Pushing Methodological Boundaries: Using the Extended Case Study Method to Explore Parental Decision-Making in Pediatric Clinical Trials

This paper aims to illustrate the application of the Extended Case Study Method (ECSM) as advanced by Michael Buroway (1998), in a research context characterized by high sensitivity and complexity: parental decision-making regarding the participation of their seriously ill children in clinical trials. Research in this area is inherently difficult due to the emotional and ethical challenges involved, the vulnerability of the participants, and the confidentiality required for both medical and personal data. Traditional approaches, such as standard case studies or ethnographies, may struggle to provide the depth of insight necessary to fully understand the nuanced factors influencing parental decisions in such sensitive circumstances. To address these challenges, ECSM was employed to extend researcher’s position from the observer to the participant, allowing for a deeper engagement with the parents' experiences and decision-making processes. The method also facilitated the exploration of broader social and institutional forces that shape and constrain these decisions, showing how the element of trust becomes the significant factor influencing decision to participate, while religion and race are embedded in this context. By integrating Symbolic Interactionism theory and the Principle of Autonomy, the study extends theoretical understanding, linking individual parental choices to larger systemic influences. This article demonstrates how ECSM can be effectively operationalized in such a difficult research setting, offering a framework for gaining indepth insights while upholding the ethical and practical constraints inherent in the study. The findings highlight the value of ECSM in capturing the complexity of decision-making processes within sensitive research domains, providing a methodological approach that balances rigor with respect for participant confidentiality and emotional well-being