Social work research ethics in China: A scoping review of research involving human subjects during COVID-19

Abstract

As the first review to systematically explore the scope and application of Chinese social work research ethics, this study incorporated web-crawling technology in the scoping review process and identified 18 eligible studies from 1168 publications from January 2020 to July 2021. Findings suggest that social work scholars are aware of research ethics when conducting human subjects research in the Chinese population. Yet, many failed to fully demonstrate practical considerations of internationally accepted ethical principles (e.g. respect for persons). We discuss education on research ethics, new challenges of the digital age, and considerations of Chinese culture in developing ethical protocols for social work research in China.

From the Nuremberg Code (Shuster, 1997), an international effort drafted in 1947 to overrule the inhumane procedures of Nazi medical experiments, to the Declaration of Helsinki (World Medical Association, 2001), the most recognized international convention on research ethics adopted in 1964, medical professionals worldwide are united in advocating for ethical standards for research involving human subjects. Although the public might perceive social sciences as not harming human subjects, many studies, especially psychology and behavioral studies, can have profound impacts on participants’ lives. For example, Milgram (1963), under deceptive conditions, exposed participants to a stressful situation in which they thought they were physically harming someone else. They were not, but the extreme pressure caused many to desire to stop and some to exhibit signs of physical and emotional discomfort. However, the researchers discouraged them from withdrawing from the experiment, which was designed to explore human obedience. Some participants were psychologically distressed after the study experience.

Social work research, including intervention research, tends to be different than that of social psychology in terms of study design and expectations of social applications, making it arguably less threatening to human participants. By contrast, due to social work’s mission, social work research often focuses on vulnerable populations, such as minors and people with mental illness. Intrusions on human participants in social work research can be inconspicuous, subtle, ambiguous, or controversial yet salient, requiring extra precautions to protect human participants from unjustified harm. Social workers have made notable contributions to the development of research ethics. For example, social worker Peter Buxtun (Kerr and Rivero, 2014) investigated the unethical treatment of human participants in the Tuskegee Syphilis Study and was instrumental in the passage of laws governing human research. In 1974, the US National Research Act established the institutional review board (IRB) mechanism, which clarified the obligations of research institutions and became a ‘common rule’ (Fischer, 2006) for federal agencies to safeguard the ethical standards of research they support.

The publicity of the Tuskegee Syphilis Study and exposure of studies in which human subjects were abused (Beecher, 1966) in the United States impelled Congress to establish the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research (Friesen et al., 2017). In 1979, the commission released the Belmont Report as a proclamation to prevent human subject abuses from happening in future research (Beauchamp, 2008). The Belmont Report regarded respect for persons, beneficence, and justice as the fundamental principles underlying ethical research with human subjects (Fischer, 2006). Each principle manifests in the research process as a practical rule. Specifically, the principle of respect for persons translates into informed consent, acknowledging human participants’ right to a sound understanding before voluntary participation. The principle of beneficence requires risk–benefit analysis for studies involving human subjects to ensure expected benefits outweigh the risks. Finally, the principle of justice refers to the participant selection process being just. Although scholars criticized the Belmont Report for narrowing the application of the three principles (Friesen et al., 2017), the deductive relationship between each principle and its applicable ethical rule set a specific and minimum standard for ethical research.

In 2017, the National Association of Social Workers (2017) approved new changes to its Code of Ethics, which not only maintains research ethics as social workers’ responsibility (Chapter 5.02, ‘Ethical Standard’ section), but also expands the provisions of research ethics in response to the increasing use of technology in social work research. For example, Provision 5.02(f) states that ‘When using electronic technology to facilitate evaluation or research, social workers should ensure that participants provide informed consent for the use of such technology’. In other words, social work researchers should follow ethical research processes regardless of their means of data collection.

Late development of social work ethics in China

In China, Confucian ethics guided civil helping activities in society for many years, and the core values of Chinese Confucian ethics coincide with the Western ethical framework rooted in Christian charitable practice. The ballast stone of Confucian ethics is harmony (translated from 大同, a concept recorded in Confucian doctrine in the Book of Rites), which pursues a just society without inequalities or war. Harmony is also the ultimate status of benevolence or humanity (translated from 仁), which may be achieved through consociation, caring, and helping among humans.

The complexity of the interpersonal relations and the situational practice background of Chinese culture, however, made it challenging for Chinese social workers to adapt Western ethical principles directly in practice (He and Xu, 2021). Chinese anthropologist and sociologist Fei (2019) noticed the familism pattern of trust and established the theory of ‘the order of stratified closeness’ (translated from 差序格局 by Wang, 2018), which depicts the many layers of strong kinship and trust instead of generalized interpersonal trust. Confucian ethics not only regulate interpersonal relationships in families but also promote the value of interpersonal care on a macro level, following the blueprint of family relationships. For example, as proposed in Mencius, an ancient Confucian doctrine that lasted more than 2300 years: ‘Expand the respect of the aged in one’s family to that of other families; expand the love of the young ones in one’s family to that of other families’ (translated from 老吾老以及人之老幼吾幼以及人之幼). Compared with Western society, where system trust (Luhmann, 2018), impersonal trust (Shapiro, 1987), or institution-based trust (Zucker, 1986) prevails, trust in Chinese society is culturally interpersonal, personal, or relational, contributing to thousands of years of home-based and family care and the relatively delayed development of the helping professions in China. Moreover, according to Confucian role ethics, developed by the renowned sinologist Roger Ames (2011) based on classical Confucianism, Chinese ethics is always adjustable in practical situations as a person’s role changes in different scenarios. The complexity and extreme feasibility of situational ethics have prevented China from developing Kantian or regulation-based ethical principles (He and van Heugten, 2021).

In addition to the delay induced by Confucianism, the late development of the social work discipline in China has also impeded the development of a social work code of ethics. The earliest version of the Chinese code of ethics dates to the 1990s, when the China Associations of Social Workers (CASW) proposed four sections of 17 articles as a directional guideline for adopting social work ethics in the China mainland. Then, on 28 December 2012, the Ministry of Civil Affairs released Guidelines on Professional Ethics of Social Workers, consisting of seven chapters, as the current practical code of ethics. In general, the two Chinese codes of ethics have embraced and demonstrated globally shared social work values such as respect and humanity. Similarly to the codes of ethics of other countries, such as the United States and Singapore, the latter code released by the Ministry of Civil Affairs specified major responsibilities of social workers to their clients, colleagues, agencies, profession, and society. However, both Chinese codes of ethics are so concise that they lack practical instructions to social workers on how to achieve ethical responsibility. For instance, the only article related to social work research that could be found in the two codes is from CASW’s Code of Ethics, which states that (translated by the authors):

Investigation and research shall be emphasized to gain in-depth understanding of the difficulties and sufferings of societal members; effective measures shall be taken to help them get out of the predicament. Improve the service level of social work through continuous investigation and research.

However, this article is too broad and fails to sufficiently specify the ethical challenges and risks regarding such ‘investigation and research’.

Research ethics in social work academia in China

Some literature has focused on cross-national comparisons of codes of ethics on the structural level from different aspects (e.g. cultural elements, philosophical roots; He and Xu, 2021; Zhang, 2016). Since the US code of ethics is considered much more comprehensive and advanced, comparative studies tended to advocate for further adoption and proper localization of the Western code in China’s social context (Shen and Liu, 2008). Although research ethics are infused and manifested in the US code of ethics, none of the cross-national comparative studies has investigated the aspect of social work research ethics. In other words, research ethics, a substantial component of Western social work research, have been overlooked in China’s social work academia. Chinese social work journals do not require authors to submit ethical statements for articles to be published.

The China Association for Social Work Education (CASWE) recently established its Ethics Committee in December 2021, which is tasked with promoting the development of Chinese ethical guidelines in social work education. It is disappointing that although Master of Social Work (MSW) students are required by CASWE to submit a dissertation to demonstrate their research capability before graduation, neither the Guidelines on Professional Ethics of Social Workers nor the agenda of the CASWE Ethics Committee has made clear provisions or statements on research ethics. Only a few Chinese social work schools review the ethics of their faculty’s research through an academic committee, and such reviews are often experiential and by request instead of institutionalized or mandatory. There is no nationwide guideline for social work students to follow in their research process, and no Western-style IRB has been established to review and ensure that ethical standards of research are met in most social work schools.

Many social work schools in China, especially those with a long history and international academic communications, are ahead in setting social work ethics as a mandatory MSW course. Nevertheless, instead of having a well-recognized textbook or recommended teaching plan for all instructors as a reference, the course content on social work ethics in different schools is highly dependent on the instructors’ interest, expertise, and experience. Instructors whose interests are practice oriented may not consider it necessary to teach social work research ethics. As a result, many Chinese MSW students do not understand the concept of social work research ethics, if they have even heard of the topic. In April 2022, the CASWE called for public comments on its new draft of Basic Requirements for MSW Degree Dissertations, in which research ethics had been added as a requirement. The article stated, ‘the report on the ethical practice of research in the dissertation follows the general norms of social science research’. However, this statement ignored the particularity and vulnerability of human subjects in social work research and did not specify these ‘general norms’, making them unclear to the social work audience.

Research aim

Based on this discussion, research ethics have yet to become an element of social work professional ethics in China. Although social work researchers often focus on the vulnerable population, there is a lack of awareness in academia that extra precautionary protection of human participants should be considered in social work research. In fact, no previous research has studied whether and how ethical principles of research have been applied in China to protect the rights of human subjects. Therefore, the present study attempted to explore the practical scope of social work research ethics in China through internationally published social work articles involving human subjects through a scoping review. The aim of this review was to serve as an evidence base for CASWE and other Chinese social work authorities to become aware of the topic and promote future changes in policy. Furthermore, this study calls on the international social work audience to reflect on the issue of research ethics in other countries.

To achieve this research aim, the present study narrowed the scoping review to one topic of social work research: studies involving human subjects conducted during the COVID-19 pandemic. Notably, since the COVID-19 outbreak, many Chinese social work researchers have published studies involving human subjects in an effort to fight the pandemic. However, human subjects involved in these studies can be suspectable to subtle harms brought by researchers under such extreme circumstances (Wang et al., 2022). Considering the lack of representation of research ethics in Chinese social work academia, it is unclear whether and how ethical standards are adopted in this social work research.

Therefore, the research question of this review was as follows: Based on the existing social work literature involving COVID-19 and human participants in China, what research ethics have been recognized and applied by social work researchers? Reviewed studies were empirical and would have required IRB approval in the Western research context.

Method

The scoping review method is considered valuable to evidence-based practice (Peters et al., 2015). It can clarify key concepts (de Chavez et al., 2005) and examine the types and scope of evidence (Decaria et al., 2012), which may help identify research gaps and research methods in the field (Callary et al., 2015). To understand the scope and application of social work research ethics in China, the present study conducted a scoping review of social work empirical studies involving human subjects, with a focus on those related to COVID-19 and published since the outbreak through July 2021. Specifically, the present study adopted the five stages of scoping review framework developed by Arksey and O’Malley (2005).

Stage 1: Identify the research question

This review explored the scope and application of social work research ethics in the existing literature involving human participants in China. The research question focused on how research ethics are recognized and applied by social work researchers in China while they conduct COVID-19-related empirical research involving human participants.

Stage 2: Identify relevant studies

Because Chinese social work journals do not ask authors to report ethical considerations in the research process, the literature search was limited to English research articles published in internationally recognized Western social work journals. Considering Scopus-indexed social work journals generally require authors to state their ethical considerations in the manuscript or include a statement on research ethics, they provide a valuable window to examine what and how ethical principles have been applied in current social work studies involving human subjects in China.

The search strategy contained two contingent steps. In the first step, the research team identified 57 top-ranked social work journals from the Scopus Index, listed on the Scimago Journal & Country Rank website under the category of social work.¹ In the second step, the research team conducted a thorough search of the official website of each journal, using a Python web crawler, for research articles published between 5 January 2020, when the World Health Organization (2020) issued its first Disease Outbreak News Report, and 15 July 2021. Specifically, the crawler fetched the title, abstract, and full text of articles that mentioned ‘COVID’ or ‘COVID-19’ in their title, abstract, keywords, or full text (if open access). Data fetched were automatically entered in an Excel file, in which rows were articles and columns featured data types (title, abstract, and link to full text). Because relevant studies were identified directly from journal websites instead of databases, which often contain overlapping articles, no duplicates were removed.

Stage 3: Select studies

To ensure only eligible studies were included in the review, identified articles went through three rounds of screening by three MSW-level research assistants (RAs). Discrepancies in screening results occurred during each round of screening, in which RAs held collaborative meetings to address discrepancies. Unresolved issues were reported to the lead author for consultation. Eventually, the RAs reached a consensus on the final included articles after rounds of screening and discussion.

In the first round of screening, each RA read the title column of the crawler-generated Excel file and excluded studies explicitly focused on other countries and systematic reviews. For example, one study titled ‘Child Maltreatment Reports and Child Protection Service Responses During COVID-19: Knowledge Exchange Among Australia, Brazil, Canada, Colombia, Germany, Israel, and South Africa’ (Katz et al., 2021) was removed.

In the second round, each RA read through the abstract column of the Excel file containing studies retained from the first round. Only studies conducted in China in response to the COVID-19 pandemic were kept.

In the third round, full-text articles were assessed for the following inclusion criteria: (a) written in English; (b) data collected in China or among people living in China; (c) empirical study conducted in response to the pandemic; and (d) involved human participants.

Stage 4: Chart the data

The lead author added new columns to the Excel file to form a template to chart data based on the research question. Then, RAs extracted key characteristics and ethical features from each study to collate them in the new columns, such as author(s)’ country of origin, time of publication, data collection methods, type of human participants, and ethical considerations. The research team also coded the full text of the included studies with ATLAS.ti 9 to triangulate the data charted in the Excel file and prepare to visualize the data with a Sankey diagram and colored tables in Stage 5.

Stage 5: Collate, summarize, and report the results

Data extracted from the data chart are presented in the ‘Results’ section to describe the characteristics of included studies, scope of ethical considerations, and application of ethical principles reported in included studies.

Results

In total, 1168 research articles were published in 50 of the 57 journals between 5 January 2020 and 15 July 2021. The seven excluded journals had not published any COVID-19-related study either during the appointed period or in English. As shown in the PRISMA flow diagram (Figure 1), the first round of screening (title) retained 481 studies for the second round of screening (abstract), which yielded 30 studies for the third round of screening (full text). Ultimately, 18 studies met all inclusion criteria and were retained for further review.

Figure 1.

PRISMA flow diagram of the stages of the search process.

Study characteristics

As summarized in Table 1, 11 of the 18 articles explored mental health in the context of COVID-19. For example, mental health status among people affected by COVID-19 was a popular research topic (e.g. Jiang, 2020; Jin et al., 2021). The other seven articles focused on COVID-19-affected populations but involved instrument development (n = 1; Feng et al., 2021), intervention development (n = 2; Liu et al., 2021; Xu et al., 2021), child education (n = 1; Dong et al., 2020), social work profession (n = 1; Du and Chan, 2021), social work policy (n = 1; Li et al., 2021), and technology-enhanced social work (n = 1; Wang et al., 2021).

Table 1.

Characteristics of included studies (N = 18) extracted from 50 social work journals (SCOPUS-indexed) on 15 July 2021.

No.	Authors	Field	PI’s origin	International collaboration	Aims	Target population	Design/data collected remotely	Sample size/sampling strategy	Scope of data collection
1	Guo et al. (2020)	Mental health	Mainland China	Yes – China, US, Netherlands, and UK	(1) To examine the impact of exposure to COVID-19 on levels of anxiety and post-traumatic stress symptomology (2) To examine the impact of pre-pandemic maltreatment experiences on mental health in adolescents.	Rural Chinese adolescents	Survey–quant/yes–online	6196/cluster sampling	10 schools of a county in Henan Province
2	Feng et al. (2021)	Instrument development	Hong Kong SAR	No	To establish a new COVID-19 Fear scale for Chinese students in higher education.	Chinese studying in universities of Mainland China, Hong Kong and overseas	Survey–quant/yes–online	219/convenience sampling	Worldwide
3	Hu et al. (2021)	Mental health	Mainland China	No	To explore the mediating role of daytime sleepiness on problematic smartphone use and PTSD symptoms.	Chinese adolescents	Survey–quant/yes–online	2090/convenience sampling	Two schools of two cities in Sichuan Province
4	Cheng et al. (2021)	Mental health	Mainland China	No	To examine the relationships between stressful events, depression, parental educational involvement & adolescents’ suicidal ideation during the COVID-19 pandemic.	Chinese adolescents and their parents	Survey–quant/yes–online	1595/convenience cluster sampling	A middle school in Southwest of China
5	Xue et al. (2021)	Mental health	Mainland China	Yes – China and the US	To investigate the knowledge, attitudes, and practices (KAP) toward COVID-19 among school-aged children in the epicenter.	Chinese school-aged children in Hubei Province	Survey–quant/yes–online	1650/convenience sampling	Two elementary schools of two cities in Hubei Province
6	Ye et al. (2020)	Mental health	Mainland China	Yes – China and the US	To explore (1) the mediating role of rumination; (2) the moderating role of psychological report in the relationship between COVID-19 stressors and stress consequences among college students.	Chinese college students	Survey–quant/yes–online	841/not stated	Not explicitly mentioned
7	Jiang (2020)	Mental health	Mainland China	No	To examine the knowledge, attitudes, and mental health status of university students during COVID-19.	Chinese university students	Survey–quant/yes–online	472/not stated	A university in China
8	Jin et al. (2021)	Mental health	Mainland China	Yes – China and Pakistan	(1) To examine symptoms of depression and anxiety during COVID-19; and (2) the associations between anxiety and problematic smartphone use, and the mediating role of resilience, perceived social support, and school belonging during COVID-19.	Chinese undergraduate students	Survey–quant/yes–online	847/stratified random cluster sampling	3 universities in Northeast China
9	Li et al. (2020)	Mental health	Hong Kong SAR	Yes – Mainland China and Hong Kong SAR	To examine (1) the comorbidity patterns of the symptoms for PTSD and GAD; (2) the role of perceived threat and stigma in distinguishing specific patterns of the symptoms among minors who were susceptible to COVID-19 in the epicenter of China.	Chinese children and adolescents (aged 8–18) susceptible to COVID-19 in Hubei Province	Survey–quant/yes–online	1172/convenience sampling through social media	Eligible respondents in Mainland China
10	Yang et al. (2020)	Mental health	Thailand	No	To explore the resilience and positive emotion regulation against trauma among Wuhan’s high-school students during the outbreak.	High-school students in Wuhan	Survey–quant/yes–online	286/purposive sampling	Four high-schools located in Wuhan City
11	Dong et al. (2020)	Child education	Australia	Yes – Australia and China	To explore (1) young children’s online learning experience and (2) parents’ beliefs and attitudes toward online learning.	Parents of children in early childhood education programs	Survey–mixed methods/yes– online	3257/not stated	An inland city of Henan Province
12	Zhang et al. (2021)	Mental health	Mainland China	No	To investigate the psychological stress among college students in COVID-19 hard-hit areas.	University students in or around Hubei Province	Survey–quant/yes–online	17935/not stated	In or around Hubei Province
13	Xu et al. (2021)	Intervention development	Mainland China	No	To explore the intervention effect of the combination of aerobic exercise and acceptance and commitment therapy on adolescents’ mental health during the outbreak of COVID-19.	Chinese adolescents	Experimental/yes –online	1018/not stated	Fujian Province
14	Du and Chan (2021)	Social work profession	Mainland China	Yes – Mainland China and Hong Kong SAR	To understand how COVID-19 impacts the professional identity of social workers in Wuhan and Hong Kong.	Social workers in Wuhan and Hong Kong who served at frontline during the pandemic	Semistructured interview–qual/yes –online and phone	15/not stated	Wuhan City and Hong Kong
15	Li et al. (2021)	Social work policy	Mainland China	No	To explore the impact of COVID-19 on migrant worker families’ frangibility and potentiality.	Chinese migrant worker families	Survey and interview–mixed methods/yes–online for partial data	46/randomly selected from sampling frame	23 provinces
16	Chen et al. (2021)	Mental health	Mainland China	No	To investigate the manifestations of cabin fever during COVID-19.	Chinese young people (aged 14–35)	Semistructured interview–qual/not stated	12/randomly recruited online then screened for eligibility	Not explicitly mentioned
17	Liu et al. (2021)	Intervention development	Mainland China	Yes – Mainland China and Hong Kong SAR	To explore the efficacy of SOCI application (a social work intervention) in Wuhan.	Adults who experienced extensive lockdown during the outbreak of COVID-19	Quasi-experimental/yes –online	150/convenience sampling	Hubei Province, mainly in Wuhan City
18	Wang et al. (2021)	Technology-enhanced social work	Mainland China	Yes – China and Australia	To investigate the use of mobile phones to access Internet plus social work among older people during the pandemic.	Chinese older people	Semistructured Interview–qual*/not stated	8/not stated	Jiaxing City, Zhejiang Province

^*The study used mixed methods. This table reports only the qualitative part, which involved data collection from human participants.

Sixteen articles had Chinese first authors, and two were led by foreign authors (one from Thailand and the other from Australia). Half of the articles (n = 9) involved international collaborations of scholars from mainland China and overseas. Only one article did not involve any coauthor affiliated with any institution in mainland China or Hong Kong (Yang et al., 2020).

Most articles adopted quantitative research methods (n = 11). For example, Zhang et al. (2021) investigated psychological stress among college students related to COVID-19 in and around Hubei Province through an online survey. Two articles (Liu et al., 2021; Xu et al., 2021) reported using quasi-experimental or experimental research designs. Other studies used qualitative (n = 3) or mixed (n = 2) research methods. Seven articles did not state their sampling strategy, including one quantitative study that mentioned neither the sampling strategy nor the spatial scope of data collection. Two articles did not state how data were collected, whereas 16 articles reported that data, at least partially, were collected online.

Most studies focused on a younger Chinese population (n = 13); these included eight articles involving minors (children and adolescents), five articles with university students, and one article involving a young Chinese population (aged 14–35). Two articles focused on two populations (social workers or migrant workers), and one article focused on Chinese older adults. As listed in Table 2, 12 articles reported findings on vulnerable participants who were confined to their home during data collection.

Table 2.

Ethical considerations reported by included studies.

No.	Authors	Home-confined sample included	Minors involved	Reported measures on respect for persons	Reported beneficence	Reported justice	Acting IRB approval	Name of acting IRB
1	Guo et al. (2020)	Yes	Yes	②	④	Not reported	Yes	Ethics Committee of Peking University Medical Center
2	Feng et al. (2021)	No	No	①②	⑤	Not reported	Yes	Human Subjects Ethics Committee of the Department of Social & Behavioral Sciences, City University of HK
3	Hu et al. (2021)	Yes	Yes	②⑥	Not reported	③	Yes	Ethics Committee of the Sichuan University and Sichuan Psychology Association
4	Cheng et al. (2021)	Yes	Yes	①②⑥	Not reported	③	Yes	Research Ethics Committee of Guizhou Normal University
5	Xue et al. (2021)	Yes	Yes	②⑥	Not reported	③	Yes	Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology
6	Ye et al. (2020)	Yes	No	①②⑥	④	Not reported	Yes	Research Ethics Committee of Jiangxi Normal University
7	Jiang (2020)	Yes	No	①②⑥	Not reported	Not reported	Not clearly stated	Not clearly stated
8	Jin et al. (2021)	Yes	No	②	④	not reported	Yes	Ethics Committee of Liaoning National Normal College
9	Li et al. (2020)	Yes	Yes	①②	Not reported	Not reported	Yes	Human Subjects Ethics Sub-committee of East China University of Science and Technology
10	Yang et al. (2020)	Yes	Yes	①②⑥	Not reported	Not reported	Yes	IRB at Suryadhep Teachers College of Rangsit University
11	Dong et al. (2020)	No	No	①②	Not reported	Not reported	Not stated	N/A
12	Zhang et al. (2021)	Yes	No	②	Not reported	Not reported	Yes	The ethical authority at the School of Educational Science, Huazhong Univ. of Science and Technology
13	Xu et al. (2021)	Unknown	Yes	①②⑥	⑤	③	Yes	The medical ethics branch of Fujian Medical Association
14	Du and Chan (2021)	No	No	Not reported	Not reported	Not reported	Not stated	N/A
15	Li et al. (2021)	Yes	No	Not reported	Not reported	Not reported	Not stated	N/A
16	Chen et al. (2021)	Unknown	Yes	Not reported	Not reported	Not reported	Not stated	N/A
17	Liu et al. (2021)	Yes	No	②	⑤	Not reported	Yes	Human Research Ethics Committee of the University of Hong Kong
18	Wang et al. (2021)	No	No	Not reported	Not reported	Not reported	Yes	Human Research Ethics Committee at the School of Government, Sun Yat-Sen University.

① Fully voluntary, for example, participants were not directed by persons in power to participate (such as students were instructed by teachers).

② Informed consent acquired from the sample.

③ Additional protection to subjects with diminished or limited autonomy, for example, guardian’s consent acquired for minor subjects.

④ Incentives policy mentioned.

⑤ Risks to human subjects were minimized, for example, people diagnosed with COVID-19 were intentionally excluded.

⑥ Data safety and privacy, for example, release policy, storage, confidentiality.

Ethical standards

Among various ethical considerations regarding human participants, the three fundamental principles established in the Belmont Report were adopted for analysis.

Respect for persons: Informed consent, voluntary participation, data safety, and privacy

The principle of respect for persons was interpreted in three aspects: informed consent, voluntary participation, and data safety and privacy. In all, 14 articles reported at least one aspect of respect for persons; all 14 reported on informed consent. In addition, participants in eight articles participated voluntarily; that is, they were not directed by persons in power (e.g. teacher) to participate. Seven articles reported taking measures to ensure data safety and privacy, such as upholding a data-release policy or making the survey anonymous (Xu et al., 2021).

Beneficence: Benefits and risks

The principle of beneficence examines the benefits and risks of research. Among the 18 articles, 3 mentioned the benefit of incentives for participants. For example, Jin et al. (2021) provided small gifts to study participants who won an online lottery. Three articles reported taking measures to minimize the risk of participation. For example, to avoid unintended psychological harm to a vulnerable population, Feng et al. (2021) cautiously excluded vulnerable adolescents from their study – namely, those who had psychiatric problems, tested positive for COVID-19, or had family members with COVID-19.

Justice: Additional protection of participants with diminished or limited autonomy

The principle of justice is operationalized as the additional protection of participants with diminished or limited autonomy. Among eight articles involving minors, four mentioned additional protection. For instance, Hu et al. (2021) acquired both parents’ and children’s informed consent before distributing a questionnaire to explore the mediating role of daytime sleepiness on problematic smartphone use and post-traumatic stress disorder (PTSD) symptoms among adolescents.

Results by visualization

After synchronizing codes with the Excel file, the research team used ATLAS.ti 9 to generate a table (Table 3) and Sankey diagram (Figure 2) to visualize the scope and depth of application of ethical standards in the identified studies.

Table 3.

Code-document table: Binarized results.

No	Authors	Respect for persons Gr = 36; GS = 3	Beneficence Gr = 6; GS = 2	Justice Gr = 4; GS = 1	Review and approval Gr = 13; GS = 1
1	Guo et al. (2020) Gr = 16	•	•		•
2	Feng et al. (2021) Gr = 14	•	•		•
3	Hu et al. (2021) Gr = 14	•		•	•
4	Cheng et al. (2021) Gr = 15	•		•	•
5	Xue et al. (2021) Gr = 14	•		•	•
6	Ye et al. (2020) Gr = 16	•	•		•
7	Jiang (2020) Gr = 13	•
8	Jin et al. (2021) Gr = 14	•	•		•
9	Li et al. (2020) Gr = 14	•			•
10	Yang et al. (2020) Gr = 15	•			•
11	Dong et al. (2020) Gr = 13	•
12	Zhang et al. (2021) Gr = 11	•			•
13	Xu et al. (2021) Gr = 18	•	•	•	•
14	Du and Chan (2021) Gr = 10
15	Li et al. (2021) Gr = 10
16	Chen et al. (2021) Gr = 9
17	Liu et al. (2021) Gr = 14	•	•		•
18	Wang et al. (2021) Gr = 10				•
Total		14	6	4	13

Note. Binarized results display the pattern of coding (present or not) rather than the actual number of codings. Gs represents the number of subgroups within the coding group and is consistent with Table 2. For example, the coding group of respect for persons contains three subgroups, namely fully voluntary (①), informed consent (②), and data safety and privacy (⑥). Gr represents the number of coded quotations.

Figure 2.

Sankey diagram: features of included studies versus ethical consideration.

Review and approval

Of the 18 identified articles, 13 clearly stated that the studies were reviewed and approved by acting IRBs. As shown in Tables 1 and 2, and Figure 2, 9 of these articles involved research of mental health topics, 10 articles involved minor participants, seven articles referenced collaborations across regions, and 10 articles had a first author affiliated with an institution in mainland China. In other words, although many social work schools in China have yet to establish an authorized and standard process to review and approve social work studies, the authors of these 13 articles found an appropriate committee to act as an IRB. For example, one article reported being approved by the Research Ethics Committee of Jiangxi Normal University (Ye et al., 2020).

These 13 articles can be categorized into three types: approved by the ethics committee of an institution of higher education (n = 10); approved by the ethics committee of a medical center or association (n = 2), such as the medical ethics branch of Fujian Medical Association (Xu et al., 2021); or approved jointly by a university and professional association (n = 1; Hu et al., 2021). Among the five articles that did not report review by an acting IRB, most adopted interview methods for data collection (n = 3). Four articles involved adults, and one article involved minors (Chen et al., 2021). Four articles had first authors affiliated with an institution in mainland China and did not collaborate with any other foreign scholars.

Ethical standards

As shown in Figure 2 and Table 3, among the three fundamental principles, ethical considerations related to respect to persons were reported most frequently. It is notable that of the 12 articles involving minor participants, only three reported extra protective measures (e.g. acquiring consent from parents). Furthermore, although the article that reported using an experimental design (Xu et al., 2021) also reported on all three ethical research principles, the four articles that collected data through interviews did not report on ethical considerations at all, regardless of the age or vulnerability of study participants.

Discussion

This scoping review found that Chinese social work scholars already account for research ethics when conducting and publishing human subjects research, although the scope of research ethics has yet to be formally defined and required in Chinese social work. Specifically, the application of research ethics primarily emphasized ethical standards derived from the principles of respect for persons, such as informed consent, voluntary participation, and data safety and privacy, whereas less reported were ethical considerations regarding the principles of justice (additional protection for participants with diminished or limited autonomy) and beneficence (risks to human subjects, incentives policy). For instance, although the identified studies were implemented during the COVID-19 pandemic, almost none of them analyzed the potential psychological harm of their instruments. Thus, readers have no way of knowing whether or how the authors tried to prevent or minimize potential harm to human participants during their study design and data collection process.

Recognition and education regarding social work research ethics

The variation in the application or reporting of research ethics among these 18 studies may be partially attributable to the lack of recognition, education, and mechanisms for ethics in the profession. For instance, of the five articles that did not report IRB approval, four were conducted by institutions in mainland China and whose authors may not be able to find an authorized committee to properly review and formally approve their research. Therefore, it is important for social work academia in China to emphasize the importance of research ethics and establish national standards or mechanisms to examine the research ethics of social work studies involving human subjects. For example, the Ethics Committee of CASWE could establish a task force to develop ethical guidelines for research in the social work profession. Meanwhile, CASWE should require that the curricula of all social work bachelor’s and master’s programs cover research ethics and develop a Chinese version of the Collaborative Institutional Training Initiative’s courses to help students and faculty members better understand the significance and requirements of research ethics, laying the groundwork for each social work institution to develop an internal mechanism to review and monitor research projects involving human subjects systematically. In addition, Chinese social work journals can add a requirement to report the protection of human subjects in their author guidelines to give researchers an impetus to consider and value research ethics throughout their research.

By contrast, the debate on the conflict between research ethics and new scientific discoveries has long existed. For social work students, conforming to research ethics throughout their dissertation research will inevitably and significantly limit their choice of dissertation topic and research methods. For example, many MSW students in China are prone to investigate a social work intervention in their dissertation, such as evaluating the effectiveness of a focus group or documenting the experiences of individuals they served in a field placement. However, most of them enter social work graduate school directly from college and have very few, if any, working experiences in the field. In other words, it is unlikely most graduating MSW students could confidently say that their intervention or data collection process caused no harm to human participants. Therefore, if they strictly conform to research ethics, these students would not be allowed to conduct such interventions as their dissertation research. To prevent research ethics from functioning as a limitation on dissertations and weakening the practice-centered nature of MSW education, proper flexibility should be established by the CASWE to achieve a balance between research ethics and novel scientific discovery.

New challenges of research ethics in the digital period

According to Reamer (2014, 2018), the digital period in which we are living is one of the five evolutionary stages of social work ethics history. In this period, both social work practice and research are making extensive use of technology, especially during the COVID-19 pandemic and when social-distancing restrictions were imposed. Based on the scoping review, at least 16 of the 18 identified studies were done remotely, most of which used WeChat (a Chinese mobile app) or Survey Star (comparable to Survey Monkey) to collect data. However, the risks of online data collection to human participants were overlooked. For example, hypothetically, a participant could receive a survey link from Survey Star through WeChat. If they pressed the link and authorized WeChat to redirect them to the survey, Survey Star would retrieve their IP address and WeChat account name, automatically extracting and compiling these data. Is this not an intrusion on the participant’s privacy? If not, then under what conditions would this be an intrusion? What if the dataset was leaked? To address these questions, more discussion is required on new challenges to online research data safety, especially for data collected online through mobile apps. Further, the use of technology arguably has enabled more protection of privacy because research is not conducted face to face, but it might also endanger the implementation of the principles of justice – for example, it favors the recruitment of certain groups of people with more access to technology.

Cultural elements shaping social work research ethics in China

Although the research team advocates for the standardization and institutionalization of research ethics in social work academia in China, culturally competent practice is critical to protect Chinese research participants better when localizing ethical principles. For example, based on this scoping review, half of the studies involving minor participants did not report acquiring guardians’ consent for the minors’ participation in the study. However, because social workers tend to draw support from teachers to sample children or interview students, the ethical requirement of acquiring parents’ consent for minors’ participation would risk falling into formalism due to the power of Chinese guanxi. Guanxi is a concept that translates roughly as ‘relationship’ and profoundly influences the ethical climate (Lin, 2011). Culturally, teachers have established not only respect but also deep trust from parents; as the proverb says: ‘a teacher for one day, a father for life’ (日为师终身为父). According to Luhmann’s (2018) theory of trust, Chinese parents may be willing to offer a favor to teachers even if it would bring no benefit, if not a cost, to them. Therefore, it is not surprising that most guardians would sign their names on a consent form to allow their children to participate in research without a second thought, as long as the form was distributed by teachers and brought home from school. Furthermore, the teacher bears the de facto role of researcher, and the pecking order in such a setting places the teacher in a controlling position over the students (Laenui, 2013), calling into question the voluntary nature of participation among students.

A more practical way to protect minor participants in research would be for social work researchers to obtain governance approval from the school or local education authorities, who are authorized to constrain teachers’ behavior, before collaborating with teachers to conduct research. Operationally, for sound assessment of research ethics, governing authorities should require both social work researchers and teachers in the field to demonstrate their capacity to sufficiently protect minor participants, such as providing a certification of prior training in research ethics. However, governance approvals have been shown to cause delays in the timely commencement of research projects (White et al., 2016) and considering the Chinese cultural context, may disproportionately affect early career and foreign researchers with fewer local connections. Therefore, cooperation between the CASWE and educational authorities is needed to establish a structured and fair mechanism of governance approval.

Limitations

The present scoping review bears certain limitations due to the searching and screening criteria. Chinese authors who could publish in world-class journals tend to be better educated about research ethics or comprehend basic ethical principles by reading the guidelines for authors on journal websites. On the other hand, most Chinese social work researchers, especially frontline social workers with limited opportunities to learn about research methods and ethics, may have a relatively shallower and more ambiguous interpretation and application of research ethics concepts, making the results of this review biased in a more optimistic direction.

Conclusion

This scoping review revealed the insufficient practical application of research ethics reported in social work literature regarding COVID-19 and involving human participants in China. Because similar problems pertaining to social work research ethics may exist in other countries, the present study indicates that although there is a substantial need to promote awareness of research ethics, educate social work students to internalize principles of research ethics, and extend the scope of research ethics to address new challenges in the digital world, researchers should conduct culturally competent practice in applying and localizing ethical considerations to truly protect vulnerable research participants in social work.

Author biographies

Yixuan Wang is an Assistant Professor in the Department of Social Work at China Youth University of Political Studies.

Shiyou Wu is an Assistant Professor in the School of Social Work at Arizona State University.

Longtao He is an Associate Professor in the Research Institute of Social Development at Southwestern University of Finance and Economics in Chengdu, China.

Linjing Li is a Graduate Research Assistant at China Youth University of Political Studies.

Zijiao Wang is a Graduate Research Assistant at China Youth University of Political Studies.