Over the last year we have witnessed unprecedented efforts to increase oncology social workers’ engagement in research. The first Post-Conference Research Institute held at the 2016 AOSW Conference, the recent call for applications for the Patient-Centered Research Collaborative (PCRC) for Psychosocial Oncology and the announcement of the creation of a new Special Interest Group (the Social Work Oncology Research Group, chaired by Dr. Elizabeth Rohan) are clear examples of the key role research has for the future of our field. The complexity of contemporary cancer care requires a carefully coordinated collaboration between oncology social workers, researchers and other healthcare professionals, with the goal to develop evidence-based practice and to foster outcome-based investigations that promote quality of care (Institute of Medicine, 2008, 2013; Oktay et al., 2016).

Although research is a core aspect of oncology social work (AOSW Oncology Social Work Standards of Practice, 2001) and more in general of the mission of social work (National Association of Social Workers Code of Ethics, 1996), engaging in research is not free of ethical risks and numerous challenges (Macrina, 2005). For those who are considering participating in a research project, sometimes for the first time, here is a list of questions that can be helpful in making the decision. These questions are the results of personal and professional reflection. (In the last 10 years I had the privilege to conduct research and participate in different research teams.) They integrate Ethical Research Framework (Belmont Report, 1979; Emanuel, Wendler, & Grady, 2000; Kitchener, 1984;) Virtue Ethics (Jordan & Maera, 1990) and Ethics of Care (Baier, 1986) which I see as building blocks of the research endeavor of oncology social workers.

The first set of questions addresses whether the project is conducted in accordance with guidelines and policies of ethical research:

1. Is the research study addressing relevant issues that can promote the quality of psychosocial care for patients, families and communities involved? Will it be possible to promote better coordination of care? 
2. Is the process of creating the research team rigorous enough? What are the modalities through which practitioners can join the research team? 
3. What are the criteria utilized to include representatives from oncology social work and other disciplines? Is the study inclusive of a variety of competences, and experiences?
4. Does the ultimate goal of the research outweigh the possible risks that derive from participation?  
5. Is the research conducted in a way that meets ethical conduct requirements and policies from participating institutions and national organizations?

After being sure that the research project is meeting the requirements for ethical research—such as respect for person, beneficence and justice—another aspect to consider is whether the study promotes or is aligned with the core values of the profession. Virtue Ethics focuses on “the character of the practitioner” (Jordan & Maera, 1990; cited by Freeman, 2000 p. 94) and places value on the “subjective qualities, traits and habits that lead an individual to a given choice and action” (Freeman, p. 89). Virtue Ethics assists us in this effort because it forces us to reflect on “whom shall I be?” and “how should I act?” (Freeman, p. 89), therefore highlighting the role we all play in representing oncology social work with our conduct and behaviors. Questions relevant to this aspect are:

6.  What is the image of oncology social work that this study conveys?

7.  What are the motivations behind my participation?

8.  Am I encouraging further development and education of the field and my peers?

9.  Is my conduct in accordance with the values of the profession?

Finally, the Ethics of Care Model highlights the virtue of caring (Freeman, 2000). In the theory developed by Baier (1985, 1986), the concept of “appropriate trust in trust” is of assistance in our reflection, as trustful relationships are a key element in our work. Furthermore, as “care-oriented thinkers” (Freeman, p. 115), we are in the unique position to see relationship paradigms in terms of connectedness, and we are moved by a moral imperative of attention and responsiveness (Freeman; Gilligan, 1982). Hence, the last set of questions suggests examining whether the proposed research initiative is promoting a sense of trust and connectedness among investigators and those involved:

10.  How is commitment to the project promoted?

11.  Is a sense of belonging and responsibility fostered?

12.  Are there modalities to promote interdisciplinary knowledge and collaborations?

We left Tampa with a sense of excitement and motivation for the future. This is a crucial time for our field because we have the opportunity to develop a community of practitioners, researchers and cancer advocates devoted to the promotion of quality of care for all. Despite challenges and barriers, the hope is that the proposed questions may assist oncology social workers in actively engaging in research that will enhance the provision of psychosocial care, and our leadership in the implementation and dissemination of patient-centered care.
 

References

Association of Oncology Social Workers. (2001). Standards of practice in oncology social work. Available online at www.aosw.org/mission/standards.html.

Baier, A. (1985). Portraits of the mind. Minneapolis: University of Minnesota Press.

Baier, A. (1986). Trust and antitrust. Ethics 96(2), 231-260.

Belmont Report. (1979). The Belmont report: Ethical principles and guidelines for the protection of human subjects of research. Available at hhs.gov/ohrp/humansubjects/guidance/belmont.html.

Emanuel, E., Wendler, D., & Grady, C. (2000). What makes clinical research ethical? Journal of the American Medical Association, 283, 2701-2711.

Freeman, S. (2000). Ethics: An Introduction to Philosophy and Practice. Belmont, CA: Wadsworth.

Gilligan, C. (1982). In a different voice. Cambridge, MA: Harvard University Press.

Institute of Medicine (2008). Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs. Washington, DC: National Academy Press.

Institute of Medicine. (2013). Delivering high-quality cancer care. Charting a new course for a system in crisis. Washington, DC: National Academy Press.

Jordan, A., & Meara, N. (1990). Ethics and the professional practice of psychologists: The role of virtue and principles. Professional Psychology: Research and Practice, 21, 107-114.

Kitchener, K. (1984). Institutions, critical evaluations and ethical principles. The Counseling Psychologist, 12, 43-55.

Macrina, F.L. (2005). Scientific integrity. Text and cases in responsible conduct of research (3rd ed.). Washington, DC: ASM Press.

National Association of Social Workers. (1996). Code of ethics. Available at http://www.socialworkers.org/pubs/code/default.as.

Oktay, J.S., Kayser, K., Lee, H.Y., Rohan, E., Smith, S.K., Zebrack, Z., & Stephenson, J. (2016). Promoting Research in Oncology Social Work. A White Paper from the Association of Oncology Social Work Post-Conference Research Institute. Available at http://www.aosw.org/AOSW/media/Main-Site-Files/Research/Documents/AOSW-Research-Institute-White-Paper-FINAL.pdf.