Christine Horrocks

Involving children in health and social research: ?Human becomings? or ?active beings??

This article draws on the authors’ experiences of undertaking health and social research involving children in Australia and England and focuses on securing the informed consent of children to participate in such research. A clear trend within literature, service provision, legislation and international conventions recognizes children as ‘active beings’ in all aspects of their lives. The services that are the focus of the research and evaluation projects in which the authors have been involved sought to empower children as active agents and decision-makers. Crucially, not only were these services available directly to children without requiring parental permission, but many children were also accessing these services without their parents’ knowledge. However, when it came to researching and evaluating users’ experiences of these services, the authors faced the problem that existing research gatekeeping systems tended to construct children as dependent, in need of protection and as ‘human becomings’. The authors found that research ethics committees would permit the research to take place only if both the child’s informed consent and that of his or her parents was obtained. The authors outline the implications of such dilemmas, which may not only be counter productive in terms of research objectives but also risk failing to afford children rightful regard in contemporary society. While the authors conclude that there are no quick fixes to the resolution of such dilemmas, they believe that researchers need to engage with the gatekeepers of research to ensure that the laudable effort to protect potentially vulnerable participants avoids overprotection, paternalism and the further disenfranchisement of already marginalized young people.

Domestic Violence and Health Care: Opening Pandora’s Box - Challenges and Dilemmas

In this article we take a critical stance toward the rational progressive narrative surrounding the integration of domestic violence within health care. While changes in recent UK policy and practice have resulted in several tangible benefits, it is argued that there may be hidden dilemmas and challenges. We suggest that the medical model of care and its discursive practices position women as individually accountable for domestic violence-related symptoms and injuries. This may not only be ineffective in terms of service provision but could also have the potential to reduce the political significance of domestic violence as an issue of concern for all women. Furthermore, it is argued that the use of specific metaphors enables practitioners to distance themselves from interactions that may prove to be less comfortable and provide less than certain outcomes. Our analysis explores the possibilities for change that might currently be available. This would appear to involve a consideration of alternative discourses and the reformulation of power relations and subject positions in health care.

Delivering the Alcohol Treatment Requirement: Assessing the outcomes and impact of coercive treatment for alcohol misuse

Under the Criminal Justice Act (2003), Alcohol Treatment Requirements (ATRs) are now available and can be dispensed as part of a community sentence. ATRs deliver coercive treatment to predominantly ‘dependent’ drinkers specifically aiming to tackle levels of alcohol consumption and reduce alcohol related crime. Data gathered from probation records and treatment files for 81 offenders sentenced to treatment were analysed exploring offender characteristics, outcomes and impact. The analysis shows that those deemed ‘suitable’ and consequently sentenced for the ATR were primarily ‘white British’ males who had committed crimes related to ‘violence against the person’. Progression through treatment on the ATR is encouraging with a 70 per cent completion rate and positive outcomes with regard to levels of alcohol consumption. While re-offending rates were also low these should be viewed with caution as the time lapse between intervention and impact assessment was short.