This paper reports on an evaluation of ethical practices and systems in Aboriginal and Torres Strait Islander health and medical research. Led by two Aboriginal women, the work upholds Indigenous methodologies and methods to offer truth-telling and calls to action from Aboriginal communities. The authors call for improved implementation and conduct of culturally safe and respectful research that truly benefits the health and wellbeing of the First Peoples of this land.

The aim of this project was to privilege Aboriginal and Torres Strait Islander community voices and experiences, and the subsequent impacts of current health and medical research practices. This work highlights community-led solutions on the ways in which the system of research should be critically transformed to appropriately uphold Aboriginal and Torres Strait Islander rights in research. 

The authors find unethical research processes and practices persist within research systems that do not align with Indigenous ethics.

Recommendations

1. Research commissioning agencies conduct an audit and evaluation of Aboriginal and Torres Strait Islander health and medical research funding distributed against ethics as defined by Aboriginal and Torres Strait Islander people.
2. Research commissioning agencies revise reporting templates to embed systematic monitoring processes regarding researchers’ adherence to ethics for Aboriginal and Torres Strait Islander health and medical research.
3. Research commissioning agencies, particularly the NHMRC, consider including assessment criteria to demonstrate ethics as defined by Aboriginal and Torres Strait Islander people.
4. Assessment panel composition for all research commissioning incorporates representatives from the Aboriginal and Torres Strait Islander community controlled sector who hold expertise in ethics.
5. Lowitja Institute be supported to convene a roundtable to inform appropriate community-led systems for health and medical research to uphold researchers’ accountability to Aboriginal and Torres Strait Islander peoples and communities.
6. Ethics committees recognise their limitations to approve research for the diverse Aboriginal and Torres Strait Islander people and communities of this country. Ethics committees should establish a process to uphold the rights of Aboriginal and Torres Strait Islander peoples and communities to define place-based ethics for research projects.
7. An independent, community controlled reporting mechanism is resourced and established by and for Aboriginal and Torres Strait Islander communities to continue to receive and report unethical research practices independent of ethics committees and institutions.
8. This discussion paper forms the basis for the development of mandatory training on ethics for researchers working in Aboriginal and Torres Strait Islander health and medical research.
9. There is increased research funding directed to the community controlled sector in line with recommendations in 1987 and under Priority Reform 2. Research commissioning should be managed by Aboriginal and Torres Strait Islander community controlled organisations, particularly Lowitja Institute, as a fundamental mechanism to uphold ethics, and Indigenous-led research commissioning process.