I’ve been asked by readers to review a new piece of research which has been quoted, at the time I’m writing this, by the Irish Examiner, Buzz.ie, and RTE Drivetime. It’s a piece by a Maynooth academic, titled “Irish healthcare workers experiences of anti-abortion protesters and the case for safe access zones.”
This particular study is different than other research I’ve reviewed for Gript in that it itself accepts that the population it surveyed was not representative, and the author, Dr Camilla Fitzsimons, openly admits to being an activist, or an academic-activist, as she puts it. As such there’s no real need for me to go through most of the methodological issues with the study, beyond saying that the admittance that the sample is not representative did not stop the media from reporting the research without noting its methodological constraints or lack of validity.
The research is based on an anonymous online survey, which doesn’t appear to have attempted to verify that participants were Irish healthcare workers beyond asking them tick a box to say they were, and which was widely spread by activist groups, and so it is perhaps more accurate to say the research is not so much unrepresentative as it is to say Dr Fitzsimons can’t even demonstrate that the people who filled out the study are actually doctors rather than, lets say, activists attempting to ensure a particular result.
The research also repeats a statement made by Ivana Bacik, based on a claim made to her by Together Safety, that “anti-choice activists have been obtaining information about dates and times of appointments for terminations so they can harass Women.” It is not noted in the research that this claim has been shown to be false, and was shown to be false substantially before the publication of this research.
What I think is most important to mention is that it appears to me, having reviewed the information available, that the study deliberately leaves out pertinent information on the groups involved in the gathering of the participants in the study, and the nature of the study.
The study itself says that it is based on an anonymous survey carried out in 2021, which 75 health care providers having fully completed the survey. Dr Fitzsimons states that she sourced participants by going to START, a voluntary network of GPs and Obstetric providers, and the Midwives Association of Ireland. Unfortunately, it does not appear that that is a full accounting of how participants were sourced or who was involved in that sourcing.
In mid-2021 Together for Safety, an activist group who campaign for protest exclusion zones, launched an online survey, in conjunction with Dr Fitzsimons, which was titled “Gathering information on Anti-Choice Protests.” Whilst the survey appears to no longer be available online an archival search shows that participants in that survey had to sign a waiver stating that “I also understand that the researchers may develop a peer-reviewed academic article from the research in the future.” The survey earlier says that “It is possible that the data will be used by the same researcher as part of a peer-reviewed article on SAZs.”
Participants in this survey, which is described as having been “circulated by the Together for Safety Campaign in collaboration with Maynooth University,” were informed that Stephen Donnelly, the Minister for Health, had said that “made it clear in responses to questions posed recently in the Dail, that as far as he is aware, there is no problem with anti-choice protests in Ireland.” This was linked to the failure of the government to bring in “Safe Access Zone legislation.”
Maynooth’s Research Ethics Committee approved Dr Fitzsimons to carry out her research between June and September of 2021, which appears to align with the dates between which the above survey was accessible. Dr Fitzsimons says that the survey she relied on for her work was distributed on social media; Dr Fitzsimons shared the Together for Safety survey on her social media, linking in several pro-choice organisations when she did so. Some of these organisations were medical organisations, or at least deal primarily with healthcare issues, but not all – some were entirely lay organisations such as the Abortion Rights Campaign. A search of the doctor’s social media, using the keyword “research”, shows no tweets referencing any other survey looking into this area, indicating that this is the study being referred to as having been distributed on social media.
In August of 2021 Dr Fitzsimons tweeted out that the preliminary results of the “collaborative research between Maynooth University and Together for Safety about exclusion zones” showed that 40% of respondents “report street protests, 89% in favour of #saz (safe access zones).” The research published by Dr Fitzsimons this month says that 44.6% of respondents had witnessed protests outside their work, and that 77% were in favour of “legislation on safe access zones.” This is to say that results presented in the new research seem to broadly reflect the preliminary results of the survey undertaken in collaboration with Together for Safety.
Reminder of collaborative research between @MaynoothUni and @together_safety about exclusion zones.
We need healthcare workers to complete. Preliminary findings 40% report street protests, 89% in favour of #saz @Startdoctors @freesafelegal @TFMRIRE https://t.co/YTIfAalr9b
— Camilla Fitzsimons 🇵🇸 (@Camilla_Fitzs) August 7, 2021
Given the above it appears rather likely that Dr Fitzsimons’ work is based on the survey results she gathered in conjunction with Together for Safety. Which is to say it appears like that an activist organisation was integrally involved with the production of Dr Fitzsimons’ work and may have been involved in the design of the actual questions, and that this information was not disclosed in her research. When Dr Fitzsimons was interviewed by RTE she was explicitly asked how she had conducted the study, and she made no mention of the involvement of Together for Safety. This is particularly concerning given that Together for Safety are referenced in the study, but no declaration is made that there is, or ever has been, an active relationship between Dr Fitzsimons and the organisation. And, again, the design of the study, and the apparent lack of effort to verify respondents were healthcare providers, means there was no barrier to activists attempting to sway the results.
There are a number of issues that arise if I am correct that the recent release is based upon this particular survey. These issues relate to the failure of Dr Fitzsimons to disclose the involvement of Together for Safety; the fact that Together for Safety have repeatedly made claims which have been later been shown to be false, which raises questions as to their suitability as a research partner; the usage of priming text on the first page of the survey which served to inform participants that their answers could be used to help, or hinder, a particular policy being implemented; and the distribution of survey links to activists groups who have a stated interest in particular policies being implemented.
There is also of course the question of why the involvement of Together for Safety, if I am correct in my believe that the two surveys references are just a single survey, was not disclosed. Whilst we cannot determine, nor would I want to guess Dr Fitzsimons’ reasons for deciding not to disclose methodological information, I would note that the lack of disclosure is materially misleading and could lead to the research being less scrutinised than it might have been had the involvement of an activist group been disclosed. I would also note that it is not that Dr Fitzsimons failed to note that she used external groups to attract respondents, it is that Dr Fitzsimons noted that she had done so and then appears to have deliberately decided not to mention Together for Safety’s involvement.
I contacted both Dr Fitzsimons and Maynooth’s Ethics Committee with questions about the methodology of this research prior to publication of this piece. We did not receive a response from either party, and so I have included the questions I sent Dr Fitzsimons, in full, below.
Dr Fitzsimons was later sent a second email which noted that we believed her research was based on the Together for Safety survey and that she had deliberately withheld disclosing that information both in her research itself and in her interview with RTE. We asked Dr Fitzsimons if she had any explanation for why this was done, or if she wished to deny the accuracy of what we had said. We received no response. We will update this piece if a reply is recieved at any point.
1 – What steps did you take to verify the identity of those who completed the survey?
2 – Could you explain how you selected the provider groups which you reached out to, START and the Midwives Association, and why it was only those provider groups you reached out to?
3 – You say the survey was circulated on social media, could you tell me how many of your respondents came from links circulated on social media rather than through the links given to the provider groups?
4 – When you promoted the research on social media did you link to, or send the link to any activists or organisations?
5 – Was this research conducted in collaboration with Together for Safety?
6 – I note that you say you have collaborated with Together for Safety, could you detail the nature of that collaboration, when it began, and if it is ongoing?
7 – I note that you conducted polling in 2021 from a form titled “Gathering information on Anti-Choice Protests.” Are any of the results in this newly released research drawn from that polling?
8 – I note in the timeline of the piece that you reference Together for Safety’s claims that pro-life protesters were passed information relation to abortions at UHL; were you aware when you wrote the timeline that those claims have been shown to be false?
This piece was first published on Gript.
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