (Hope, 1999) to those for
fully integrated hermeneutic approaches (Widder-
shoven, 2006). In this paper, I take as my focus
arguments for the development of ethnographic
approaches to bioethics (Bosk, 1999, 2001; Davis,
1991; Jennings, 1990; Kleinman, 1997, 1999). An
example of this is Kleinman’s (1999) demand for the
incorporation of ethnographic methods into
bioethics in which he argues that bioethics lacks
what Geertz (1973), following Ryle (1971), calls
‘thick description’. In its most common forms, even
in many of those informed by empirical research,
Kleinman argues, bioethics fails to take seriously
the importance of the local realities within which
people, including patients, families and doctors
actually live and practice. This is an important
failing, because for Kleinman, following Geertz and
Ryle, it is meaning that counts in the analysis of
such realities.
The concept of culture I espouse, [y] is
essentially a semiotic one. Believing, with Max
Weber, that man is an animal suspended in webs
2249
of significance he himself has spun, I take culture
to be those webs, and the analysis of it to be
therefore not an experimental science in search of
law but an interpretive one in search of meaning.
(Geertz, 1973, p. 5).
The failure of bioethics to pay sufficient attention
to meaning and culture means that its attempts to
apply ethical principles are bound to be insensitive
to morally significant features of its object of
concern (Kleinman, 1997, p. 48). By means of thick
descriptions of how those who actually live in these
worlds make sense of their own lives and those of
others around them (Hammersley & Atkinson,
2006, p. 6; Hoffmaster, 2001, pp. 4–5.), ethnography
offers the possibility of a bioethics better informed
about the meaning and intersubjective significance
of the situation under consideration and of the local
‘worlds of experience’ within which and in relation
to which bioethical issues arise (Kleinman, 1999, p.
70). From this ‘naturalistic’ perspective the ethno-
grapher’s task is to understand the situated ration-
ality of the context within which people’s actions
make sense.
It is through ongoing interaction and a develop-
ing relationship with the individuals and groups
who belong to the milieu being explored that the
researcher enters ever-more deeply—psychologi-
cally and interpersonally, as well as intellec-
tually—into its social structure and culture and
the experiences, personae, and lives of those who
people it. (Fox, 2004, p. 314).
The epistemological claim here is that it is
possible to understand what is involved for people
themselves, i.e. to perceive local ‘webs of signifi-
cance’ (Geertz, 1973) by spending significant ex-
tended periods of time in the setting: participating,
talking to people, observing what goes on, studying
documentary sources, exploring the meaningful
roles of material objects, and collecting other
meaningful features of the setting. In short, through
participant observation. In achieving this, the
ethnographer relies (to some extent) upon the
everyday epistemological skills of social actors.
Fortunately, the capacities we have developed as
social actors can give us such access. As
participant observers we can learn the culture
or subculture of the people we are studying. We
can come to interpret the world in the same way
as they do, and thereby learn to understand their
behaviour in a different way to that in which
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2250 M. Parker / Social Science & Medicine 65 (2007) 2248–2259
natural scientists set about understanding the
behaviour of physical phenomena. (Hammersley
& Atkinson, 2006, p. 8).
In these ways it is argued, by Kleinman and
others, ethnographers and through them bioethi-
cists, can begin to get a ‘thick’ sense of the worlds of
the social actors under consideration.
Much of the situated rationality of interest to
ethnographers will of course itself be moral. For
when an ethnographer studies kinship relations, the
role of ‘gifts’, ‘signals of regard’, and so on, these
will in very many cases be productive, implicitly or
explicitly, of entitlements, obligations, rights, duties,
or more nebulously of conceptions of what it means
to live well. Indeed, Kleinman argues that local
experiences are fundamentally moral (Kleinman,
1997, pp. 44–45).
Why moral? Because they consist of the con-
testations and compromises that actualize values
both for collectives and for individuals. Indeed,
the individual-collective dichotomy is overdone;
within these social processes values are nego-
tiated and reworked among others in a space that
is thoroughly intersubjective. (Kleinman, 1999,
p. 2—my emphasis).
The value of ethnography, Kleinman argues, is
that it offers methods for coming to understand and
make sense of these moral experiences, fragmentary
and lacking in coherence as they may be, from
within, because it provides methods of entering into
these social spaces. And if the subject matter of
ethnography is taken, as Kleinman argues it must
be, to be the actualisation of values in the everyday
situated negotiations of meanings, then all ethno-
graphy is, in effect, to be conceptualised as moral
ethnography (see also Dzur, 2002).
Having placed particular emphasis on the ethno-
grapher’s grasp of local moral practices, Kleinman
goes on to introduce a distinction between the
ethnographer’s concern with the moral on the one
hand and the bioethicist’s concern with the ethical
on the other. The use of this distinction is
interesting. For him, whilst the moral consists of
the actual commitments, compromises and practices
by means of which social participants negotiate
what is at stake locally, ethics (the concern of the
bioethicist) is a universalising, principled or codified
body of abstract knowledge about the definition
and realisation of the good. (Kleinman, 1997, p. 45)
In making this distinction, Kleinman is not suggest-
ing that the moral is more important than the
ethical. Indeed, in his own writing he places a great
deal of emphasis on the ethical and the application
of ‘universal standards’, e.g. in his critique of
practices in Rwanda and Bosnia. His point in
highlighting the distinction is to draw attention to a
methodological problem faced by bioethics, and to
the contribution moral ethnography might make to
overcome it. He argues that in order to be coherent
and adequate to its task, bioethics needs to develop
both a method for ‘accounting for local moral
experience and a method of applying ethical
deliberation’ (Kleinman, 1999, p. 69, emphasis
mine) and sees this as a challenge bioethics will
only be able to meet if it incorporates complemen-
tary ethnographic methods.
[y] bioethics is confronted with an extraordina-
rily difficult quandary: how to reconcile the
clearly immense differences in the social and
personal realities of moral life with the need to
apply a universal standard to those fragments of
experience that can foster not only comparison
and evaluation but also action. For philosophers,
the gulf between the universal and the particular
may be regarded as an irksome and a perennial
barrier; but bioethicists, like clinicians and policy
implementers, simply cannot function without
finding a way of relating ethical deliberation to
local [moral] contexts (Kleinman, 1999, p. 70).
Bioethics, Kleinman argues, must become cap-
able of taking both local, networked, moral
experience and universal, transcendent ethical
‘standards’ into account (Kleinman 1999, pp. 1,
69), and his call for a complementary and con-
structive relationship between bioethics and ethno-
graphy is intended to lead to the development of a
methodologically coherent and empirically rich
approach to the ethical and moral dimensions of
medicine and health care.
The positing of a complementarity between
bioethics and ethnography is not unproblematic as
a response to the separation of the ethical and
empirical however, because it rests upon the very
bifurcation it is intended to resolve. Bioethics and
ethnography can only be coherently conceptualised
as complementary and bioethics only be said to be in
need of ethnography, insofar as disciplinary distinc-
tions are held to exist between those concerned with
the ethical and those concerned with the moral and
insofar as they can be considered to be concerned
with radically different objects. There are a number
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M. Parker / Social Science & Medicine 65 (2007) 2248–2259
of reasons for being sceptical of these distinctions.
Firstly, practice in ethnography has throughout its
history been explicitly or implicitly ‘ethical’.
Whether in the sense that it was associated with a
‘body of abstract knowledge held by experts about
‘the good’ and ways to realise it’ (Kleinman 1997,
p. 45); in its associations with colonialism (Pels,
1999); or more recently in its perception of itself as
having a duty to represent or to ensure a voice to
marginalised or vulnerable groups (Scheper-
Hughes, 1995). In this respect, ethnography has
always embodied the ethical in the nature of its
approach to the moral (Pels, 1999; van der Scheer &
Widdershoven, 2004). What this suggests is that,
whatever else the incorporation of ethnography into
bioethics might do, it cannot be coherently con-
ceptualised as the complementing of ethical delib-
eration with (non-ethical) empirical, moral,
richness.
Second, and relatedly, as Geertz makes clear,
ethnography is in its very methodological self-
understanding, a fundamentally interpretive enter-
prise and for this reason too what it brings to
bioethics cannot be disentangled from values or
ethics (Geertz, 1973). This is at least part of the
point intended to be captured by the concept of
‘reflexivity’.
Reflexivity [y] implies that the orientations of
researchers will be shaped by their socio-histor-
ical locations, including the values and interests
that these locations confer upon them. What this
represents is a rejection of the idea that social
research is, or can be, carried out in some
autonomous realm that is insulated from the
wider society and from the particular biography
of the researchery. (Hammersley & Atkinson,
2006, p. 16).
Thirdly, what the two problems above reveal is
that the conceptualisation of the situated rationality
of local experience and of practices as fundamen-
tally moral, and of the epistemological role of the
ethnographer in terms of the description of these
moral practices, is itself deeply problematic. In
particular, the description of culture as fundamen-
tally moral is too thin. For many cultures, even that
of the culture of ethnography (as the concept of
reflexivity shows), will involve and in some cases be
constituted by, interplay between the moral and the
ethical. The identification of the empirical with the
moral—where the moral itself is identified with
relatively unproblematic day-to-day normalised
2251
practices and commitments (even if these are
practices of contestation)—must inevitably fail to
capture the ethico-moral complexity of forms of
everyday life in which consideration of ‘the values,
rules of conduct and character traits which are
involved in right action, doing good, and living well’
plays a significant role and in which local experi-
ences are fundamentally ethico-moral (Ashcroft,
2007). What this suggests is that a more interesting,
productive and plausible way to conceptualise the
relationship between ethics and morals might be to
think of the moral as the commonly shared,
normalised practices and values which structure
everyday life, and the ethical as constituted by
situations in which, and by the extent to which, the
moral is seen to be problematic, contested, in need
of deliberation, analysis, or critique. Something like
this account, to which I return later in this paper, in
which the ethical is conceptualised as the enactment
of the moral as problematic, i.e. as an object of
concern, has the advantage of making possible a
richer account of both morality and of ethics, and of
the interplay between them and also has the
advantage of making visible the fact that ethics is
itself enacted in practices. On this account, the
methodological problem of how best to understand
the relationship between the moral and the ethical
becomes one shared by both the bioethicist and the
ethnographer, and not one for the bioethicist alone
(Parker, 2007).
Thus, whilst Kleinmann is surely right to call for
activity at the interface between bioethics and
ethnography, whatever ethnography brings to the
table will not come free of ethics, values or morals.
Ethnography is, like bioethics, a practice situated in
and concerned with ethico-moral ‘webs of signifi-
cance’. The incorporation of ethnography into
bioethics will therefore not be coherently achieved
by conceptualising this as the complementing of
ethical deliberation with empirical richness. Any
coherent response to the problem of how to
understand the enfolding of ethics and morals will
involve the generation of new ethico-ethnographic
methods for the investigation of genuinely ethico-
moral objects (Law & Urry, 2002).
The ethics of ethnography
I began by considering calls for the use of
ethnography to complement bioethics. In what
follows I explore moves in the opposite direction,
i.e. calls for increasing attention to be paid to the
 ARTICLE IN PRESS
2252 M. Parker / Social Science & Medicine 65 (2007) 2248–2259
ethical dimensions of ethnographic research. These
have arisen both out of internal debate within
anthropology and from developments outside of the
discipline. From inside, the theoretical and regula-
tory turn to ethics has arisen out of the growing
realisation that anthropology’s own history has
been value-driven (by colonialism, by the obliga-
tions of ‘representation’ and so on), and that
ethnographic research has implications for the
communities it studies. The ethical turn in anthro-
pology has also been driven by important cultural
shifts outside the discipline, notably by develop-
ments in the regulation of medicine and medical
research. Changes in medicine have had profound
and wide-ranging implications for research in other
disciplines, including anthropology. The Nurem-
burg Code and the Declaration of Helsinki, for
example, which were developed because of concerns
about medical research, have led to a broad
expectation that all researchers, whatever their
discipline, should submit their research protocols
for consideration by an ethics committee (Strathern,
2000a, p. 294). The form of the ethical turn in
anthropology (and other disciplines) has also been
affected by the substantive ethical issues arising in
medical ethics, primarily the need to obtain
‘informed consent’ from research participants.
Driven to some extent by each of these sets of
forces, increasing attention has been given to the
ethics of ethnography by professional associations
and funding bodies relevant to ethnographic re-
search (Fluehr-Lobban, 2003). For example, the
American Anthropological Association, British
Sociological Association, Association of Social
Anthropology of the UK and the Commonwealth,
and the Economic and Social Research Council,
have all in recent years developed codes of ethics or
ethical ‘frameworks’ (American Anthropological
Association, 1998; Association of Social Anthro-
pologists of the UK and the Commonwealth, 1999;
British Sociological Association, 2002; Economic
and Social Research Council, 2006). There has been
a great deal of resistance in anthropology to the
development of professional codes of ethics how-
ever and to the idea that ethnographic research
should be subject to ethical review by ethics
committees on the same terms as other forms of
research (Pels, 1999). Some such resistance has
focused on claims that the harms associated with
ethnographic research are nothing like of the same
order as those associated with clinical research in
medicine (Murphy & Dingwall, 2007, p. 8). The
majority has however focused on the inadequacy of
the medical model that ethnographers have been
forced to follow and in particular its concept of
informed consent as a mechanism for respecting and
protecting the interests of those with whom the
research is to be carried out. The concerns
ethnographers have about informed consent are
largely related to the fact that it has tended to be
interpreted in anticipatory terms, i.e. based on the
idea that implications of the research, its methodol-
ogy and research questions can be anticipated,
discussed and agreed to before the research has
begun. Strathern, for example, has argued that this
is itself unethical.
This could, I suggest, hold a new way of being
demeaning to informants. It pushes the explora-
tory, indeterminate and unpredictable nature of
social relations (between ethnographer and his or
her third party) back onto a ‘point of produc-
tion’, with the ethnographer as initiator. How-
ever much talk there is of collaboration or of
conserving the autonomy of subjects or recogniz-
ing their input into the research or taking power
into account, this aspect of ethics in advance, of
anticipate negotiations, belittles the creative
power of social relations. (Strathern, 2000a,
p. 295).
It is important to recognise that such concerns do
not arise because ethnographers consider consent to
be unimportant. Indeed, ethnographers have, as
evidenced by the growing literature in this area,
become increasingly preoccupied with the need to
involve, respect and appropriately represent host
communities, and with the ethical dimensions of the
discipline more broadly. The problem with many
professional codes, and with the deliberations of
many ethics committees for ethnographers, is that
they fail to recognise that consent needs to be
thought of differently in ethnography, where the
research undertaken is based upon the tentative
development of research questions and analysis in
the context of emergent relationships of trust. At the
heart of these concerns is a belief that within the
context of ethnography the obtaining of consent
from those with whom the research is to be pursued
must involve developmental and creative processes
incompatible with the concept of anticipatory
informed consent.
Ethnographic consent is a relational and sequen-
tial process rather than a contractual agreement
and lasts throughout the period of research. [y]
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M. Parker / Social Science & Medicine 65 (2007) 2248–2259
Typically, at the start of such research, consent is
both tentative and limited and the researcher’s
access to sensitive aspects of the setting may be
restricted. Over time, as the trust between the
researcher and host develops, access may be
granted to previously restricted areas or interac-
tions. (Murphy & Dingwall, 2007, p. 5).
Increasingly, ethnographers have argued that
appropriate consent can only be achieved through
an ongoing and developmental negotiation of the
relationship between researcher and research hosts.
[y] we need an investigation of the possibility of
an emergent ethics, one which is no longer tied to
a specific community (such as a professional
association) but which locates ethical discussion
in the negotiation of individual or communal
interests that is characteristic of the practice
of fieldwork. (Pels, 2000; in Strathern, 2000b,
p. 163).
The concept of ‘negotiation’ is not unproblematic
as a basis for the identification and addressing of
ethical issues in ethnography however. One reason
for this is that, given the emphasis in ethnography
on cultural difference, the call for negotiation begs
the question of the extent to which the meaning of
what is being negotiated can in fact be established
prior to the completion of the research. This is an
important methodological consideration, for if the
purpose of negotiation between the researcher and
the researched is to reach agreement about what is
to constitute ethical research practice, it will be
essential for some degree of intersubjective agree-
ment to be possible about what is meant by, for
example, an ‘ethical consideration’. The ethno-
graphic assumption that understanding is not
possible without thick description means that, from
within this practice, the possibility of negotiation
about ‘ethics’ cannot be taken for granted. That is,
it is not easy to see how the ethnographer (or the
member of the community hosting the research) can
be confident about just what it is that is under
negotiation. A further and complementary reason
why the concept of a negotiational solution to the
problem of ethics in ethnography is problematic is
because in addition to it being unclear what exactly
is being negotiated, it is also going to be difficult for
the parties to be confident about the meaning of the
processes of negotiation themselves. That is, it is not
going to be clear, for any of the parties concerned,
what it means for the other to ‘negotiate’ and ‘reach
2253
agreement’. The social spaces within which negotia-
tion about what matters locally takes place and
within which cultural conflicts are resolved are
precisely those which are presupposed by the
ethnographer to be radically different between
cultures and in need of interpretation on the basis
of extended research. These two points are not
unrelated of course, partly because both concern the
possibility of emerging understanding and of shared
meanings about what it means to carry out ethical
research, but also because taken together they make
it clear that what is under negotiation, that is
‘ethics’, will be shaped by the how of negotiation,
that is ‘method’, and vice versa.
In the first section of this paper, I argued that the
coherent incorporation of ethnography into
bioethics could not simply be thought of as the
complementing of ethical deliberation with empiri-
cal richness, but had to be seen as requiring both the
development of new forms of ethico-ethnographic
knowledge production and the reconceptualisation
of the relationship between the ethical and the
moral. In this second section, I have reached a
similar conclusion in response to calls for the
incorporation of ethics into ethnography. An
adequate and appropriate approach to both the
ethnography of ethics and the ethics of ethnography
will be one which acknowledges that, in the
negotiations between researcher and researched, it
is not going to be possible to separate the what of
negotiation from its how. Negotiation requires the
actualisation of values in an intersubjective project
of making moral sense where the object of the
research, its method, and its ethics will be up for
grabs.
The liminal and the duplex
Anthropologists have sometimes theorised ethno-
graphy as a ‘liminal’ discipline positioned astride, or
perhaps creating, a threshold between two moral
cultures. (Fluehr-Lobban, 2000, p. 2; Hammersley
& Atkinson, 2006; Kleinman, 1999).
Ethnography is a method of knowledge produc-
tion by which the ethnographer enters into the
ordinary, everyday space of moral processes in a
local world. The ethnographer, no matter how
successful she is in participant observation, either
is or becomes an outsider- even if she begins as an
indigenous member of the community she
studies. She feels the tug of local obligations
 ARTICLE IN PRESS
2254 M. Parker / Social Science & Medicine 65 (2007) 2248–2259
and the push of local practices, but for all of that
she is never so completely absorbed by what is
most at stake for community members that their
world of experience is entirely hers. (Kleinman,
1999, p. 5).
The implications of the arguments presented thus
far are that the concept of ‘liminality’, when thought
of as ‘standing at the threshold between two worlds’
does not go far enough towards capturing the
productive implications of folding ethics and
ethnography together. In response to something
like these considerations, Pels (Meskell & Pels, 2005;
Pels, 2005) argues for a more radical position than
that of liminality, one he refers to as duplexity (Pels,
1999).
Like the archaeologists confronted with a Hopi
scholar telling them a story with a moral,
ethnographers are bound to acknowledge the
moral ‘duplexity’ of research: the fact that
engagement with people living in one’s field of
study requires one to negotiate ‘other’ values
instead of implicitly assuming that our principles
of ethics and expertise are universal. (Meskell &
Pels, 2005, p. 8).
An ethnographic role is duplex for Pels when it
requires not only acknowledgment of the ethical
dimensions of the positioning of ethnography, but
also recognition of the fact that what must be
negotiated in cross-cultural encounters is both the
ethics of the research and its modes of knowledge
production. Duplexity suggests that a resolution of
the problem of enfolding ethics and ethnography in
research is only to be found in the intersubjective
and interdisciplinary negotiation of what such
research is to become.
Thus, we have come full circle: rethinking ethics
implies rethinking expertise, and that implies
rethinking modernity as well: as something that
emanates not from ‘us’ but from interaction. We
should locate ethics not in a Kantian, lawlike
universal nor in the postmodernist ‘moral self’
whose ethical relation to the elusive other we can
only take on trust, but in concrete practise of
interaction with others. (Meskell & Pels, 2005,
pp. 8–9).
The duplex role is then, for Pels, one in which
there is an interactive fusion of ethics and method in
the intersubjective and interdisciplinary actualisa-
tion of the values of research, and in which the
negotiation of ethics cannot be separated from
questions of methodology.
The fusion of ethics and method [y] seems to
promise to constitute the scientific subject as an
ethical one immediately, rather than by proxy
that entails a tendency to dissemble the expert
‘self’ from the practice of research as such.
(Meskell & Pels, 2005, p. 23).
Whilst Pels’ duplex position comes closer than
that of liminality to resolving the relationship
between ethics and ethnography in ways compatible
with the arguments discussed above, the concept of
‘duplexity’ also has significant limitations as a way
of theorising the folding together of ethnography
and ethics. For, whilst Pels’ intention is to replace
the disciplinary separation of ethics and ethnogra-
phy with an emergent ethico-ethnographic method
grounded in negotiation, he attempts to do so whilst
holding on to the methodological centrality of
radical cultural difference. This means that in the
end, the concept of duplexity merely re-describes the
problem.
[y] the primary moral engagement of fieldwork
is the negotiation of different moral complexes
with each other. The necessity of living with
double standards—in duplexity signifies a moral
topography of differences that pertains every-
where—not only among Yanomami but also
when we study a biogenics company, participate
in the definition of an archaeological site, or try
to get used to the linguistic conventions of an
internal review board [y]. (Meskell & Pels, 2005,
pp. 93–94).
[y] I want to argue that since the late 19th
century anthropology’s epistemological commit-
ment to cultural difference has made its morals
essentially duplex: without duplicitous intention
or moral corruption, anthropologists cannot but
adopt ‘double standards. (Pels, 1999, p. 102).
The arguments of the second part of this paper
regarding the necessary conditions for meaningful
negotiation show that it is not going to be possible
to take ethics seriously without also putting the
commitment to difference at risk. For any resolu-
tion of the relationship between ethics and ethno-
graphy will involve the problematising of both
ethics and method in an intersubjective commitment
to making moral and methodological sense across
difference. This implies the possibility of an
emergent-shared understanding about both ethics
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M. Parker / Social Science & Medicine 65 (2007) 2248–2259
and method in which each is shaped by the other.
That is, it is an approach in which the ‘creative
power of social relations’ is reaffirmed (Strathern,
2000a, p. 295). This is not to suggest that difference
is unimportant. It is to argue however, that in the
enfolding of ethics and ethnography something new
and shared is created and this requires that the
interplay between researcher and researched be
conceptualised not simply as the resultant of the
combination of differences nor simply as the
recognition and valuing of difference, but rather
as involving the joint creation of something new.
It would be difficult to overestimate the metho-
dological impact of the concept of negotiation in
this context. For in addition to emphasising the
creative power of social relations across difference,
it also brings with it another significant challenge.
The challenge arises because the shared under-
standings required for negotiation to work as the
mode of engagement at the heart of ethical research
practice will themselves be in large measure ethical.
When ethnographers call for a negotiational
approach to ethics (rather than one based in
professional codes, or in abstract principles), they
implicitly acknowledge that there are non-negotia-
tional methods by which ethico-methodological
issues might be resolved. This raises the question
of just what it is that makes negotiation better than
other available approaches to ethical research
practice in ethnography, and this is an ethical
question. Whilst this paper is not the place to
pursue this discussion very far, it is clear that the
call for negotiation is only going to be capable of
doing the work required of it in association within a
constellation of other ethical concepts. What does it
mean to say that an anthropologist should negotiate
with her host community? Would the threat of
violence if the host community did not cooperate
with the research constitute negotiation? If not,
what is it that marks the significant difference
between the threat of violence and negotiation? At
this point some kind of cross-cultural engagement
with thick ethical (rather than moral) concepts such
as ‘recognition’, ‘respect’, ‘suffering’, ‘justice’, and
‘dignity’ begins to look unavoidable for the
possibility of any ethico-ethnography. And if
concepts such as these are to be capable of
delineating the ethical conditions for ethico-ethno-
graphic method, they must be capable of moving
across cultural and practice boundaries. And for
this to be possible, they must be a very special kind
of object. They must be capable of putting
2255
difference at risk. Just as it proved impossible to
import ethnography into ethics without changing
both the method and its object, so too has it proved
in relation to the importing of ethics into ethno-
graphy. The importing of ethics, as negotiation, into
ethnographic research turns such research into an
intervention involving the negotiation of ethics and
method with the research hosts and this is an
intervention in which it is not going to be possible to
avoid cross-cultural engagement with concepts such
as those listed above.
Ethics as an object of concern
I have argued that the folding together of the
ethical and the empirical requires the development
of new ethico-ethnographic methods for the inves-
tigation of ethico-moral objects. I have conceptua-
lised the moral as those commonly shared, relatively
normalised moral practices which constitute and
structure everyday life and have conceptualised the
ethical as practices in which the moral is enacted as
problematic or as the subject of deliberation,
arguing that many cultural practices will involve
interplay between the ethical and the moral. This
means that research which enfolds the ethical and
the ethnographic will take the enactment of ethics
and the interplay between ethics and morals as its
objects. One of the most distinctive features of
ethics on this definition is that it is enacted as an
object of concern. As such, ethics involves the
enactment of moral practices as problematic,
worrying, the subject of deliberation and of
potential revision. This means that ethics is an
object the enactment of which opens up practice and
makes new kinds of encounters with experience
possible.
That ethics is enacted in practices implies that the
mapping of the enactment of ethics as an object of
concern and of the interplay between the ethical and
the moral will involve the tracking of the forms, uses
and trajectories of this object over time and across
practices-the mapping of its biographies (Appadur-
ai, 1986; Kopytoff, 1986). The enactment of ethics
as an object of concern in research folding together
ethics and ethnography will therefore be an object
characterised by movement.
I have also argued that research enfolding the
ethical and the ethnographic will be characterised
by the creative, intersubjective negotiation of
method and ethics by the researcher and the
researched. This has the implication that such
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2256 M. Parker / Social Science & Medicine 65 (2007) 2248–2259
research will take the methodological form of an
intervention, a cross-cultural engagement in which
the creative power of social relations is realised and
in which difference is put at risk. What this also
means is that ethico-ethnographic research of the
kind proposed in this paper will not be research
which attempts to hide in the background but will
involve researcher and researched in the joint
enactment of and deliberative engagement with
ethics as an object of concern. It suggests, that is,
a research intervention which is itself implicated
(explicitly) in the enactment of the moral as
problematic, i.e. as ethical. This points to a
particularly creative and productive use of reflex-
ivity, and of a singularly interesting form of research
encounter (Fortun, 2000; Fortun & Fortun, 2005)
for the enactment and tracking of ethics as an object
of concern.
I briefly referred, at the beginning of this paper, to
a particular research experience of my own, the
Genethics Club. In this concluding section I want to
offer a preliminary sketch of how the Genethics
Club-and, specifically, my participation in and
analysis of it-exemplifies the potential for ethico-
ethnographic research of the type I have been
discussing.
When the Genethics Club was established in
2001, its aim was to provide a social space in which
anyone working in clinical genetics in the United
Kingdom, including nurses, counsellors, doctors,
laboratory staff, and medical researchers, could
present and discuss ethical issues arising in their
practice (www.genethicsclub.org). The clinical mod-
el for this intervention was the Dysmorphology
Club, a pre-existing regular national forum for the
presentation and discussion of difficult clinical cases
by members of different Regional Genetics Services.
Since its inception, the Genethics Club has met 15
times. It has been popular with health professionals
and researchers, and attended on average by 45
people, involving several hundred different atten-
dees overall, and including, on a regular basis,
members of every clinical genetics service and NHS
laboratory in the country. Meetings of the Gen-
ethics Club involve presentations by those working
in genetics of ‘cases’ that they consider to present
ethical issues and to be problematic, either in
themselves or in relation to their implications for
practice more widely. These case presentations have
tended to be rich and have been followed by open
discussion, facilitated by an ‘ethicist’ (the author).
Often, the discussions open up and generate many
other ethical issues to those initially presented. Since
it began, the Genethics Club has seen approximately
150 case presentations.
My (the ethicist’s) role in the Genethics Club has
been multi-faceted. Perhaps most importantly, I
have been responsible for the continued mainte-
nance of the Genethics Club as a welcoming social
space for the enactment of ethics as an object of
concern across multiple genetics practices in a
number of different locations. I have organised the
space to allow sufficient time for the presentation of
the cases. I have facilitated the subsequent discus-
sion, ensuring that all who want to speak have a
chance to do so. I have tried to ensure that marginal
voices and perspectives are heard and taken
seriously. I have used my knowledge of the
literature, my experience of previous Genethics
Club meetings, and my experience of work in a
genetics unit, to introduce issues and contrasting
practices I think have been overlooked. I have
adopted a methodologically critical stance to
established practices. In other words, I have
implicated myself in the enactment of the moral as
problematic. At the same time, I have taken notes
and attempted to map and track the enactment of
ethics as an object of concern over the course of a
meeting, and over the life of the Genethics Club,
bearing in mind that my role is deeply implicated in
the enactment of ethics in this setting.
I conclude by commenting briefly on some of the
features of ethics as an object of concern as it has
been enacted in the Genethics Club.
One of the things that has become apparent as an
on-going theme throughout the discussions at the
Genethics Club is how the problematisation of
everyday practices is often linked to the spatial and/
or temporal distribution of material objects. While
in an unproblematised situation, material objects
are seamlessly woven into every day practice—
family pedigrees are produced, blood samples are
taken, medical records are filed away etc., in some
cases the movement of these material objects into
different physical locations, or even the particularity
of their arrangement or configuration, can serve to
problematise those practices. An example of this
might arise where individual medical records are
brought together into a ‘family file’—a file which in
addition to containing the files of a number of
individual family members, also contains informa-
tion relating to the family as a whole, e.g. a family
pedigree drawing together pieces of information
from several of the individual files, which may as a
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M. Parker / Social Science & Medicine 65 (2007) 2248–2259
result constitute information about the family as a
whole beyond that which any single individual
family members knows. Such a family file has the
potential to be of help to clinicians in their
treatment of individual family members in verifying
diagnoses and facilitating risk assessment, but
where the bringing together of this information in
a single overarching picture reveals information
relevant to the care, or life choices of an individual
who has perhaps not asked for such information
(because they do not know it exists), such files have
problematised everyday accepted practices around
the use and storage of medical information.
(Ashcroft, Lucassen, Parker, Verkerk, & Widder-
shoven, 2005; Parker & Lucassen, 2004) In other
words, the transformation of a moral practice into
an object of ethical concern—the enactment of
ethics as an object of concern—is bound up with the
spatial arrangement and movement of material
objects. By the exploration of such cases, the
Genethics Club serves to enrich everyone’s under-
standing of ethics as an object of concern in their
practice. Importantly, it does this not by comple-
menting ethical deliberation with empirical richness,
but through the enfolding of the ethical and the
moral (every day moral practice): the analysis shows
how ethics is an assemblage constituted by the
organisation of material objects in specific spatial
and temporal relations.
The above case illustrates that the movement of a
biological sample or medical record from the clinic
to the laboratory, or across an international border,
may well transform the ethico-moral object drama-
tically, and the number of possible ethical objects of
concern has multiplied. It may also be however that
a particular configuration of materials and practices
gives rise to an ethical object of concern that is
already multiple (Mol, 2002). A particularly good
example of this is a frequently occurring case
presented at the Genethics Club in which a genetic
test requested by one patient has the potential to
reveal the genetic status of one of their relatives.
This might happen, for instance, where one twin
wishes to take a presymptomatic test for breast
cancer but the other, who is genetically identical,
either does not wish to have their status revealed, or
simply does not know that the test is being
considered. On some occasions these cases are
presented as an ethical object of concern on account
of the issues of consent and counselling. In such
cases, clinicians see the case as problematic both
because a test on one twin will reveal the genetic
2257
status of the other, who has not given consent, and
also because there is the potential for this twin to be
informed of their genetic status without having
received appropriate counselling and support, for
example in the midst of a family argument. On other
occasions, or from the perspective of a different set
of practitioners, this type of case is presented as an
object of ethical concern on account of the issue of
duty of care to the patient in front of them. This is
because, were it to be decided that the provision of
the test depended upon the consent of both twins,
for example in cases where the second twin is
demanding that the test should not go ahead, this
would in effect be to provide a third party—with
whom the doctor may also be in contact—with an
unacceptable veto over the provision of care to the
patient (Parker &Lucassen, 2003). The enactment of
this object of concern from the perspective of two
different sets of practitioners gives rise to ethics as a
multiple object of concern.
The multiplicity of ethics as an object of concern
means that the Genethics Club, as a space which
brings together different health professionals-
geneticists, counsellors, nurses, and laboratory
staff—from a wide range of locations, is inevitably
also on some occasions a space characterised by the
juxtaposition of diverse ethical practices: through
the presentation and discussion of cases which
would be enacted as ethically problematic in differ-
ent ways in different locations. One of the things
that has become apparent as an on-going theme in
the Genethics Club is that the multiple enactment of
ethics as an object of concern, combined with
awareness of the possibility of the movement of
patients, samples, and even health professionals
between settings, can sometimes lead to the enact-
ment of this multiplicity itself as problematic. Here,
the Genethics Club serves to enrich everyone’s
understanding of ethics by providing a space within
which it becomes apparent that everyday moral
practices can be problematised—enacted as an
object of ethical concern—by the juxtaposition of
divergent practices, and the associated defamiliar-
isation. In the case of the twins described above, for
example, the enactment of practice as problematic
in one setting in a different way to its enactment as
problematic in another itself comes to be seen as
problematic—as an ethical object of concern.
Awareness that patients in one setting may gain
access to tests and treatments not available else-
where, or that patients in one area, but not in
another, may be ‘tested’ without their consent, has
 ARTICLE IN PRESS
2258 M. Parker / Social Science & Medicine 65 (2007) 2248–2259
problematised practice in ways that put such
difference at risk. This may lead those present to
make attempts to justify the maintenance of
diversity of practice, that is to preserve difference,
or efforts to reach agreement about which shared
practice should be adopted from now on. In either
case, such deliberations must involve the enactment
of ethical objects capable of moving across bound-
aries between practices—between different clinics
for example, or between the clinic and the labora-
tory—and this involves cross-cultural engagement
with thick ethical objects such as ‘justice’, ‘suffer-
ing’, ‘fairness’, ‘reciprocity’, ‘duty of care’ and so on
in something like the ways I discussed in the
previous section. A related on-going theme emer-
ging from the Genethics Club is that, once enacted
in relation to a particular case, such moving objects
can go on to put unproblematised practice and
difference elsewhere at risk, exerting an influence
well beyond the ‘case’ under consideration. This
makes possible another way in which the Genethics
Club serves to enrich understanding of ethics as an
object of concern in genetics—through the delib-
erative exploration of the relationships between
these moving objects and previously unproblematic
practice. In such explorations, both the practices
and the mobile ethical objects of concern are put at
risk and the creative power of social relations
provides an opportunity for the opening up of
practice, making new kinds of encounters with expe-
rience, and the emergence of new practices, possible.
Conclusion
In this paper, I have investigated the implications
of folding together the ethical and the empirical in
research. I began by considering pleas for the
integration of ethnographic methods in bioethics,
and argued that approaches which see the ethical
and the empirical as ‘complementary’ are not able
to do justice to the methodological implications of
enfolding the ethical and the ethnographic. I then
went on to consider calls for the integration of ethics
into ethnography and argued here too that the
enfolding of the ethical and the empirical requires
the development of new methods. The folding
together of the ethical and the empirical requires
the development of new ethico-ethnographic meth-
ods for the investigation of ethico-moral objects. In
the paper’s concluding section, I explored the
implications of these arguments for research prac-
tice, using The Genethics Club as an example.
Acknowledgements
In thinking about and writing this paper I have
benefited tremendously from conversations with
and comments from several people: Steve Woolgar,
Sarah Franklin, Simon Cohn, Alison Shaw, Ri-
chard Ashcroft, Bronwyn Parry, Sue Dopson, Mary
Dixon-Woods, and above all, Mariam Fraser. The
Genethics Club is organised by Angus Clarke, Tara
Clancy, Fiona Douglas, Ian Ellis, Anneke Lucassen,
and Michael Parker.
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