ISSUES IN CLINICAL NURSING RESEARCH Informed Consent and the Limits of Confidentiality1

Investigators encounter many legal and ethical issues when they conduct research on partner abuse. Balancing abused women’s rights to privacy with legally mandated reporting require-ments involves considerable thought and planning. Failure to protect participants may result in escalation of abuse as well as loss of children to protective services. Various perspectives on maintaining participant privacy while conforming to legal mandates to report child abuse, homicidality, and suicidality are discussed. The role of confidentiality certificates in providing legal immunity for researchers and the method of obtaining the certificates are presented. In addition, the authors describe the strategies for participant protection that are implemented in a federally funded study of abuse, women’s self-care, and pregnancy outcomes. The decision to clearly and specifically inform abused women of the limits of confidentiality allows participants to make informed decisions about disclosures, but may result in diminished recruitment. Nursing research about partner abuse is important to providing improved care to abused women. However, research on vulnerable women is very sen-sitive and complex. Ethical dilemmas relating to rights of participants must be balanced with furthering the knowledge that will improve health care delivery. Human participant protections for participants who disclose infor-mation about abuse in their lives are critical. As Campbell (1998) pointed out, “It is important for clinicians and researchers to remember that battered women decide to whom and when to disclose their abuse ” (p. 185). Walking the line between advancing knowledge and safeguarding individuals can be a daunting task. According to Sieber and Stanley (1988)