Placing ethics in the centre: Negotiating new spaces for ethical research in conflict situations

Abstract

Issues of power and consent, confidentiality, trust, and benefit, risks to researchers, and potential harm to participants, are all contested when working with different cultures and within environments marked by violence and insecurity. Difficulty resolving these dilemmas may paralyse ethics committees, may fail to give the guidance sought by researchers, and will not help populations who are among the world's most vulnerable. Even where efforts are made to respond to ethical guidelines and to improve practice, considerable impediments are present in many developing countries, including lack of formal ethical review structures in unstable settings, lack of required skills, limited political and institutional recognition of ethical issues, competing interests, and limitations in clinical and research practice (Elsayed 2004, Macklin 2004). In conflict settings, these limitations are more marked, and the responsibilities of the researcher for ethical practice are greater, but the mechanisms for oversight are weaker. Moreover, the constant focus on vulnerabilities and problems, and the often almost total lack of recognition of strengths and resilience, can further disempower already exploited groups and individuals. The capacity of refugees and communities in conflict to take an active role in the research process is seldom acknowledged, and undermines the potential for more innovative research which can help generate the evidence for better policy and practice.

Research Ethics Review in Humanitarian Contexts: The Experience of the Independent Ethics Review Board of Médecins Sans Frontières

“…Research to devise and test new interventions will remain an important part of MSF's agenda, and will most probably increase. As this happens, a major concern will be to ensure that communities in which such research takes place are empowered to become true partners and that vulnerable individuals and groups are effectively protected [29]. The ethical oversight provided by the MSF ERB will be crucial in addressing these challenges.…”

Health systems research in fragile and conflict affected states: a qualitative study of associated challenges

“…What is novel to one context, however, might not be novel to another. Therefore, the authors suggest that an effective question with which to start is ‘What ideas and methods effectively used to facilitate HSR in non-fragile contexts might be transferable to fragile ones?’ Zwi et al [18] suggest that more active participation of refugees and communities in the research process in conflict situations could be promoted.…”

Familiar ethical issues amplified: how members of research ethics committees describe ethical distinctions between disaster and non-disaster research

“…According to Zwi et al “the constant focus on vulnerabilities and problems, and the often almost total lack of recognition of strengths and resilience, can further disempower already exploited groups and individuals. The capacity of refugees and communities in conflict to take an active role in the research process is seldom acknowledged, and undermines the potential for more innovative research which can help generate the evidence for better policy and practice.” [30] The interviewees in this study did not discuss resilience although the concept can also be applied to populations that have experienced a natural disaster. Alongside consideration of vulnerability, the ethics review process may present opportunities for careful consideration of the strengths and resilience of communities who have experienced a disaster and suggest opportunities to engage further with communities and local researchers.…”