Ethics and values in social care research
Ethics and values are a fundamental part of the way people work in social care, so much so that in social work they are one of the nine capabilities within the Professional Capabilities Framework (PCF). However, they are not necessarily fundamental to all types of research. McLaughlin (2012) gives three examples of medical research where practice was far from ethical:
- In New Zealand, women who had pre-cancerous symptoms were divided into two groups without their knowledge, and only one of the groups was treated for their symptoms.
- An anti-viral HIV drug was tested against a placebo by American companies in African, Caribbean and Asian countries. Testing in this way was unlikely to pass ethical standards in the USA.
- In the UK, doctors at Alder Hey Hospital kept organs for medical research purposes from babies who had died, without asking their parents' permission to do so. The parents thought they had buried their children with their organs intact. The BBC described this practice as 'harvesting organs' and called it an 'organ scandal' (BBC 2001).
Consider the three examples given above and list the ways in which they were unethical. What values should be considered in relation to these examples?
Although research in the field of social care is closely governed to try and ensure that this sort of behaviour cannot take place, it is impossible to say that no harm ever occurs as a result of research in this area. Much social care research involves people who may be seen as vulnerable or isolated within the community, and the level of contact and resulting relationships that can be built up during the research process can raise expectations that are unlikely to be fulfilled (Orme and Shemmings 2010). Service users can feel that they are being 'used' for the research process, or that, on reflection after their participation, they have exposed more of themselves to the world than they are comfortable with (Hardwick and Worsley 2011).
In order to try and protect research respondents and participants from harm, researchers in social care must ensure that their work follows a set of ethical guidelines and gains approval from a research ethics committee, as well as having research governance authorisation. Not all social work researchers are also social workers. While we might hope that they chose this field of research because of a commitment to social justice, emancipation and other social or political values, they are not regulated by the same professional codes of practice and conduct as a registered social worker, whose codes include those issued by the General Social Care Council (GSCC) or the Health Professionals Council (HPC).
However, regardless of the background of the researcher, all research within social care 'should' follow ethical practices, and Butler (2002: 241) argues that 'the ethical foundation for a code of research ethics for social work research is to be derived from the ethics of social work itself'. He goes on to say that this is the case if the research is about social work and its practice and theory, or is aimed at a social work audience, including practitioners, managers, educators, policy-makers and researchers within this category.
Credible research can account for itself in the way it is implemented according to a clear set of ethical rules or an ethical code. However, not all research that social care practitioners come across will be from social care and use a code derived from social work practice. Therefore, ethical practice should be appraised within each piece of research, rather than simply being expected to happen as a matter of course. Being research-minded means being able to assess whether a piece of research has been ethical in its design, delivery and reporting. There are a variety of resources which look at different ethical codes and guidelines, such as those produced by the British Sociological Association (BSA) the Social Policy Association (SPA) and the Social Research Association (SRA).The ESRC has an online guidebook on social research ethics, which includes guidance on applying for ethical approval as well as some key elements of ethical practice in research.
The ESRC 'six key principles' of ethical social research
1.Research should be designed, reviewed and undertaken to ensure integrity, quality and transparency.
2.Research staff and participants must normally be informed fully about the purpose, methods and intended possible uses of the research, what their participation in the research entails and what risks, if any, are involved.
3.The confidentiality of information supplied by research participants and the anonymity of respondents must be respected.
4.Research participants must take part voluntarily, free from any coercion.
5.Harm to research participants must be avoided in all instances.
6.The independence of research must be clear, and any conflicts of interest or partiality must be explicit.
(ESRC 2010: 3)
While the ESRC's framework for research ethics is a useful starting point from which to assess the ethics within a project, the nature and extent to which researchers explicitly consider ethics and values within different research disciplines varies enormously, and is a contested topic. It is important to bear in mind that social work and social care, with their emphasis on respect, dignity, participation and human rights, often require much stronger ethical positioning than other disciplines. For instance, in psychology experiments the information given to respondents beforehand is often vague, so that prior knowledge does not skew the outcome of the test. By contrast, in social work and social care research, every effort must be made to ensure participants are clear about the purpose of the research so that they agree to take part in an informed way. Corby (2006) argues that this may push social research towards critical, qualitative research and exclude some 'effectiveness' models, while on the other hand, Orme and Shemmings (2010) point out how important this has been because of the resulting removal of a hierarchical approach to research. This shift has helped social research to move towards a more empowering participation agenda in line with its emancipatory aims, instead of the weaker positioning of the participant as 'research subject' which is still inherent in much quantitative research (Corby 2007).
It is important that an ethical approach works its way through the whole of a research project and is not squeezed into just the pre-project planning. It needs to remain alive even in the dissemination of the findings (Shaw 2008). This is aligned with working as 'morally active researchers' (Orme and Shemmings 2010: 55). It embodies a reflective, value-led approach which can better deal with the realities of research, where life's complexities often move the researcher away from their ideal plan of work and contingency plans have to be created almost on the spot.
Research governance and research ethics committees
All research proposals in the social sciences require approval via a stringent process before being allowed to commence. Research projects are normally assessed in two ways, through governance and through ethics committees, although the ways in which this happens can vary enormously depending on which local authorities are involved (McLaughlin and Shardlow 2009).
In social care research, research governance seeks to ensure that the overall project is sound and in the public interest. It looks at the mechanics of the research as well as ethical considerations to decide whether any risk has been properly assessed and managed. The DH first published the Research governance framework for health and social care in 2001, and this was updated in 2005. The framework 'seeks to promote improvements in research quality across the board' (DH 2005: 1.1.7). It sets out key standards across five domains, and lists some core elements of quality research in health and social care.
The DH key standards reach across the following five domains:
- health, safety and employment
- finance and intellectual property.
The key elements of a quality research culture are listed in the Framework as:
- respect for participants' dignity, rights, safety and well-being
- valuing diversity within society
- personal and scientific integrity
- clear and supportive management.
While the framework looks specifically at adult health and social care, it is also sometimes used across services for children and families (McLaughlin 2012). Recently, Boddy and Oliver (2010) undertook a review for the (now defunct) Department for Children, Schools and Families (DCSF) to assess the use of research governance in children's services. They found a variety of arrangements and no consistent approach. This lack of consistency, varying from stringent, time-consuming regulations to relatively lax approaches, can make it difficult for researchers to move into their project work. Within adult services, the Association of Directors of Adult Social Services ADASS has a governance process for projects that will cover four or more local authorities, but many local authorities will insist on their own checks. What remains important here is that researchers do not use these processes as merely an initial checkpoint for quality, safety and accountability, and as Roger Smith (2009: 158) cautions:
Formal compliance of this kind should not become more important than the underlying professional principles of establishing and maintaining good ethical practices, although this does seem to reflect wider social trends towards a preoccupation with form rather than substance.
While not all projects will come across issues with research governance, depending on their subject and where they are situated, all social care research that undertakes some form of interface with people as respondents or participants (empirical research) must undergo an ethics check. Research ethics committees (RECs), which may be based within an organisation, a university or other workplace, look at the researchers' plan to manage ethics within the project and decide whether suitable care has been taken. In some cases further approval must be granted. Where the NHS is involved, where research moves into areas where participants are seen as very vulnerable, or where local arrangements cannot assess larger projects, then specific RECs come into play.For example, the Social Care Research Ethics Committee (SCREC) looks at projects within social care and social work, and particularly where these cross over into health. Where there is any NHS patient or resource involvement, the National Research Ethics Service (NRES) will become involved instead. The NHS also requires its own research governance protocols to be followed, adding another layer of protection for patients, staff and, arguably, the organisation itself.