Relating rightly: Toward a relational-ethical framework for peer support service through an ethnographic study in...

Peer workers have become increasingly incorporated into addiction services worldwide, yet mainstream frameworks continue to approach their work in terms of individual roles, clinical outcomes, or organizational barriers and facilitators to implementation. These approaches often overlook the relational and ethical dimensions through which peer support is practiced and experienced, particularly under conditions of stigma, social exclusion, and structural constraint. This study draws on 18 months of ethnographic fieldwork (February 2021-July 2022) in a nonpeer-led nonprofit organization in eastern urban China. Data include participant observation, organizational documents, and in-depth interviews with peer workers and staff. Analysis followed an abductive, interpretive approach informed by anthropological theories of relationality and ordinary ethics. Participants described peer involvement not as a set of individual roles but as ongoing processes of relational restoration and moral navigation. Becoming and remaining a "peer" entailed rebuilding trust with family, sustaining mutual obligations among peers, demonstrating loyalty toward the organization, and negotiating stigma and surveillance in everyday life. While these commitments enabled solidarity and opened limited spaces for agency, they also translated tensions rooted in systemic inequalities into moral evaluations of relationships. In this process, the organization itself became incorporated into participants' relational worlds as a moral partner, while the peer leader worked to mediate competing moral expectations between peers and the institution. This relational-ethical framework complements existing peer scholarship by foregrounding how care, personhood, and accountability are negotiated in everyday practice, offering insights relevant to contexts where peer services are expanding and becoming institutionalized within addiction service systems.