Staff members are human subjects, too

Top management, clinical supervisors, secretaries, government administrators, counselors, and patients are all examples of informants and agents used by health services researchers as they strive to learn how organizational and managerial factors affect the effectiveness, efficiency, quality, and the cost of substance abuse treatment and prevention services. Patients are clearly a vulnerable population, and researchers in clinical settings, as a rule, strive to protect patient safety and rights to privacy. However, as researchers begin to expand the scope of their study to the organizational contexts in which services are delivered, those responsible for providing services (staff members) are frequently enlisted to serve both as informants on policies and practices, and as participants acting as agents of the researchers in innovating therapeutic and business practices. Researchers need to be mindful that staff members, when acting as informants or as agents, are human subjects, too; and, as such, research procedures should be designed in a manner that minimizes their risk and conforms to sound ethical guidelines. In the interest of stimulating dialogue on ways to protect staff members from unintended harm, this essay overviews human subjects protection policy, describes examples of risks, and offers suggestions for preventing harm when designing studies.