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    When Do No Harm Is Not Enough: TheEthics of Research with Refugees and

    Other Vulnerable Groups

    Richard Hugman*, Eileen Pittaway, and Linda Bartolomei

    Richard Hugman is Professor of Social Work, School of Social Sciences & International Studies,University of New South Wales, Sydney. NSW 2052 e-mail: [email protected]. Eileen

    Pittaway is Senior Lecturer in Social Work, School of Social Sciences & International Studies

    and Director, Centre for Refugee Research, University of New South Wales, Sydney. NSW

    2052 e-mail: [email protected]. Linda Bartolomei is Lecturer in Social Work, School

    of Social Sciences & International Studies and Deputy Director, Centre for Refugee Research,

    University of New South Wales, Sydney. NSW 2052 e-mail: [email protected]

    *Correspondence to Richard Hugman, School of Social Sciences and International Studies,

    University of New South Wales, Sydney, NSW 2052, Australia. E-mail:[email protected]

    Abstract

    Ethics in social work research increasingly recognises that the rights and interests of

    subjects must be primary. The principal aim is to ensure that the subjects of research

    are protected from harm that might result from their participation in the research. In

    this article, research ethics are examined in the context of refugees and other vulnerable

    groups. It is argued that the ancient idea of seeking to do no harm that continues to be

    a key principle in the refugee field, while necessary, is insufficient to ensure ethically

    sound research practice. A more sophisticated approach is required in research with

    such groups in order to ensure that social works ethical responsibilities are realised.This article discusses a model of participatory research as a vehicle for developing

    research ethics in social work.

    Keywords:Ethics, research, refugees, service users, social work

    Accepted: February 2011

    Introduction

    In recent years, there has been a sustained increase in the number of refu-gees and other forced migrants worldwide (UNHCR, 2010, p. 1). This

    # The Author 2011. Published by Oxford University Press on behalf of

    The British Association of Social Workers. All rights reserved.

    British Journal of Social Work (2011) 41, 12711287doi:10.1093/bjsw/bcr013Advance Access publication March 1, 2011

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    increase in numbers has had many consequences, including disrupted com-munities and social networks, contests over limited resources, multiplecomplex health risks and heightened instances of human rights abusesincluding sexual and gender-based violence (Pittaway and Bartolomei,

    2003; Limbu, 2009). For these reasons, there has been a considerablegrowth in research about and with these populations, which is inevitablyundertaken in very complex, and sometimes difficult and dangerous, situ-ations. These factors, together with the vulnerability and marginalisationof refugee communities, highlight the need for research and simultaneouslyplace these communities at great risk of exploitative and harmful researchpractices, however unintended such outcomes might be (Allotey and Man-derson, 2003;Elliset al., 2007). While the baseline of do no harm is recog-nised as an important starting point, there is a growing sense that research

    into human suffering ought only to be justifiable if it contributes to theending of that suffering (Jacobsen and Landau, 2003, p. 186). Suchmatters are of concern to social work researchers and practitioners asmuch as they are to others involved in this field (Christie, 2003; Nashet al., 2006; Briskman and Goddard, 2007). In research undertakenthrough the Centre for Refugee Research at the University of New SouthWales (UNSW), Australia, examples of ethically poor practice have beenboth directly observed as well as reported by refugees themselves (Pittawayand Bartolomei, 2003,2004,2005;Pittaway et al., 2007). Drawing on insights

    from participatory action research with refugees living in camps or in urbanareas of countries of first settlement in Asia and Africa, this article looks atthese important ethical challenges in research with refugees and suggestsways of rethinking such practice so that good intentions are translatedinto action that lives up to the professions own ethical statements.

    Ethics, refugee research and social work: the background

    Jacobsen and Landau (2003)identify the refugee field as one in which thereare many complex ethical challenges that stem from a combination of theprecarious situation of refugees themselves combined with a risk that, forsome researchers, the ends may justify the means, leading to ethicallapses (Jacobsen and Landau, 2003, pp. 187, 1923). Indeed, althoughJacobsen and Landau illustrate their point with examples of ethicallyvery poor practice, even positively seeking to do no harm can become awell-meant but empty aspiration if refugees are put at further risk by thevery process of the research.

    Social workers, along with other health and human services professionals,

    are involved in many ways in the provision of services for refugees. Areas ofpractice include advocacy, aid programmes, health services, trauma coun-selling, rehabilitation and settlement support, social and recreational pro-grammes, community development and educational programmes (Cox

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    Fifth, in other areas, social workers have developed more reflectiveapproaches to their professional roles, seeking to support service users toachieve their own voice in knowledge about their needs and the bestways to provide services (see, e.g. Beresford, 2000, 2003; Cowden and

    Singh, 2007). Practice with refugees shares many common features ofthese other areas.

    For all of these reasons, therefore, social workers ought to be concernedabout research in the refugee field. Social workers share responsibilitieswith other health and human services professionals to ensure that researchis good in both senses of the word. This means that research must be meth-odologically sound and, at the same time, it must be conducted in ways thatare ethically appropriate. Yet, there appears to be negligible attention inthe social work literature to research ethics in this field, notwithstanding

    some focus on the ethics of social work practice with refugees (e.g.Duvall and Jordan, 2001;Christie, 2003;Briskman, 2006). In response tothis gap, this article first examines ethics in research and social work andthen considers research practices before drawing some conclusions morewidely for social work and research with vulnerable groups.

    Ethics in research and social work

    Developments in ethics specifically concerned with social research tend tobe dated from the middle of the twentieth century (Barnes, 1979). The par-ticular reason for this lies in the atrocities committed in the name ofresearch under Nazism, often by bio-medical researchers, but other pro-fessions including social work were also implicated (Johnstone, 1994).Although there were some defences made that many of those who had per-petrated these atrocities were acting on the basis of duty and not self-interest (seeArendt, 1964), the international war crimes tribunal decidedotherwise and noted that there were also many people who did not partici-pate in such acts. Moreover, this reading of the ethics of duty was seen as aserious error and one that also completely ignored the ancient medical oathof Hippocrates that above all else [we should] seek to do no harm. As aresult, a code of practice was set out by the tribunal (Nuremberg Code,1949) and this was further developed in the Declaration of Helsinki(WMA, 1964). The consensus was that no research should use human sub-jects against their will, either by force or deception, and that, even whensubjects provide informed consent, research should not expose them toundue risk of harm. These ideas have continued to inform debates inresearch ethics for the last half-century and remain the consensus view

    (Elliset al., 2007).Social work has not been silent about the implications of such develop-

    ments (Hugman, 2010). For example, the Code of Ethicsof the AustralianAssociation of Social Workers (AASW) contains a specific section

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    addressing research ethics (AASW, 2002, paragraph 4.5.2). In summary, itcontains statements based on the types of ethical approaches that ofteninform professional ethics more widely (Hugman, 2005). There are state-ments based on the concepts of duty, a concern with consequences and

    also the inherent character of the good social work researcher. The firstof these is embodied, for example, in terms of a duty of respect owed tohuman research subjects expressed in the protection of privacy, dignity,anonymity and confidentiality or in ensuring that the informed consent ofparticipants is given without coercion or duress. Second, placing partici-pants interests ahead of researchers interests, the minimisation of anypotential harm and an obligation to use relevant findings to promotesocial justice are all instances of consequential ethics. Third, for theAASW Code (2002), the good researcher should demonstrate ethical

    awareness, competence in the methods being used and adherence to stan-dards of accountability (demonstrated in submitting research proposalsand findings to appropriate bodies such as ethics committees and otherforms of peer review). The Australian code of ethics for social work thusreflects the highest international ethical standards. Indeed, in many othercountries, the same principles can be seen to operate in ethical statementsabout research (e.g.NASW, 1999;BASW, 2002).

    Butler (2002)has argued that the ethics of social work research should gobeyond this standard, in the sense that as well as demonstrating common

    principles, our thinking also ought to take account of the scope of practice.That is, we must recognise that each of us has to take responsibility formaking sense of these principles and the balance between them as theyapply in every situation that we encounter. The example Butler gives isthat of empowerment (Butler, 2002, p. 243) in which respect forpeoples moral agency and beneficence is combined. Drawing on Hus-bands (1995) notion of the morally active practitioner, Butler arguesthat the need to relate core principles to each situation requires the criticalengagement of each social worker: it can never be a matter of routine or theapplication of a formula (also seeBarsky, 2010).

    The section concerning research in the British Association of SocialWorkers (BASW) Code of Ethics (BASW, 2002, paragraph 4.4.4) isclosely based on Butlers work. The BASW code extends these ideas tomake a definite statement that research should directly involve actual orpotential service users as human participants in research projects and, byimplication, to all social work research, as appropriate to the topic underinquiry and the methods used. This includes, for example, people whohave needs associated with mental health issues, physical or mental disabil-ity, old age, physical ill-health, problems in family or community relation-

    ships, addictions to alcohol or prescribed drugs and children in care, aswell as refugees, asylum seekers and other forced migrants.

    The key statements in the BASW Code of Ethics are that social workresearchers ought to: predicate their work on the perspectives and lived

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    experience of the research subject except where this is not appropriate;seek to ensure that the research in which they are engaged contributesto empowering service users, to promoting their welfare and to improv-ing their access to economic and social resources; seek to work together

    with disempowered groups, individuals and communities to devise,articulate and achieve research agendas that respect fundamentalhuman rights and aim towards social justice (BASW, 2002, paragraph4.4.4.b). This subsection then goes on to make statements concerningthe prevention of harm, attending to the implications of all aspects ofresearch for service users, avoiding the compromise of service userslegitimate interests and strict limitations on the use of concealment inresearch methodologies.

    The British code can be seen as heavily influenced by the service user

    movement in the UK and its relationship to research (Beresford, 2000,2003; Ramon, 2003; Faulkener, 2004). The central argument is that allresearch is undertaken from a standpoint (Humphries, 2007). In so faras social work research (like other aspects of practice and policy) mighthave tended to be done without the participation of service users in allstages, this means that such research inevitably embodies the standpoint(s)of others, such as social workers, agency managers, academics, governmentsand so on. For this reason, it can be questioned whether such research meetsthe principles that form the basis of the professions codes of ethics. The

    alternative is that research concerning service users ought to involveservice users as active participants or co-researchers and not simply con-struct them as sources of information.

    Some critics, such asBeresford (2000,2003), go further and argue thatresearch that does not have service users as active participants is harmful.Not only are service users perspectives marginalised, with implicationsfor reinforcing the dependency status of service users generally, but thereare times at which specific service users can be exposed to risk because ofa lack of accountability by professionals or academics (similar argumentsare made by health researchers in Canada; seeMaiter et al., 2008). Ulti-mately, there are power differentials in the relationship that place signifi-cant responsibilities on the part of professionals and academics.

    This problem has been identified in refugee research (Allotey and Mander-son, 2003; Jacobsen and Landau, 2003; Ellis et al., 2007; Mackenzie et al.,2007). In this field, good research is vital for the development of better policiesand practices by governments and service providers, including internationaland national non-government organisations working in various locations aswell as government agencies in countries of settlement. So, it is importantthat attention to the ethics of such research is tied also to questions about

    methodological rigour. To examine the ethical issues in refugee research inmore depth, this discussion will now consider some concrete examples,before going on to consider ways in which such research can be improved.

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    The reality: tales from the field

    Research work conducted in Africa and Asia in recent years, by staff andassociates of the UNSW Centre for Refugee Research, has identified

    many instances of ethically inappropriate practice (Pittaway and Bartolo-mei, 2003,2005; Pittaway et al., 2007). In particular, refugees report thatthey have provided information in good faith, seeing this as part of arelationship with researchers that might benefit their condition, only tofind that their information is treated like a commodity. This is illustratedby the words of one refugee:

    We are really fed up with people just coming and stealing our stories, takingour photos and we never get anything back, not even a copy of the report.Nothing ever changes (Pittaway and Bartolomei, 2003, p. 36).

    There is a sense that they have been used by researchers from othercountries, for purposes that are unclear but that do not demonstrateobviously how they are related to the refugees own well-being. In otherinstances, the consequences are actually harmful:

    I gave a long interview and never heard anything, until a year later someonebrought me an international magazine and there was my story and my photowith my name. It put me in even more danger (Pittaway and Bartolomei,2003, p. 2).

    The risks faced by refugees in such situations include those of intimidationand discrimination within camps and also threats to physical safety, fromsecurity forces, camp managements and even from other refugees.Women experience heightened levels of risk (Pittawayet al., 2007). Theseare illustrative quotes, from extensive interviews conducted in fourlocations over a three-year period; the same types of statements weremade by many different participants in each place.

    What is revealed here is that, although the refugee in each instance pro-vides information willingly, such willingness appears to be based on a mis-apprehension of the research process. These views indicate that thepurposes of research, possible outcomes, the steps that will be taken byresearchers to protect participants and, indeed, the longer-term moralrelationship between researchers and researched have all been seriouslymisunderstood. This raises important questions, which bring togetherethical and methodological concerns about such research.

    First, this evidence has implications for the confidence with which it maybe concluded that researchers have understood the participants view of theprocess. This, in turn, raises critical problems for the findings of such work

    altogether. If the meanings of the researchprocessfor participants have notbeen grasped, doubts ought to follow about the other aspects of a study.

    Second, these types of statements indicate problems with the way inwhich the researcher has communicated her or his own view of the

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    process and of the relationship that she or he has with the participants.Either this shows that a researcher is not sufficiently aware of her or hisown role in the process of informed consent or it shows a lack ofattention to related ethical aspects, such as the maintenance of privacy, con-

    fidentiality or anonymity. Especially in qualitative research, informedconsent may more usefully be seen as a process rather than an event inthat participants may need to be reminded of the relationship at manystages (Redwood and Todres, 2006;Mackenzie et al., 2007;Maiter et al.,2008). For matters in which this cannot happen, perhaps because theresearcher has now left the field, a default position of consent withheldmight operate. Participants also need to have risks explained clearly andsimply. To reach this conclusion is not to be patronising, as, althoughsome participants may be able to grasp research issues quickly and easily,

    others may have little or no experience to draw on or may be influencedby unrealistic expectations about the benefits of providing information.Where researchers in these situations actively deceive participants concern-ing the information on which consent is based, such practice explicitlystands outside the terms of all codes of ethics and should be regarded asreprehensible.

    Third, there is a problem when researchers see the research relationshiponly within the context of direct contact. In other words, while it is clear thatparticipants regard themselves as continuing to be part of the research, for

    some researchers, it would appear that once they leave the field, partici-pants are effectively reduced to being sources of data as opposed to remain-ing people with whom there is an ongoing relationship.

    The potential impact of the use of data, whether qualitative or quantitat-ive, has long been recognised. Barnes (an anthropologist) notes that there isa level of responsibility on the part of researchers for the way in whichresearch exposes vulnerable people to scrutiny, which cannot be expectedof participants themselves (Barnes, 1979, pp. 1556). Simply following aformal protocol of asking a person in such circumstances to give theirconsent is insufficient. When entering difficult camp situations as white/Western researchers, we have observed that people are so desperate forany form of assistance that they appear to agree to requests for partici-pation in the hope that we might be able to assist them in some tangibleway. This is not to suggest that people from non-Western backgrounds donot understand the principle of giving or withholding consent; rather, itreflects the quite tangible and stark power differentials between themand those who want to involve them in the research process and also theimplications of the context in which consent is being sought. This makesasking for permission to interview people in such vulnerable situations or

    take photographs highly problematic, to say the least. Indeed, as oneresearcher asked, what does informed consent mean in an isolated. . .camp with security problems and no proper interpreters? (Pittaway andBartolomei, 2003, p. 37), to which the answer has to be that it may mean

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    very little, unless researchers attend to their considerable responsibilities torespect the humanity of participants, to pursue beneficence and non-maleficence and to seek justice. An important aspect of this point is thatit applies not only to those who may use or abuse research outcomes,

    such as governments and other forces that drive people from their homes,the usual suspects or those people over there, but also to those whoundertake research in the first place: that is, to ourselves as Westernoutsiders.

    Rethinking research, rethinking ethics

    So, if we are to take these criticisms seriously, how may we respond? To

    answer this question, we want to sketch out the approach to ethics thatunderpins a model for participatory research that is being developedthrough the UNSW Centre for Refugee Research (Pittaway et al., 2004).This model, which has been termed reciprocal research, is based on thenotion of exchange. It operates through establishing a more reciprocalrelationship between researchers and participants than might be seen inmany forms of research, in that it seeks to create relationships betweenresearchers and participants in which there is a more equal exchange ofideas and of the benefits to be gained by being involved in the research

    project. It is research in which the costs of involvement, including potentialrisks, are balanced by the potential for gains that are valued by the partici-pants (Mackenzieet al., 2007, p. 311). That is, the research participants areactively involved in all stages and it is they who determine what is to countas a gain. In that sense, it draws on but adds to the growing field of parti-cipatory action research (compare withMaiter et al., 2008).

    The model arose from a request to undertake research in a refugee camparising out of advocacy work around the abuse of women refugees by mili-tary and government personnel. Initially, the women refugees involvedrefused to take part in research because of their bad experiences with pre-vious research projects. However, because the researcher (Pittaway) wasalready known to them, they felt able to express and discuss their reser-vations. What emerged over a period of several months was a process inwhich the women agreed to take part in an action research project thatwould enable a study to be undertaken, out of which the women themselveswould receive training in human rights documentation and in advocacy (Pitt-away et al., 2004). This then enabled the women to undertake interviewsthemselves within their own communities and use their own material for self-advocacy: it became participatory action research. This process has then

    been repeated in other locations (Pittaway and Bartolomei, 2005). Thewomen from the camp in Thailand have since produced books and tabledthese at various United Nations fora (KWO, 2004,2007;WLB, 2004;Mack-enzie et al., 2007, p. 314). This process contributed to the passing of

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    Conclusion 105 on the Protection of Refugee Women and Girls at Risk at theUNHCR Executive Committee (UNHCR, 2006). So, in summary, the waythat this research began was through establishing relationships that demon-strate actual benefits for the participants (in this case, prior provision of a

    valued service). It then progressed through the direct involvement of partici-pants in all stages of the research, including establishing the agenda and thequestions to be asked. Then, following initial stages, the participants con-tinue to be involved in taking action, review and further questioning.

    So far, this model has been quite consciously built on an action researchframework (see, e.g.Wadsworth, 1997). Action research does not, of itself,require the degree of participatory involvement that is suggested here, butit is readily adaptable in this way. Within such a framework, many specificmethodologies can be used, including quantitative, qualitative and mixed

    methods. It is also the case that the cyclical, developmental characteristicsof action research are not a necessity: what is important is that the relation-ship between (external) researchers and participants is based on a processand not seen as a single event. It must involve dialogue with refugee com-munity groups themselves in all aspects of the research, including the ques-tions to be asked, techniques to be used, the interpretation of data anddecisions about publication.

    One of the strong claims made out of this body of work is that the stan-dard approach to research ethics is insufficient in work with refugees (and,

    by implication, with other comparably vulnerable populations). The prin-ciple of informed consent, in itself, is ethically sound, but the evidencefrom work with refugee groups is that it does not go far enough becauseof the assumptions on which it depends about how individuals are able actu-ally to achieve moral autonomy. Mackenzie et al. (2007, p. 309) proposethat, instead of the individualistic, liberal notion of autonomy thatinforms research ethics, we should consider autonomy as relational. It isnot that the experience of seeking refuge and associated traumas necess-arily takes away peoples capacities to understand and to exercise theirown good judgement: it may or it may not. The point is that the contextof giving consent does have an impact on understanding, choice and soon. Autonomy is a capacity that is socially acquired and can be enhancedor undermined in many different ways. A relational approach to the ques-tion of autonomy enables researchers to think in more subtle ways abouttheir obligations. In so far as that traditional injunction to do no harmcan be seen to be insufficient, which this research suggests is the case insuch situations, this argument does not mean that it should be abandoned,but rather seen as a beginning point from which other moral values might beenacted. What this means in practice is that consent is given through a

    process that involves groups meeting and discussing all the implicationsof the research and, should they agree to participate, continuing to thinkabout their involvement in such a way that either individuals may withdrawor even a whole group can decide to end their involvement.

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    Mackenzie et al. (2007, p. 310) argue that there are both negative andpositive aspects to the ways in which the idea of relational autonomymight impact on research with refugees. First, negatively, it introduces anobligation for researchers to attend to the ways in which research might

    compromise peoples capacities to exercise moral agency and to take allpossible steps to ensure that this does not happen. When informedconsent becomes an iterative process, this obligation is facilitated throughthe way in which participants can gain shared control over what is happen-ing. Second, the positive aspect is seen in the ways in which this model canassist refugees to strengthen their autonomy as well as identifying theirplight and providing a means by which it can be addressed. The action ofrefugee women in the camps of Thailand in using participatory researchto highlight the problem of the perpetration of rape in war and civil conflict

    to the international arenas of the UN (Conclusion 105, noted above) is aclear example of this.Such an understanding of relational autonomy has a great deal in

    common with the ethics of care, in the form in which it is integrated withvalues of (human) rights and (social) justice (Tronto, 1993;Sevenhuijsen,1998; Hugman, 2005). Tronto (1993, pp. 1038) argues that care hasfour dimensions: care about (active commitment to the good of others);taking care of (action to meet formal obligations to promote the goodof others); care-giving (undertaking specific acts to promote the good of

    specific people); and care-receiving (engaging in reciprocal relationshipsof care with known others). Trontos argument is that the first two dimen-sions tend to be enacted in the public arena and they may be instrumentallydelivered, while the latter two dimensions are more (inter)personal andthey tend to have an affective content. The normative content of theethics of care must include all four components. Within these terms,justice is the equitable balancing of social power and resources thatpromote the capacities of all people to integrate these dimensions of carein their actions (Hugman, 2005, p. 70). Thus, for example, justice concernsnot only the objective fact, the truth, about violence towards women inrefugee situations being heard at the UN, but also the truthfulness, thatis, the moral meaning for participants, of the relationship between theresearchers and the women concerned (compare with Hugman, 2005,p. 128). This powerful dynamic led to their stories being told by thewomen themselves.

    Beginning to reach some conclusions

    This article has spelled out the significance of refugee research for socialwork, explored research ethics generally and specifically in social workand has examined issues raised by a participatory research model. In reach-ing some tentative conclusions, it is necessary to identify and counter

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    potential objections concerning the practicality of this model beforedrawing out some wider implications for social work research.

    There appear to be four main areas in which objections might be raisedabout this participatory approach. (There may be more, and the current

    authors will be interested to hear any other criticisms.) The first of theserelates to the logistics of research projects. This participant action researchmodel as it has been developed so far in refugee research is perhaps moretime-consuming than might be the case if more orthodox techniques areused. At the same time, it should be acknowledged that time is often aresource factor in research of many kinds, including longitudinal surveys,detailed ethnography and action research projects. But, as with thoseother forms of research, the benefits of using the participatory actionmodel with vulnerable populations such as refugees can be substantial.

    Not only does it generate material that is more effective, for examplebecause it is able to bring out responses from participants that can behidden in other circumstances (Pittaway and Bartolomei, 2003), but it isalso able to provide tangible outcomes for participants, for example instrengthening capacities and affirming agency. Thus, it may be said thatthis approach is better in both a technical and an ethical sense.

    Second, there are likely to be issues faced by researchers in obtaining insti-tutional ethics approval for projects in which a developing relationship leadsto reiterations of informed consent. Unfortunately, where institutional

    ethics committees are narrowly focused on more traditional understandingsof core principles, this may be the case (Redwood and Todres, 2006;Dom-inelli and Holloway, 2008). There is often a need to negotiate, even toeducate, those colleagues who constitute such committees about the practi-cal realities of conducting research well in ethical terms in this type of setting.However, the experience of the present authors is that this need not be inevi-table and agreements can be reached, for example, that provide flexibilityfor researchers who need to make decisions quickly in situations in whichthey cannot go through processes of application for a change in the termsof approval. Again, this is a problem that has long been faced by qualitativeresearchers and the recent Australian guidelines on research ethics thatinclude detailed advice on how to deal appropriately with such matters area welcome development (NHMRC/ARC/AVCC, 2007). Interestingly,this document also includes a good description of qualitative research thatcan be used to inform committees about ways of conducting research thatlie outside the more positivistic models that have tended to predominatein such bodies. Although researchers choosing to use a participatoryaction model may be required to do more work in obtaining institutionalapproval, this can be done by providing a clear strategy of how difficulties

    will be handled in the field that is related to the principles that such commit-tees are trying to uphold. Competent researchers should have some ideaabout how they will handle unusual or difficult situations and it is not

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    relationship (compareFook, 1999, withBenhabib, 2002). Most importantly,this identity must be understood in the context of the imbalance of powerbetween researchers and refugees in such situations. Questions of socialpower are embedded in all research relationships, which is why ethics is inte-

    gral to every aspect of research (Hugman, 2010). The approach discussed inthis article provides an insight into a response to this challenge that may beextrapolated to other fields of social work research (compare with Beres-ford, 2000, 2003). It thus offers a perspective on how anti-discriminatoryand culturally sensitive practice might be developed in this aspect of socialwork (Dominelli, 2002; Clifford and Burke, 2009). This way of thinkingabout and doing research has much to offer social work research withother vulnerable communities, among whom many service users can befound. There is a risk that service users involvement can become tokenistic

    in that service user involvement becomes formulaic and does not actuallygive service users access to shared power over the definition of problemsand ways of intervening, as has been argued recently in the UK ( Cowdenand Singh, 2007). Research approaches that treat service users simply assources of information, in other words as data, can be said to fail in termsof the ethics that has been presented here. So the challenge is to find waysof ensuring that research relationships are congruent with the empoweringand developmental goals of social work as a profession. The dynamic of reci-procity in relational ethics is a way of achieving this.

    The issues that are identified here have faced social scientists for decades(Barnes, 1979). This discussion invites social workers researching with vul-nerable communities to recognise these as ethical issues. Do no harm is anecessary but insufficient principle alone as the ethical basis for such work.It needs to be integrated with respect, beneficence and justice in a morerelational approach that can be gauged in terms of what is offered backto participants in ways that are meaningful to them (Hugman, 2005,2010). As has been noted, this may add some logistical complexity to pro-jects in some situations, but it strengthens rather than weakens researchmethodologically. A participatory, relational model thus provides a basisfor good action research with participants from vulnerable communities,in both the technical and ethical senses. From this, it can become a solidbasis for good practices and policies for social work.

    Acknowledgements

    The authors are grateful to Leanne Dowse and Rebecca Eckert (University

    of New South Wales) for their contribution to associated work that hasinformed the thinking behind this paper, and also to Karen Postle (Univer-sity of East Anglia) for advice on UK material concerning service users andresearch.

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    References

    Allotey, P. and Manderson, L. (2003) From case studies to casework: Ethics and obli-

    gations in research ethics with refugee women, in P. Allotey (ed.), The Health of

    Refugees: Public Health Perspectives from Crisis to Settlement, South Melbourne,Oxford University Press.

    Arendt, H. (1964) Eichmann in Jerusalem: Notes on the Banality of Evil, 2nd edn,

    New York, Viking Press.

    Australian Association of Social Workers [AASW] (2002)Code of Ethics 1999, Revised

    edition, Barton ACT, AASW.

    Barnes, J. (1979) Who Should Know What? Social Science, Privacy and Ethics,

    Harmondsworth, Penguin.

    Barsky, A. E. (2010) The virtuous social work researcher,Journal of Social Work Vales

    and Ethics, 7(1), available online at www.socialworker.com/jswve/spring2010/

    6virtuoussw.pdf.Benhabib, S. (2002) The Claims of Culture: Equality and Diversity in the Global Era,

    Princeton, Princeton University Press.

    Beresford, P. (2000) Service users knowledges and social work theory: Conflict or col-

    laboration?, British Journal of Social Work, 30(4), pp. 489504.

    Beresford, P. (2003) Its our Lives: A Short Theory of Knowledge, Distance and Experi-

    ence, London, Open Services Project.

    Briskman, L. (2006) Pushing ethical boundaries for children and families: Confidentiality,

    transparency and transformation, in Adams, R., Dominelli, L. and Payne, M. (eds),

    Social Work Futures: Crossing Boundaries, Transforming Practice, Basingstoke,

    Palgrave-Macmillan.Briskman, L. and Goddard, C. (2007) Not in my name: The peoples inquiry into immi-

    gration detention, in Lusher, D. and Haslam, N. (eds), Yearning to Breathe Free,

    Sydney, The Federation Press.

    British Association of Social Workers (BASW) (2002) The Code of Ethics for Social

    Work, Birmingham, BASW.

    Butler, I. (2002) A code of ethics for social work and social care research, British

    Journal of Social Work, 32(2), pp. 239248.

    Christie, A. (2003) Unsettling the social in social work: Responses to asylum seeking

    children in Ireland,Child and Family Social Work, 8(3), pp. 22331.

    Clifford, D. and Burke, B. (2009) Anti-Oppressive Ethics and Values in Social Work,Basingstoke, Palgrave-Macmillan.

    Cowden, S. and Singh, G. (2007) The user: Friend, foe or fetish? A critical exploration

    of user involvement in health and social care,Critical Social Policy, 27(1), pp. 523.

    Cox, D. and Pawar, M. (2006)International Social Work: Issues, Strategies and Programs,

    Thousand Oaks, Sage.

    Dominelli, L. (2002) Anti-Oppressive Social Work Theory and Practice, Basingstoke,

    Palgrave-Macmillan.

    Dominelli, L. and Holloway, M. (2008) Ethics and governance in social work research in

    the UK,British Journal of Social Work, 38(8), pp. 100924.

    Duvall, F. and Jordan, B. (2001) How low can you go? Dilemmas of social work withasylum seekers in London, Journal of Social Work Research and Evaluation, 2(2),

    pp. 189205.

    When Do No Harm Is Not Enough 1285

    byguestonNovember27,2013

    http://bjsw.oxfordjournals.org/

    Dow

    nloadedfrom

    http://www.socialworker.com/jswve/spring2010/6virtuoussw.pdfhttp://www.socialworker.com/jswve/spring2010/6virtuoussw.pdfhttp://www.socialworker.com/jswve/spring2010/6virtuoussw.pdfhttp://www.socialworker.com/jswve/spring2010/6virtuoussw.pdfhttp://www.socialworker.com/jswve/spring2010/6virtuoussw.pdfhttp://www.socialworker.com/jswve/spring2010/6virtuoussw.pdfhttp://www.socialworker.com/jswve/spring2010/6virtuoussw.pdfhttp://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://www.socialworker.com/jswve/spring2010/6virtuoussw.pdfhttp://www.socialworker.com/jswve/spring2010/6virtuoussw.pdfhttp://www.socialworker.com/jswve/spring2010/6virtuoussw.pdfhttp://www.socialworker.com/jswve/spring2010/6virtuoussw.pdfhttp://www.socialworker.com/jswve/spring2010/6virtuoussw.pdf
  • 8/13/2019 Br J Soc Work 2011 Hugman 1271 87

    16/17

    Ellis, B. H., Kia-Keating, M., Yusuf, S. A., Lincoln, A. and Nur, A. (2007) Ethical

    research in refugee communities and the use of community participatory research,

    Transcultural Psychiatry, 44(3), pp. 45981.

    Faulkener, A. (2004)The Ethics of Survivor Research: Guidelines for the Ethical Conduct

    of Research Carried out by Mental Health Service Users and Survivors, Bristol, Policy

    Press.

    Fook, J. (1999) Critical reflectivity in education and practice, in Fook, J. and Pease, B.

    (eds), Transforming Social Work Practice: Postmodern Critical Perspectives, St Leo-

    nards, Allen and Unwin.

    Hugman, R. (2005) New Approaches in Ethics for the Caring Professions, Basingstoke,

    Palgrave-Macmillan.

    Hugman, R. (2010) Social work research and ethics, in Shaw, I., Briar-Lawson, K.,

    Orme, J. and Ruckdeschel, R. (eds), The Sage Handbook of Social Work Research,

    London and Los Angeles, Sage Publications.

    Humphries, B. (2007) Research mindedness, in Lymbery, M. and Postle, K. (eds), Social

    Work: A Companion for Learning, London, Sage.

    Husband, C. (1995) The morally active practitioner and the ethics of anti-racist social

    work, in Hugman, R. and Smith, D. (eds), Ethical Issues in Social Work, London,

    Routledge.

    Jacobsen, K. and Landau, L. B. (2003) The dual imperative in refugee research: Some

    methodological and ethical considerations in research on forced migration, Disasters,

    27(3), pp. 185206.

    Johnstone, M.-J. (1994) Bio-Ethics: A Nursing Perspective, 2nd edn, Marrickville,

    W. B. Saunders/Ballie` re Tindall.

    Karen Womens Organization (KWO) (2004) Shattering the Silences: Karen Women

    Speak Out about the Burmese Militarys Use of Rape, Bangkok, KWO.

    Karen Womens Organization (KWO) (2007)State of Terror, Bangkok, KWO.

    Limbu, B. (2009) Illegible humanity: The refugee, human rights and the question of rep-

    resentation, Journal of Refugee Studies, 22(3), pp. 25782.

    Mackenzie, C., McDowell, C. and Pittaway, E. (2007) Beyond do no harm: The chal-

    lenge of constructing ethical relationships in refugee research, Journal of Refugee

    Studies, 20(2), pp. 299319.

    Maiter, S., Simich, L., Jacobson, N. and Wise, J. (2008) Reciprocity: An ethics for

    community-based participatory action research, Action Research, 6(3), pp. 30525.

    Nash, M., Wong, J. and Trlin, A. (2006) Civic and social integration: A new field of social

    work practice with immigrants, refugees and asylum seekers, International Social

    Work, 49(3), pp. 34563.

    National Association of Social Workers (NASW) (1999) Code of Ethics, Washington,

    DC, NASW.

    National Health and Medical Research Council (NHMRC)/Australian Research

    Council (ARC)/Australian Vice-Chancellors Committee (AVCC) (2007) National

    Statement on Ethical Conduct in Human Research, Canberra, NHMRC.

    Nuremberg Code(1949), fromThe Trials of War Criminals Before the Nuremberg Mili-

    tary Tribunals Under Control Council Law No. 10, Nuremberg/Washington, DC, US

    GPO.

    Pittaway, E. and Bartolomei, L. (2003) Women at Risk Field Research Report: Thailand

    2003, Sydney, Centre for Refugee Research, University of New South Wales.

    Pittaway, E. and Bartolomei, L. (2004) Women at Risk Field Research Report: Thailand

    2004, Sydney, Centre for Refugee Research, University of New South Wales.

    1286 Richard Hugman et al.

    byguestonNovember27,2013

    http://bjsw.oxfordjournals.org/

    Dow

    nloadedfrom

    http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/http://bjsw.oxfordjournals.org/
  • 8/13/2019 Br J Soc Work 2011 Hugman 1271 87

    17/17

    Pittaway, E. and Bartolomei, L. (2005) Field Research Report: Kakuma, Kenya, Sri

    Lanka, Ethiopia and Thai-Burma Border, Sydney, Centre for Refugee Research,

    University of New South Wales.

    Pittaway, E., Bartolomei, L. and Rees, S. (2007) Gendered dimensions of the 2004

    tsunami and a potential social work response in post-disaster situations, International

    Social Work, 50(3), pp. 30719.

    Pittaway, E., Bartolomei, L. and Shaw, C. (2004) Reciprocal Research: Human Rights and

    Gender Training in a Burmese Refugee Camp in Northern Thailand , Sydney, ANCO.

    Ramon, S. (ed.) (2003) Users Researching Health and Social Care: An Empowering

    Agenda?, Birmingham, Venture Press.

    Redwood, S. and Todres, L. (2006) Exploring the ethical imagination: Conversation as

    practice versus committee as gatekeeper, Forum Qualitative Sozialforschung/Forum:

    Qualitative Social Research,7(2), March, Article 26, 25 paragraphs, available online at

    www.qualitative-research.net/index.php/fqs/article/view/129.

    Reichert, E. (1996) Keep on moving forward: NGO forum on women, Beijing, China,

    Social Development Issues, 18(1), pp. 8997.

    Sevenhuijsen, S. (1998) Citizenship and the Ethics of Care: Feminist Considerations on

    Justice, Morality and Politics, London, Routledge.

    Tronto, J. (1993) Moral Boundaries: A Political Argument for an Ethic of Care,

    New York, Routledge.

    United Nations High Commission for Refugees (UNHCR) (2006) Conclusion on Women

    and Girls at Risk, Executive Committee Conclusions, 6 October, Document No. 105

    (LVI)2006, Geneva, UNHCR.

    United Nations High Commission for Refugees (UNHCR) (2010) 2009 Global Trends:

    Refugees, Asylum Seekers, Returnees, Internally Displaced and Stateless Persons,

    Geneva, UNHCR.

    Wadsworth, Y. (1997) Do It Yourself Social Research, St Leonards, NSW, Allen and

    Unwin.

    Womens League of Burma (WLB) (2004)System of Impunity, Bangkok, WLB.

    World Medical Association (WMA) (1964)Declaration of Helsinki, as amended in 2004,

    Ferney-Voltaire, WMA.

    When Do No Harm Is Not Enough 1287

    byguestonNovember27,2013

    http://bjsw.oxfordjournals.org/

    Dow

    nloadedfrom

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