Accepting the Legitimacy of Difference: Tools to Support the Decolonisation of Human Research Ethics in Western Health Research.

Within the context of health research, the values, traditions and worldviews of First Nations populations need to be represented in an inclusive and ethically sensitive way. Current human research ethics processes are deeply rooted in Western philosophy, which may result in frequent tension and misalignment with the values of First Nations populations, indicating the need for the decolonisation of Western human research ethics processes. While it is important to acknowledge potential points of alignment between the Western and First Nations peoples' research ethics paradigms, it is crucial to recognise and address the inherent complexities and discrepancies between these two standpoints. These discrepancies can also manifest themselves in healthcare provision, healthcare education, and the delivery of other services to First Nations peoples. This may exacerbate current disparities in the ability of First Nations peoples to access quality care. Cultural insensitivity, systemic biases, and a lack of representation of First Nations peoples may also worsen these issues. The purpose of this discussion paper is to examine the prevailing Western philosophical standpoint that influences health research and to explore its misalignment with the beliefs and cultural practices of First Nations peoples. Existing literature that examines the multifaceted challenges faced by First Nations populations when navigating norms associated with Western ethics in the health research process will be explored. The historical context of colonisation and its impact on ethical paradigms within First Nations communities will also be considered. The need for decolonisation of Westernised dominant approaches within health research ethics for First Nations populations is evident because such approaches can pose significant challenges to the well-being and rights of First Nations communities. By promoting a fairer, inclusive, and culturally informed research ethics framework, researchers can contribute to the development of processes that address historical injustices and promote investigations that are tailored to examine phenomena experienced by First Nations peoples. IMPLICATIONS FOR THE PROFESSION: This paper provides a critique of current Western health research ethics processes and proposes an evidence-based tool to guide researchers in promoting inclusivity and cultural safety. Implementing these recommendations can improve health and well-being outcomes for First Nations peoples and communities. IMPACT: The paper addresses the problem of cultural insensitivity and systemic biases in Western health research ethics, highlighting the need for decolonisation to ensure equitable healthcare access for First Nations populations. The findings will impact researchers, healthcare professionals, and policymakers by promoting culturally safe research practices and fostering better health outcomes for First Nations communities. WHAT PROBLEM DID THE STUDY ADDRESS?: The study addresses the misalignment between Western health research ethics and the values and cultural practices of First Nations peoples, which result in cultural insensitivity, systemic biases, and disparities in healthcare access and quality. WHAT WERE THE MAIN FINDINGS?: Significant discrepancies exist between Western and First Nations research ethics paradigms, including differing views on consent, relationality, data ownership, and holistic well-being. Western frameworks have perpetuated cultural insensitivity and marginalisation, exacerbating healthcare disparities. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: The research will impact researchers, healthcare professionals, and policymakers by promoting culturally safe research practices. The findings aim to foster better health outcomes for First Nations communities in Australia and potentially other First Nations populations globally. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: This paper contributes a critical examination of Western health research ethics and its impact on First Nations populations, providing a framework for decolonising research practices. The proposed evidence-based tool can guide the global clinical community in promoting inclusivity and cultural safety, ultimately improving health outcomes for Indigenous peoples worldwide. No Patient or Public Contribution.