Picturing consent: Using photographs in a visual consent form. By Jennifer Thompson

You can download this ERIC case study as a pdf in English, français, español, 한국어, Türkçe and Bahasa Indonesia.

The Tiwai Island Wildlife Sanctuary in Sierra Leone is a community-based conservation and eco-tourism initiative managed by the environmental NGO, the Environmental Foundation for Africa (EFA). I conducted my Master’s research in the Tiwai communities in 2008-2009 in collaboration with EFA. The study facilitated an intergenerational dialogue about conservation and development using photovoice, a participatory visual method, whereby research participants take photographs to represent their lives, experiences and priorities.

The ethical challenge:
As part of preparing my university ethics application, I needed to develop a consent form with an accessible format. Rural Sierra Leone is characterized by relatively low rates of literacy, so a written consent form was inappropriate. Oral consent was considered, however because there was no electricity in the research communities at the time and audio devices were not readily available, sharing an audio recording of the oral consent with participants would be difficult. I needed a consent tool that was low-tech, tangible, and accessible across a range of literacy levels.

It was important that participants received a copy of our agreement to work together that they could understand and refer back to throughout the project. The consent form was an important communication tool between myself, the NGO staff, and the research participants. The form could initiate a conversation about the implications of consenting to participate in the study, document roles and expectations across the research process, and ensure my accountability as a researcher.

Choices made:
As I was planning to use photovoice, using photographs in the consent form seemed like an appropriate way to approach the consent process. It also served to begin a dialogue about images. I was probably also influenced by my experiences working in primary schools in Canada with children with special needs. In this work, images were often used throughout the school day, as teaching instruments, as tools to engage learners, as visual cues for school activities, and as expressive tools for emotions.

I began by drafting an oral consent script for the project. I broke the main concepts, ideas and information into segments for which I could imagine a photograph. It was an iterative and creative process – the structure of the consent script shifted as ideas for possible photographs emerged.

In a previous internship in agricultural communities in Sierra Leone, I had noticed that paper resources were scarce. I therefore wanted to limit the visual consent form to one page. Part of breaking the consent script down into segments was balancing how many photographs could fit onto one page while maintaining clarity and readability.

I also decided to include some written words on the form. This decision was partly to help structure my thinking when making the form. Importantly, including written words helped to avoid making broad assumptions about participants’ literacy levels and provided an extra method of communication for participants. It had additional benefits of making the purpose of the form clear for the ethics review committee and provided a more concrete guide for my collaborators. The sections included in the form are found in Table 1 below. So that the images on the form reflected the local context, I worked with the EFA staff in Freetown and on Tiwai Island to take photographs for the form. Due to a tight budget, I photocopied the form in black and white. I did not have the opportunity to ask the research participants about the effectiveness of the consent form towards aiding understanding about the research process. I think the form provided a space for the research participants to visualize their potential participation in the project and ask questions about it. Many participants brought the form to each research workshop, and many kept the form – along with the photographs they took – as evidence of their participation in the project.

Reflexive questions/considerations:

  • The format of the consent form: Should there be written text on the form? If so, how much text and in what language? What is the best way for participants to sign? How many pages should the form be? Black and white, or colour? What might a colour booklet, for example, with one photograph per page look like?
  • Who should be in the photographs? The people photographed on the original form are EFA staff members. The staff agreed to model for the form for in-house use in the research communities around Tiwai Island. At the time, we had no idea about the interest a visual form would generate across the broader academic community. While the staff later agreed to have a digitally-blurred version of the form published in Claudia Mitchell’s (2011) book, Doing Visual Research, some of the staff expressed discomfort with broader distribution of the form, in particular on the internet. It is becoming increasingly problematic, however, to control what goes on the internet. For example, books often become e-books.
  • Location of photographs: Where should the photographs be taken? For logistical reasons, we took most of the photographs at EFA’s head office in Freetown. Using the form in the Tiwai communities, however, I quickly realized that the concrete infrastructure of the office compound and the urban office wear of the staff looked significantly different from the traditional mud and thatch building materials and rural clothing. It would have been more effective to take photographs in the agricultural context where the research actually took place.
  • Photograph content: What is the most effective way to break down the process of consent within any particular research context? What additional photographs could be included? For example, in retrospect, I would include a photograph to show how the research might be disseminated, such as presented at a conference, published in a journal or book, or uploaded to a website.
  • Increasing participatory input to the consent form: What would a visual consent form developed in a participatory way with research participants look like? Many of the decisions informing the design of the consent form were made by me, thereby reflecting my priorities, experiences, aesthetics and imagination. How might the research participants picture the components, ideas, stages and implications of the study? How might other participatory visual techniques deepen the consent process?
  • The consent form as a component of the informed consent process: What other ethical steps should be taken to ensure the effectiveness of the informed consent process and ensuring ethical research more generally? While including photographs might strive to improve understanding, a consent form is by no means a stand-alone document. The form was conceptualized to be used in conjunction with ongoing dialogue about consent through various stages of the research. I also worked with local structures of authority, presenting the project at a meeting of project stakeholders and hosting public meetings in each community to ensure that permission was granted and that the communities consented to being involved in the project.
  • Contributed by: Jennifer Thompson, PhD candidate, Department of Integrated Studies in Education, McGill University, Canada.