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Observing the consent process: Building trust by being present

David Staley ( is Research Compliance Officer, and Hannah Gilbert ( is Research Compliance Analyst at Children’s Hospital Colorado in Aurora, CO.

The immensity of regulated environments decreases face-to-face experiences. That immensity distances compliance offices from the team members who operate in their respective environments. How then do we evaluate the compliance of operations if we evaluate and make judgments about that compliance from a distance? The enormity of our stewardship is often too much to fathom. Inevitably, compliance professionals slip into viewing team members abstractly. As a result, the value of the role compliance professionals play diminishes, because they evaluate and make judgments about compliance in the abstract. From a distance, we put limits on how we collaborate and build trust. We put a strain on limited resources. We foster misunderstanding and complacency. In essence, compliance professionals can’t be trusted until they are present. So, how then do we promote closeness?

Let’s turn to wise, ancient counsel. A version of one of Æsop’s classical fables recounts two encounters between a lion and a mouse. In the fable, they recognize how being close during moments of life and death depends on their trust in one another. The fable reads:

Once, when a Lion was asleep, a little Mouse began running up and down upon him; this soon wakened the Lion, who placed his huge paw upon him and opened his big jaws to swallow him. ‘Pardon, O King,’ cried the little Mouse. ‘Forgive me this time, and I shall never forget it; who knows but what I may be able to do you a good turn one of these days?’ The Lion was so tickled at the idea of the Mouse being able to help him, that he lifted up his paw and let him go. Sometime after, the Lion was caught in a trap and the hunters, who desired to carry him alive to the King, tied him to a tree while they went in search of a wagon to carry him on. Just then, the little Mouse happened to pass by and, seeing the sad plight of the Lion, went up to him and soon gnawed away the ropes that bound the King of the Beasts. ‘Was I not right?’ said the little Mouse.”[1]

This fable illustrates how closeness, regardless of rank, title, or fierceness, cultivates an understanding from which trust is built. That closeness can transform what was once abstract into something real. We simply need to shorten the distance. However, the value of recognizing the distance only partially concretizes the abstraction. Without a structured approach—a small effort that can produce great results—compliance offices may wrestle with exactly what it means to get close to the teams they serve.

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