Is the indicator ethical?

An ethical indicator is one for which the gathering, processing and presentation of the data it requires are ethical in terms of the rights of the individual to confidentiality, freedom of choice in supplying data, and informed consent regarding the nature and implications of the data required.

Reproductive health encompasses many sensitive issues and the data needed to reflect these issues also requires a level of sensitivity, particularly during the collection process. For example, indicators of infertility or on urethral discharge, run the risk of being unethical if the information was sought through coercion of individuals or without their full (informed) knowledge of its collection, or where their privacy was not maintained during the gathering or analysis of the data. Judging whether an indicator is ethical or not thus depends not only on an understanding of the process of generating the basic data, but also of the context in which this will take place and the safeguards to preserve the rights of individuals. Surveys on sexually transmitted infections, sexual behaviour and HIV require special attention to issues of informed consent and confidentiality. When using survey methodologies, efforts should be made to ensure that the interviews or observations take place privately and that the information revealed by respondents or health personnel is not shared by anyone from the local community. Where an indicator requires screening for a condition e.g. for cervical cancer, this may also be regarded as unethical if there are no resources available for follow-up and treatment, since the data collection is unlikely to have secured informed consent.