Objective: To define ethical issues in intercultural research as uncovered in a study of barriers to equitable access to health/mental health services.
Design: Re-analysis of the process and outcome of the Ethnoracial Seniors project (ERSP), a participatory action research(PAR) study in two communities conducted by an intercultural Research Team (IRT)and guided by a Community Work Group(CWG).
Materials and Methods: The principal researchers have reappraised the ethical implications of community-based ethnocultural studies in light of the methodology with its integrated approach to involving the communities at each step of the project.
Key Informants were identified by snowball technique and focus group participants and Consensus conference delgates, including policy-makers, were selected by sampling frame. The CWG participated in development of the research method including the series of community forums where findings were presented popular drama format followed by small group discussion. Enquiry and discussion throughout the study was informed by grounded theory.
An Implementation Task Group (ITG) of representatives designated by health and social service agencies supported the establishment of pilot health/mental health and wellness programs, thus implementing findings that emerged from the data.
Results: Ethical issues confront researchers and communities alike, with the consideration of why and by whom research should be undertaken, to whom do the data belong, and who should implement the findings. When researchers are part of a mainstream institution, there is a differential power-base in comparison with members of the community.
The outcome of this study illustrates the strengths and pitfalls of this type of research. Scrutiny of the underlying ethical principles of justice and paternalism is necessary in the conceptualisation of studies. Similarly,the principle of autonomy requires appropriate attention in decision-making processes, as do beneficence and non-maleficence in the dissemination of knowledge and the implementation of findings.
Conclusion: Ethnoracial elders and their families participate in research in the expectation that "something good will come out of it." The expectation of improvement of services as a consequence of their participation was the reason for the choice of methodology, selection of Participatory Action Research. In PAR, ongoing implementation of strategies for change can be expected, which are informed by data.
The onus is on researchers to provide meaningful reasons for undertaking the research and to be committed to sustainable change. Research can lead to appropriate, accessible and acceptable programs and services only if underlying ethical values are explicitly understood and acknowledged in the "text," the proposal, and if administrative structures and partnerships sustain the "context" of the work through continuing communication with the communities.
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