Research Ethics for Counsellors, Nurses & Social Workers

Dee Danchev, Alistair Ross, Author

• Publisher: SAGE Publications Ltd
• Year: 2013
• Print ISBN: 9781446253366, 9781446253359
• eBook ISBN: 9781446292648
• Edition: 1
• Topic: Psychology
• Subtopic: Psychotherapy Counselling
• Index: Psychology

Research Ethics for Counsellors, Nurses & Social Workers is designed to help you make the best start in your research career. With ethical implications and considerations arising at each stage of the research process, engaging with the wide range of issues and ideas can often prove a challenge. Dee Danchev and Alastair Ross will help you overcome this challenge and become confident, skilled researchers by providing you with:

-An in-depth explanation of the theoretical base for a range of ethical demands and approaches, equipping you with the tools to make the right decisions for your project.

-Key research ethics findings so students can apply the latest thinking to your research practice.

-Short case examples and checklists to help you apply theory to practice and reflect on what you have learned.

-Further reading and important resources to support your continued learning.

Whether you are an experienced researcher or coming to research for the first time, this highly practical, step by step guide, is a must for your bookshelf.

Dee Danchev is a counselling psychologist and Pastoral Advisor at Nuffield College, Oxford.

Alistair Ross is Director of Psychodynamic Studies and Dean of Kellogg College, Oxford.

1

The researcher: researching and developing ourselves

Researchers usually have an idea for a research project or an area for exploration in place at the start of their research study and in the initial stages tend to focus on refining these ideas. We would argue that attending to ethics is an equally important factor that needs consideration at the beginning of any research study, and we recommend that researchers start this process by reflecting on themselves. This chapter focuses on how researchers can develop their ethical sensitivity in order to achieve a sound basis for ethical practice in relation to others. The usefulness of codes of conduct and ethical guidelines in helping the researcher to achieve ethical competence is considered, and we give an overview of the theoretical basis for ethical research practice. We hope that it will give readers an understanding of the theories that underpin research ethics and the practical decisions that they will be making. An integral part of heightening researchers’ ethical awareness is ensuring that they are caring for themselves within the research process. Counsellors, nurses and social workers will be well aware that in order to care for others it is necessary to be proactive in maintaining self-care and this applies equally when conducting research.

We will begin by considering the meaning of ethics. Beauchamp and Childress (1994: 4) define ethics simply as ‘a generic term for various ways of understanding and examining the moral life’. Slote (1995) provides a more descriptive definition. Ethics, according to Slote, encompasses a wide range of questions about what is good, right and/or virtuous, and questions of value: ‘What kind of life is best for the individual and how ought one behave in regard to other individuals and society as a whole’ (Slote, 1995: 721). Our aim is to be able to conduct research ethically but how do individual researchers achieve this? When attempting to behave ethically there is often an understandable desire for a set of rules that will tell us what to do.

Codes, guidelines, frameworks and principle ethics

Counselling, nursing and social work are relatively new professions and in recent decades they have moved towards attaining professional status. An important strand of this evolution has been the development of codes of conduct. These ethical guidelines set standards to ensure that professionals will be competent, trustworthy, refrain from the deception and exploitation of others, and contribute to the greater good through their work (Tjeltveit, 1999). Most caring professions have a basic code of ethics or an ethical framework and some, such as the British Association for Counselling and Psychotherapy (BACP) and the British Psychological Society (BPS), have developed separate ethical guidelines for research. Guidelines provide us with useful prompts and are usually based on principle ethics. At this stage it would be much easier for the reader if we said ‘when you do research use this ethical code’, but we are more ambitious in thinking that researchers need to understand the underpinnings of these codes and frameworks. We want to put ethics at the centre of the research process rather than treat it as an after-thought. In order to do this we are going to delve more deeply into principle ethics.

Principle ethics form the middle level of a five-level model of ethical reasoning developed by Kitchener and Kitchener (2009). This model provides a useful map of the different levels of ethical reasoning and we will take a closer look at it before returning to think about the usefulness of ethical guidelines and frameworks.

The first level of the model is the intuitive, immediate response of the individual’s moral conscience, often experienced as the ‘gut feeling’, and is based upon moral upbringing and experience. Shillito-Clarke (2003) suggests that it is often a sound guide but it may not be adequate when there are time pressures or unusual circumstances. The second level consists of the specific laws and codes of conduct that shape and constrain behaviour, such as a professional ethical framework.

At the next level are principles, which are universal values of equal worth (Shillito-Clarke, 2003). This level is very useful in practical reasoning and forms the basis for most ethical frameworks and guidelines. Beauchamp and Childress (1994) have identified four principles that have a ‘prima facie’ validity. These are beneficence (do good), non-maleficence (do no harm), autonomy (respect for self-determination), and justice (fairness). Two further principles have been identified as integral to ethical reasoning and are useful additions. Shillito-Clarke (1996) adds Kitchener’s (1984) principle of fidelity (faithfulness), which she identifies as important for forming and maintaining therapeutic relationships, and Meara, Schmidt and Day (1996) add veracity (truthfulness), as it is a fundamental ingredient in establishing trust between people.

The principle of beneficence involves taking positive action to do good and includes an obligation to act. Choosing research topics that are most likely to make a positive contribution to knowledge and being proactive in ensuring that research participants are properly debriefed are examples of beneficent acts. Non-maleficence is defined as an obligation to do no harm. This embraces issues of competence as well as ensuring that exploitation and the abuse of power do not occur in practice, research or professional dealings with others. Autonomy means ensuring the right of the other to self-determination. This applies to such aspects of research as ensuring informed choice and the identification and careful management of issues that may oppress or disadvantage participants. Justice, according to Meara et al. (1996), is primarily concerned with distributive justice, for example, ensuring sensitivity to inequalities, and attention to civil rights. Fidelity involves the obligation to be trustworthy and loyal within relationships and to ensure that disruptions of trust, such as inappropriate dual relationships, do not occur. Meara et al. (1996) describe veracity as truthfulness and cite Bok’s (1989) argument that veracity is a foundation of human community. ‘I can have different kinds of trust: that you will have my interest at heart, that you will do me no harm. But if I do not trust your word, can I have genuine trust …?’ (Bok, 1989: 31). When making an ethical judgement, no principle is considered paramount. Principles are examined for their relevance to a particular situation and then weighed against each other. We will return to principle ethics in Chapter 5 where we will show how these ethical principles can be applied in practice to aid in solving ethical dilemmas.

The fourth level of the ethics model is ethical theory. There are, of course, a vast range of ethical theories but Kitchener and Kitchener (2009) identify the ethical theories that are especially useful to researchers. These are: natural law ethics, virtue theory, utilitarianism, deontology, and the ethics of care. Natural law ethics hold that morality is implicit in human nature and that ethical outcomes can be arrived at by reasoning. The Stoic form of natural law emphasises the equality of all human beings. Virtue theory maintains that the development of each person’s moral capacity, rather than laws or sets of rules, forms the basis for ethical actions. Utilitarianism places emphasis on the outcomes of actions. If an action results in something beneficial, then it is judged to be morally good. Utilitarians also take the view that moral actions should produce the greatest good for the largest number of people. Deontology is the science of duty and its most famous proponent is Immanuel Kant. Kant argued that duty should be the guide for actions. He placed emphasis on the importance of motives and said that it is not the outcome of an action that matters but the motives of the person concerned. The ethics of care focus on the obligation to act with care towards others (Kitchener and Kitchener, 2009). This strand of ethics includes feminist ethics and the ethical theories that prioritise relationship and responsibilities towards others. It can be seen that each of these ethical theories has its strengths and each may be particularly relevant in certain situations. However, it is also evident that they are often in opposition to each other and deciding which theory should take precedence or how these theories can interact in ethical decision making is the concern of the fifth level of metaethics.

Model of ethical reasoning

Level 1. Immediate level: the intuitive response.

Level 2. Laws: ethical rules, codes, guidelines and frameworks.

Level 3. Principle ethics: beneficence, non-maleficence, justice, autonomy, fidelity, and veracity.

Level 4. Ethical theories: natural law ethics, virtue theory, utilitarianism, deontology, and the ethics of care.

Level 5. Metaethics: deciding which ethical theory takes precedence and how ethical theories might interact. (Kitchener and Kitchener, 2009)

Philosophical theory is a complex subject and we have given the briefest possible overview but we hope that it will act as a reminder of the basic ideas. For those who are interested in ethical theory and its relation to research, Kitchener and Kitchener (2009) provide a readable and more detailed guide.

Let us return to thinking about ethical guidelines and how helpful such guidelines are for researchers. In these guidelines, which are based on principle ethics, there is often a stronger focus on non-maleficence than on the other principles. Bond (2004) observes that the motivation for developing codes of ethics often arises from a concern to redress previous wrongs; they are developed primarily to avoid harm rather than to do good. This means that there is a defensive element to them and researchers will often check them to ensure that they are not doing anything wrong (O’Donahue and Mangold, 1996). Such codes can foster a tick-box approach and do not inspire or encourage in-depth ethical consideration.

So are these guidelines adequate and if we adhere to them will they ensure ethical research practice? On the positive side they form a basis for good practice and alert us to previously unconsidered aspects of ethical practice. They aim to protect the public and establish confidence in professionals and they underpin a pre-existing assumption on the part of the general population that professionals will behave ethically. However, ethical codes or guidelines may also have less admirable functions. They have been criticised as being too focused on the well-being of the professions and, as Bersoff (1994) notes, this is not surprising as they are usually generated by the professionals concerned. Ethical committees attempt to redress this problem by appointing lay people but they are often in a minority and Veatch (1989) argues that clients and key stakeholders should have a much greater degree of participation in the development of ethical standards. It is also important that if these codes are to cater for a diverse community, then this diversity must be represented on the committees and within the codes or guidelines. This point is emphasised by Pederson (1989), who warns that codes of ethics can inscribe the dominant culture. An often-stated aim is to protect the public, but do guidelines actually do this or is ethical behaviour generated from a different source?

[T]hey do little or nothing to protect the public. They tell us nothing, surely that we do not accept for ourselves as a result of how we understand the process of psychotherapy. As a psychotherapist I do not need a code of ethics to tell me not to exploit someone…. I do not do this because of my own personal ethics and because of my understanding of transference and of the power relationship between therapist and patient.

(Gordon, 1999: 35, 36)

Gordon firmly places the responsibility to behave ethically within the individual and argues that it cannot be imposed by external regulation. This means that fundamentally good research practice depends on individual researchers taking responsibility to treat others with care and it is not dependent on regularly consulting ethical codes. As Kitchener (1996: 369) says, ‘No code can legislate goodness.’ In other words, codes of conduct are not enough to ensure ethical practice. Moreover, interpreting such codes or guidelines is not a simple matter. At times it requires a good deal of ethical sensitivity and experienced researchers differ on how the principles and guidelines should be applied in particular situations (Corey, 1991). There is even concern expressed that strict adherence to codes of conduct may encourage unethical behaviour. ‘They do little to develop or support the active independent critical judgement or discernment that should be associated with true moral responsibility. They may engender confusion, passivity, apathy and even immorality – the antithesis to ethical discourse and responsibility’ (Pattison, 1999: 375). Lowenthal and Snell (1997) expand on this perspective. They underline Levinas’s (1989) emphasis on the importance of putting the other first and highlight two consequences that follow from this position. If the other is to be put first, then a code of conduct cannot be put first as it provides us with the wrong conceptual starting point. Secondly, they say that codes of conduct militate against being thoughtful about practice.

Bond (2005: 9) places codes of conduct in a useful perspective. He argues against rules ‘becoming too dominant as a method of constructing ethics’. As an external authority, codes of conduct demand compliance and weaken the capacity of the researcher to develop an individual sense of ethical responsibility. However, Bond feels that a basic code of conduct is necessary and that it can provide a springboard for the individual practitioner to develop ethical mindfulness. He describes ethical mindfulness as a heightened awareness of the interplay between externally imposed ethics (extrinsic ethics) and individual ethical values (intrinsic ethics).

It is also important to recognise that ethical opinion is not a static entity. What is considered to be good ethical practice at one point in time may be viewed very differently twenty years later. Ethics are subject to transformation and our views on morality change as new challenges are met and we appreciate the complexities of our rules and regulations at a deeper level. Ethical guidelines have to be regularly reviewed in order to reflect changing times and mores.

A more positive view is that research guidelines and codes of conduct have served the purpose of raising the level of ethical discourse within the caring professions. However, it can be argued that the ethical principles that underpin codes and guidelines are themselves value-laden. Principle ethics have been developed from the Western individualistic tradition and have attracted criticism in their application to other cultural settings. The emphasis on the principle of autonomy, it is argued, is inappropriate for non-Western cultures where the well-being of the family or group is considered to be more important than that of the individual (Varma, 1988).

Principle ethics are also criticised from a feminist perspective by Rave and Larsen (1995), who assert that the feeling-intuitive dimension is under-emphasised. Gilligan (1982) supports the view that subjective feelings should be given a greater emphasis, and argues that intuition is a significant factor in the decision-making process. Robson et al. (2000) suggest that a rationalisation of actions takes place after the intuitive decision has been made, creating the illusion that a logical process has been followed. Their view is that the role of intuition should be fully acknowledged and balanced by opening the decision-making process to the scrutiny of peers and the public.

It is also evident that principle ethics focus on dilemm...

Table of contents

• Cover Page
• Halftitle
• Advertisement
• Title
• Copyright
• Dedication
• Contents
• About the authors
• Acknowledgments
• Introduction
• 1 The researcher: researching and developing ourselves
• 2 The participant: responsibility, care and consideration
• 3 Relational ethics: the relationship between the researcher and the participant
• 4 Establishing trust: the fundamental ingredients
• 5 Research dilemmas, decisions and details
• 6 Research ethics committees: structures and procedures
• 7 The social and political contexts of research and the ethics of dissemination
• Index