Module 1 Chapter 3: Ethical Conduct of Research

The NASW professional code of ethics has quite a lot to say about ensuring that research be conducted in an ethical manner, so here we revisit the code of ethics to review these research-specific standards. We begin with an overview of historical events that bring us to where we are today in the research ethics arena. This content is covered in greater depth and detail in your CITI (Collaborative Institutional Training Initiative) program training modules. Then, we return to the section of NASW’s (2017) Code of Ethics that we initially visited in Chapter 1.

In reading this chapter, you will learn:

• Key facts about research ethics;
• Statements from the NASW Code of Ethics specific to the ethical conduct of research

History and Research Ethics

Following the conclusion of World War II and subsequent “Doctors’ Trial” portion of the Nuremberg Trials, the 10-point Nuremberg Code was developed as a response to numerous examples of unethical, inhumane “medical” experiments conducted in concentration camps. The Nuremberg Code was relatively ignored for many years, at least in the United States. Subsequently, a number of grievously unethical experiments were conducted on prisoners, institutionalized patients, and children—disproportionately on poor and racial minority populations—including exposure to toxins, diseases, radiation, or torture. The Tuskegee syphilis experiment represents a critical turning point in the nation’s tolerance of unethical human research. In 1932, the U.S. Public Health Service partnered with the Tuskegee Institute to study the natural course of syphilis among 399 black men. Over 40 years, the men believed they were being treated for syphilis, but were in fact receiving no treatment for the disease, even when penicillin proved to be an effective form of treatment by 1947. Beginning in 1968, concerns were being raised and condemning news reports were widely circulated in 1972, leading to the study being ended. By 1974, the Tuskegee Health Benefit Program was established by the U.S. government to ensure health and burial benefits to the study’s remaining survivors, wives, widows, and children.

In response to concerns about unethical research practices, a national group was formed (in 1974, the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research), and created what is now known as The Belmont Report (1979). The Belmont Report, in turn, influenced development of federal policy (1981, revised 2009) concerning protections for human research subjects—the Common Rule. The Belmont Report presented a summary of ethical guidelines for engaging in research that involves human subjects. The guidelines are based on three core principles:

• Respect for persons.This principle is founded on a conviction that “individuals should be treated as autonomous agents” (Belmont Report, 1979, p. 4). The report explains this autonomy in terms of respecting a person’s right to making considered, informed choices, and places a responsibility on researchers to ensure that a person has all of the information necessary for self-determined choices and is free from constraints on making self-determined choices. The discussion also addresses situations where a person might not be capable of self-determination and what protections might be necessary in these instances.
• Beneficence.This principle is about an obligation for protecting participants from harm and “making efforts to secure their well-being” (Belmont Report, 1979, p. 5). This translates into ensuring that benefits to participants are maximized and possible harms or risks are minimized.
• Justice. This principle is about fairness. Justice in this context is about ensuring a fair and just distribution of both the potential burdens and the potential benefits of participating in research. “Another way of conceiving the principle of justice is that equals ought to be treated equally” (Belmont report, 1979, p. 5).

These three core principles are closely aligned with the core values of our social work profession. Our code of ethics is based on principles that include respect for the dignity and worth of the individual, which includes fostering client self-determination, as well as practicing with integrity.

The Belmont Report (1979) also contains language about distinguishing between research and professional practice. The report defines practice in this way:

 “…interventions that are designed solely to enhance the well-being of an individual patient or client and that have a reasonable expectation of success” (p. 3).

Research is defined in the Belmont Report as:

 “…an activity designed to test an hypothesis, permit conclusions to be drawn, and thereby to develop or contribute to generalizable knowledge” (p. 3).

These two types of professional activity are clearly contrasted—their goals are markedly different. Practice goals relate to benefits for the individuals being served; research goals are served by the individuals who participate.

Revisiting the NASW Code of Ethics

We previously examined what the NASW Code of Ethics had to say about the role of research and evidence in professional practice and the role of social work professionals in engaging with research and evidence. At this point, we turn again to the Code of Ethics to see what is specified in terms of the ethical conduct of research. These details are in addition to what was discussed earlier about research integrity.

Standard 5.02: Evaluation and Research continued. Let’s pick up where we left off in reviewing the NASW Code of Ethics content related to engaging in evaluation and research as a social work professional. The Code of Ethics (p. 27-28) replicates many elements found in the current federal policy concerning the protection of human subjects in research and in the 1996 Health Insurance Portability and Accountability Act (HIPAA). The Code of Ethics states that:

• (d) Social workers engaged in evaluation or research should carefully consider possible consequences and should follow guidelines developed for the protection of evaluation and research participants. Appropriate institutional review boards should be consulted 

• (e) Social workers engaged in evaluation or research should obtain voluntary and written informed consent from participants, when appropriate, without any implied or actual deprivation or penalty for refusal to participate; without undue inducement to participate; and with due regard for participants’ well-being, privacy, and dignity. Informed consent should include information about the nature, extent, and duration of the participation requested and disclosure of the risks and benefits of participation in the research.

• (f) When using electronic technology to facilitate evaluation or research, social workers should ensure that participants provide informed consent for the use of such technology. Social workers should assess whether participants are able to use the technology and, when appropriate, offer reasonable alternatives to participate in the evaluation or research.

• (g) When evaluation or research participants are incapable of giving informed consent, social workers should provide an appropriate explanation to the participants, obtain the participants’ assent to the extent they are able, and obtain written consent from an appropriate proxy.

• (h) Social workers should never design or conduct evaluation or research that does not use consent procedures, such as certain forms of naturalistic observation and archival research, unless rigorous and responsible review of the research has found it to be justified because of its prospective scientific, educational, or applied value and unless equally effective alternative procedures that do not involve waiver of consent are not feasible.

• (i) Social workers should inform participants of their right to withdraw from evaluation and research at any time without penalty.

• (j) Social workers should take appropriate steps to ensure that participants in evaluation and research have access to appropriate supportive services.

• (k) Social workers engaged in evaluation or research should protect participants from unwarranted physical or mental distress, harm, danger, or deprivation.

• (l) Social workers engaged in the evaluation of services should discuss collected information only for professional purposes and only with people professionally concerned with this information.

• (m)Social workers engaged in evaluation or research should ensure the anonymity or confidentiality of participants and of the data obtained from them. Social workers should inform participants of any limits of confidentiality, the measures that will be taken to ensure confidentiality, and when any records containing research data will be destroyed.

• (n) Social workers who report evaluation and research results should protect participants’ confidentiality by omitting identifying information unless proper consent has been obtained authorizing disclosure.

• (o) Social workers should report evaluation and research findings accurately. They should not fabricate or falsify results and should take steps to correct any errors later found in published data using standard publication methods.

• (p) Social workers engaged in evaluation or research should be alert to and avoid conflicts of interest and dual relationships with participants, should inform participants when a real or potential conflict of interest arises, and should take steps to resolve the issue in a manner that makes participants’ interests primary.

• (q) Social workers should educate themselves, their students, and their colleagues about responsible research practices.

Together, these 14 statements reflect a responsibility for social workers to :

• participate in appropriate Institutional Review Board (IRB) procedures,
• ensure the safety and protection of participants in social work research and evaluation studies,
• engage in effective informed consent procedures,
• responsibly utilize information technology in research,
• collect and discuss only information relevant to the study,
• preserve participant privacy and confidentiality (or anonymity),
• engage in research with integrity,
• prevent or responsibly resolve conflict of interest instances, and
• remain informed about responsible research practices.