Republic of the Philippines

TARLAC AGRICULTURAL UNIVERSITY

Camiling, Tarlac

ETHICS CHECKLIST

To complete the Checklist please check the Yes or No box. If any of the answers checked are in bold (Yes
or No), an ethical issue arises that requires you either to reconsider your procedures, or to provide
additional information. In the latter case, attach a written note explaining the pertinent circumstances and
the provisions you will make to ensure ethical practices, and/or elaborate in the project description.

Basic Review
Principle Indicators
1. Voluntary 1. Will the subjects/participants be told that they can ___ Yes
participation discontinue their participation at any time without ___ No
incurring any penalties for doing so?
2. Do you foresee that the subjects/participants might feel ___ Yes
or perceive any degree of manipulation, coercion, ___ No
constraint, or undue influence concerning any aspect of
their participation in the study?
3. Will there be any actual or perceived material ___ Yes
inducements to participate that exceed reasonable ___ No
compensations for such things as transportation,
unusually lengthy time demands, etc.?
4. Will there be any actual or perceived social ___ Yes
inducements to participate that exceed such things as ___ No
interest in the research, an interesting activity, etc.?
5. Will there be any actual or perceived disincentives for ___ Yes
not participating in the research? ___ No
2. Informed consent 6. Will the people studied be aware that they are the ___ Yes
subjects of your research/scholarship? ___ No
7. Does the study involve temporarily misleading the ___ Yes
subjects/participants as to the study’s purposes, ___ No
incomplete disclosure of the study’s purposes, or
temporary concealment of other information (e.g.,
staged occurrences, having subjects/participants do one
thing while in fact something else they do is being
observed, etc.)?
8. Will subjects’/participants’ written consent be ___ Yes
obtained, or if this is inappropriate, will an alternative ___ No
method of obtaining informed consent be used?
9. Will free and informed consent procedures be used ___ Yes
both at the outset of the subject’s participation, and ___ No
thereafter throughout the study (e.g., by notifying
subjects/participants of any later changes or
developments that might influence informed consent,
Note: This checklist was adapted from the Category ‘B’ Human Ethics Checklist of the University of
Winnepeg retrieved from https://www.uwinnipeg.ca/research/docs/forms/ethics-cat-b-checklist.pdf

3. Safety and security of
Participants
4. Confidentiality and/or
anonymity
Note: Regarding Questions 19 and 20, there may be situations
in which the subjects/participants agree to or even seek public
Note: This checklist was adapted from the Category ‘B’ Human Ethics Checklist of the University of
Winnepeg retrieved from https://www.uwinnipeg.ca/research/docs/forms/ethics-cat-b-checklist.pdf
and seeking further consent to these)?
10. Will informed consent information include a statement ___ Yes
of the research purpose, the identity of the ___ No
investigator(s), the expected duration and nature of
participation, a description of research procedures,
and a description of any foreseeable harms and
benefits that may arise from participation?
11. Before giving their consent to participate, will the ___ Yes
subjects/participants be informed fully of the nature of ___ No
their research involvement, and of all features of the
research that will reasonably might be expected to
influence their willingness to participate?
12. Will the information describing the study and the ___ Yes
materials used to seek consent be worded in language ___ No
clearly comprehensible to the subjects/participants?
13. Does the study involve physical stress (or the ___ Yes
expectation thereof) such as might result from heat, ___ No
noise, electric shock, pain, sleep loss, physical
deprivation, drugs, alcohol, etc.?
14. Do you foresee that the study might result in the ___ Yes
subject’s/participant’s experiencing mental discomfort ___ No
(e.g., fear, anxiety, loss of self-esteem, shame, guilt,
embarrassment, becoming aware of personal
weaknesses)?
15. Will the investigator attempt to induce long-term ___ Yes
change in subjects’/participants’ behavior or attitudes? ___ No
16. Will any individually-identifiable information about ___ Yes
subjects/participants be disclosed without their ___ No
informed consent (e.g., to teachers, doctors, therapists,
parents, employers, other researchers, etc.)?
17. Could public presentation of the study’s results ___ Yes
possibly harm either the subject/participant, or his/her ___ No
membership group?
18. Has the investigator taken all possible steps in the ___ Yes
design of the study to balance potential harms to the ___ No
subjects/participants against potential benefits of the
research/scholarship?
19. Is the confidentiality of the subject’s/participant’s ___ Yes
identity positively ensured? ___ No
20. Are there circumstances under which the ___ Yes
subject’s/participant’s identity might be deduced by ___ No
someone other than the investigator if the study results
are presented publicly?
 identification. If this applies, explain, and also provide an
assurance that you will obtain consent to revealing
subjects’/participants’ identities.
Special Review
21. If the investigator plans to induce short-term behavioral ___Yes
or attitude change, will such change definitely be ___ No
reversible? ___N/A
22. If private materials (documents, third-person interview ___Yes
contents, etc.) provided by the subject will be made ___ No
public as a consequence of the scholarship/research, ___N/A
will due care be taken to obtain subjects’/participants’
written consent, and otherwise to avoid infringing on
the subjects’/participants’ rights?
23. If the study takes place within or in cooperation with an ___Yes
institution or agency (e.g., schools, day care centres, ___ No
churches, seniors’ homes, hospitals, social work ___N/A
agencies, playgrounds, prisons, etc.), has written
approval been obtained from its administrators?

Note: Attach copies. If no letters of approval can yet be

provided (e.g., because agency approval is contingent
on University ethics approval), attach an explanatory
note undertaking not to begin research before you are
in receipt of approval letters, and to submit copies of
such letters to UREC immediately upon receipt. Note:
The requirement of approval from external institutions
may not apply in instances where it would interfere
with free inquiry. If so, explain.
24. If the subjects/participants are children (under age 18), ___Yes
will written parental or guardian consent be obtained? ___ No
___N/A
25. If a written consent form is used, will copies be given ___Yes
to the subjects/participants to retain? ___ No
___N/A
26. If the subjects/participants are legally or otherwise ___Yes
incompetent to provide informed consent, will the ___ No
written consent of authorized third parties be obtained? ___N/A
27. If the subjects/participants are not legally competent, is ___Yes
there any other legally-competent group that could be ___ No
studied in order to address the research question? ___N/A
28. If the subjects/participants are drawn from ___Yes
institutionalized or otherwise “captive or dependent” ___ No
populations (e.g., in prisons, hospitals, psychiatric ___N/A
facilities, mandatory treatment programs, etc.), will
special care be taken to ensure that consent is given
Note: This checklist was adapted from the Category ‘B’ Human Ethics Checklist of the University of
Winnepeg retrieved from https://www.uwinnipeg.ca/research/docs/forms/ethics-cat-b-checklist.pdf
 freely, and that no actual or perceived coercion,
constraint, or undue inducement to participate is
present?

Note: In your project description, be sure to describe

clearly how this will be achieved.
29. If the consent of a parent or an authorized third party is ___Yes
obtained, will each subject/participant also be informed ___ No
independently of his/her right to decline to participate ___N/A
at any point in the study?
30. If the study will be conducted in a country other than ___Yes
Philippines and/or under jurisdiction of an institution ___ No
other than the TAU, and if an ethics review body that ___N/A
has jurisdiction in that country or institution exists, will
the study undergo review by that ethics body before the
research begins?

Note: If so, please attach documentation, or attach a note

undertaking to provide documentation to Research Services
immediately upon receipt.
31. If there is any possibility of physical danger or harm to ___Yes
the subjects/participants will all necessary and prudent ___ No
measures be taken to ensure their safety (e.g., from ___N/A
dangers such as electrical shock, lack of oxygen, falls,
traffic or industrial accidents, the possibility of hearing
or vision loss, etc.)?
32. If subjects/participants have initially formed any false ___Yes
impressions about the purposes of the study or the ___ No
nature of information collected, if the study purposes ___N/A
were not completely disclosed initially, or if any
information was concealed temporarily, will full
disclosure be made at the conclusion of data collection?
Will the reasons for false impressions, concealment, or
incomplete disclosure be explained; and will
subjects/participants then be given the opportunity to
withdraw their data/information, should they so
choose? Will everything possible be done to re-
establish trust and respect?
33. If information on subjects/participants will be obtained ___Yes
from third parties (e.g., institutions, doctors, other ___ No
researchers, etc.), will subjects/participants be so ___N/A
informed, and will their written consent be obtained?
34. If any adverse subject responses to the study are ___Yes
anticipated, have procedures been devised to ameliorate ___ No
such responses? ___N/A
35. If the possibility of commercialization of the research ___Yes
Note: This checklist was adapted from the Category ‘B’ Human Ethics Checklist of the University of
Winnepeg retrieved from https://www.uwinnipeg.ca/research/docs/forms/ethics-cat-b-checklist.pdf
 findings exists, will the subjects/participants be so ___ No
informed? ___N/A
36. If there is any actual or apparent conflict of interest on ___Yes
the part of the investigator(s), their institutions, or their ___ No
sponsors, will the participants be so informed? ___N/A
37. If the research/scholarship involves secondary uses of ___Yes
already-collected data or information regarding ___ No
identifiable individuals, will appropriate measures be ___N/A
taken to ensure the privacy of the individuals and the
confidentiality of the data, and to minimize potential
harms to subjects/participants?
38. If secondary use is to be made of already-collected data ___Yes
or information regarding identifiable individuals, will ___ No
appropriate measures be taken to ensure the privacy of ___N/A
the individuals and the confidentiality of the data, and
to minimize potential harms to subjects/participants?
39. If the study concerns generic behaviors/characteristics ___Yes
that are not specific to particular, identifiable social or ___ No
cultural groups (e.g., child poverty, access to legal ___N/A
services), will any persons be excluded from
participation on the basis of culture, religion, race,
ethnicity, mental or physical disability, sexual
orientation, sex, or age?
40. If information is to be presented to and/or collected ___Yes
from subjects/participants in a language that the ___ No
investigator does not speak/understand fully, will every ___N/A
possible effort be made to ensure that translation is as
clear and accurate as possible?
41. Does the study include the use of personal health ___Yes
information? The Data Privacy Act outlines ___ No
responsibilities of researchers to ensure safeguards that ___N/A
will protect personal health information. If yes, in an
attachment to this checklist, please indicate provisions
that will be made to comply with this Act.
Answer Questions 42 – 47 if your project involves sub-cultural, NA
cultural, national, ethnic, or religious group characteristics as a
focus of study.
42. Will the investigator ensure that privacy (as defined ___Yes
from the standpoint of the subjects/participants) will be ___ No
respected?
43. Will the investigator ensure the accurate description of ___Yes
customs, community, and heritage? ___ No

44. In the case of field work in which informed individual ___Yes

consent cannot be obtained because of cultural ___ No
constraints, has the investigator devised
Note: This checklist was adapted from the Category ‘B’ Human Ethics Checklist of the University of
Winnepeg retrieved from https://www.uwinnipeg.ca/research/docs/forms/ethics-cat-b-checklist.pdf
 methodological safeguards to protect the
subjects/participants fully? Note: If so, describe these
fully in the project description or in an attached note
45. If the study involves indigenous peoples or subcultural, ___Yes
cultural, national, ethnic, or religious groups, and if ___ No
individuals are to be interviewed, will the investigator
exercise caution in generalizing findings for these
individuals to the culture or group as a whole? Note:
Explain fully how this will be done, e.g., by
representing differing viewpoints that may exist within
the community, and/or consulting community
institutions and representatives, etc.
46. If the study involves indigenous peoples or subcultural, ___Yes
cultural, national, ethnic, or religious groups, will the ___ No
investigator cooperate with community institutions,
consult within the community, and/or otherwise ensure
that the group has been informed and involved as fully
as is appropriate and possible concerning the study?
47. If the study involves indigenous peoples or subcultural, ___Yes
cultural, national, ethnic, or religious groups, will the ___ No
investigator provide the community with an appropriate
opportunity to react to the study’s findings before they
are presented publicly? Note: If the community, or
segments of it, disagree with the findings after
considered discussion and exchange, the investigator
should undertake to provide an opportunity to make the
community’s views known, and/or should report
accurately the contents of such disagreements in any
public presentations of the study.
Answer all of Questions 47-53 only if your study involves the N/A
purchase or acquisition of manuscripts, documents, or artifacts.
Otherwise, indicate N/A for this section
48. Will the investigator ensure that the acquisition of ___Yes
materials will be for the sole purpose of ___ No
research/scholarship, and not for personal gain, private
collection, or sale?
49. Will the acquisition of materials meet the legal ___Yes
requirements of the country of origin? ___ No

50. If legal ownership of materials is in doubt, will the ___Yes

investigator inform the proper authorities of the country ___ No
concerned, and abide by their decision regarding
disposition?
51. Will the investigator ensure proper storage, protection, ___Yes
security, and cataloguing of acquired materials? ___ No

Note: This checklist was adapted from the Category ‘B’ Human Ethics Checklist of the University of
Winnepeg retrieved from https://www.uwinnipeg.ca/research/docs/forms/ethics-cat-b-checklist.pdf
 52. If acquired materials are to be deaccessioned or ___Yes
discarded after use, will the investigator ensure that ___ No
they are first offered to public or educational
institutions in the area of origin, then offered to
Philippine institutions, and/or otherwise made
accessible in the public domain?
53. If the acquired materials are publicly exhibited, ___Yes
discussed, or published, will the investigator attempt to ___ No
ensure that no undue embarrassment is caused to the
individuals, groups, or countries of the materials’
origin?

Informed Consent Checklist

The following list is to ensure that all of the necessary elements of a Consent Form(s) have been
addressed. If you check “No” or “N/A” for any of the items listed below please provide a brief
explanation in the area at the bottom of the page.

Elements YE NO N/A
S
Note: This checklist was adapted from the Category ‘B’ Human Ethics Checklist of the University of
Winnepeg retrieved from https://www.uwinnipeg.ca/research/docs/forms/ethics-cat-b-checklist.pdf
 1. The letterhead of TAU is used
2. Identity of the researcher and contact information
3. Research topic/question, nature of participation, duration, and research
procedures
4. Risks and benefits of participation
5. State how feedback is provided to the participants
6. Confidentiality and/or anonymity
7. Point of withdrawal and refusal to answer questions
8. Section for Consent/ assent to participate in the study
9. Parent/Guardian Assent Form
10. Point of withdrawal in the Parent/Guardian Assent Form

Comments

Note: This checklist was adapted from the Category ‘B’ Human Ethics Checklist of the University of
Winnepeg retrieved from https://www.uwinnipeg.ca/research/docs/forms/ethics-cat-b-checklist.pdf