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‘Refrain from unethical research’
View(s):By Kumudini Hettiarachchi
Studies should be by competent people & vulnerable survivors should not be exploited – Dr. Athula Sumathipala
A cautionary note about how to conduct research in times such as these, comes from Senior Consultant Psychiatrist Dr. Athula Sumathipala.
“Research has its due place and no one is saying that research should not be done. But if a research is possible in a non-disaster situation, such research should not be done after disasters,” says Dr. Sumathipala who is Director of the Institute for Research & Development and coordinated the psychosocial section of the Centre for National Operations following the tsunami in Sri Lanka.
He is Professor of Psychiatry, Research Institute for Primary Care & Health Sciences, Keele University and Emeritus Professor of Global Mental Health, King’s College London, United Kingdom.
Dr. Sumathipala underscores that all research should be of high scientific rigour, with high ethical standards and such studies should be conducted by competent people with knowledge of the local setting, respecting local needs.
Here are some pointers from a publication by Dr. Sumathipala and colleagues titled, ‘Ethical issues in post-disaster clinical interventions and research: A Developing World Perspective’:
- Disasters cause destruction, death, disease/disorders, displacement, disappearance and disarray, all of which have implications for mental health, public health, ethical/human rights and social policies.
- Disaster response should be integrated, appropriate and evidence-based. Therefore, it may be unethical not to conduct research in such situations, since ethical research that takes into account the needs and priorities of affected communities can contribute to mitigating the effects of future disasters. However, the research may be a gross additional burden on people, who are already traumatised.
- Therefore, research planned to be conducted after a disaster should be essential and not possible in non-disaster situations.
- Research needs to be contextual and culturally and regionally appropriate. However, exploitation and abuse of vulnerable survivors should be prevented.
- The objectives of all potential research in disasters should be weighed very carefully for their potential contribution to the survivors and for their value in future disaster situations.
- All phases of the research must be culturally sensitive and should involve those familiar with the community’s situation and their cultural beliefs and practices.
- In addition to the accepted national and international guidelines for conduct of research, particular attention should be paid to enhanced ethical standards when conducting research in disaster-affected situations. These include the potential for harm resulting from the research process and potential for exploitation of research participants and the affected community
- More stringent policies and guidelines have to be followed to prevent unethical data collection and exploitation of the disaster survivors, giving due attention to issues such as: (i) what types of research; (ii) how soon; (iii) if based on local needs and priorities; and (iv) complexities when combined with aid and clinical care
- While general ethical issues on research are still very applicable, the following issues become more crucial given the specific characteristics of populations affected by disasters and complex emergencies:
(i) Scientific rigour and professional competence of the research team for their specific tasks; the highest standards of scientific research and peer review should apply.
(ii) Quality and adequacy of the ethical review process especially in relation to the expedition of ethical review, obtaining ethical permission from the host country, the potential for collusion by local ethics committees due to conflicts of interest and the lack of governance to deal with these issues.
(iii) Risks acceptable under ordinary circumstances may not necessarily be acceptable in disaster situations.
- Dissemination of results – much disaster research is published in local journals easily accessible within the country where the research was conducted and should be shared with the public too.
- Since disaster-affected populations are particularly vulnerable, it must be ensured that the conduct of research imposes absolutely minimal risk.
- Risks that are acceptable under ordinary circumstances may not necessarily be acceptable in disaster situations.