SCHEDULE ‘B’
ESSENTIAL ELEMENTS OF AN INFORMED CONSENT STATEMENT
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
Identify interviewer (name, company/university they represent);
Date;
Identify interviewee (name and any affiliation they may have with community/
company/university);
Identify community of interviewee as well as community where interview is taking
place;
Brief statement about goals/rationale of project and specifically, what the interviewer
wants from the interviewee and why;
Identify what this information will be used for;
Identify who will benefit from this information;
Identify who will be using this information;
Identify who will have access to the information;
Identify how this information will later benefit the interviewee, their community and
future generations of that community;
Identify what the interviewer is gaining from this information (i.e. University degree,
Government contract, etc. – if payment for future sales of information in book form,
where proceeds will go from the sale of this information, etc.)
Indicate if information is to be recorded, either by audio tape or video tape and if so,
what is to be done with this tape, where will this information be stored, how many
copies of the information will be made, who will have access to this recorded
information now and in the future;
Does the interviewee want to be cited or credited for any information being given? If
yes, cited in general (such as in a bibliography) or specifically (such as at the end of
all quotes). If no, does the interviewee want a pseudonym created and used? If not
cited, the interviewer must assure confidentiality of all information received. This
point is crucial in traditional knowledge collection;
Crucial to informed consent is the clause that the interviewee understands that they do
not have to answer any questions they do not want and that they can stop the
interview at any time;
Assure that a draft of information collected will be presented again, either personally
or in a community forum for verification and any suggestions at that time will be
considered and incorporated into the final report;
Copy of the report will be forwarded to interviewee when available, or alternatively
to the community when available;
Ensure that written consent is given to the above elements once it has been read and
explained in English or in Gwich’in. Alternatively, if the interviewee does not read
or write, the Consent Statement should be read to them in English, and/or in
Gwich’in, any questions answered and a verbal consent recorded on tape. Any
exceptions to the above should also be noted in the Consent Statement.
10
DRAFT
January 21, 2004