Advertisement

Journal of Academic Ethics

, Volume 7, Issue 1–2, pp 115–123 | Cite as

Health Research in Complex Emergencies: A Humanitarian Imperative

  • John D. Pringle
  • Donald C. Cole
Article

Abstract

Health researchers, research trainees, and ethics reviewers should be prepared for the special application of research ethics within complex humanitarian emergencies. This paper argues that as a precursor to published ethical guidelines for conducting research in complex emergencies, researchers and research ethics committees should observe the following primary ethical considerations: (1) the research is not at the expense of humanitarian action; (2) the research is justified in that it is needs-driven and relevant to the affected populations; and (3) the research does not compromise the humanitarian principles of neutrality, impartiality and independence. These primary considerations are in harmony with the humanitarian goals of saving lives, alleviating suffering, and témoignage. Furthermore, there is an important role for research in supporting humanitarian action, and the extreme vulnerability of research participants in complex emergencies demands intense research ethics scrutiny. It is important to discern which ethical considerations are essential, and which are merely desirable, as excessive research ethics requirements may impede life-saving research.

Keywords

Complex emergencies Displaced populations Humanitarian aid Humanitarian principles Nongovernmental organizations Refugee health Research ethics War 

Notes

Acknowledgements

Thanks to Dr Richard Bedell and Dr Ross Upshur for their expertise and input, and to the University of Toronto Open Scholarship for financial support.

References

  1. Banatvala, N., & Zwi, A. (2000). Public health and humanitarian interventions: developing the evidence base. British Medical Journal, 321(7253), 101.CrossRefGoogle Scholar
  2. BBC News. (2003). Polio in Nigeria threatens region. Retrieved 9/29/2009, 2009, from http://news.bbc.co.uk/2/hi/africa/3216329.stm.
  3. Black, R. (2003). Ethical codes in humanitarian emergencies: from practice to research? Disasters, 27(2), 95–108.CrossRefGoogle Scholar
  4. Brown, V., Guerin, P. J., Legros, D., Paquet, C., Pecoul, B., & Moren, A. (2008). Research in complex humanitarian emergencies: the Médecins Sans Frontières/Epicentre experience. PLoS Medicine / Public Library of Science, 5(4), e89.Google Scholar
  5. Burkle, F. M., Jr. (2006). Complex humanitarian emergencies: a review of epidemiological and response models. Journal of Postgraduate Medicine, 52(2).Google Scholar
  6. Canadian Institutes of Health Research, Natural Sciences and Engineering Research Council of Canada & Social Sciences and Humanities Research Council of Canada. (1998). Tri-council policy statement: Ethical conduct for research involving humans. 1998 (with 2000, 2002 and 2005 amendments). http://pre.ethics.gc.ca/eng/policy-politique/tcps-eptc/.
  7. Checkland, P., & Holwell, S. (1998). Action research: its nature and validity. Systemic Practice and Action Research, 11(1), 9.CrossRefGoogle Scholar
  8. de Torrente, N. (2004). Humanitarian action under attack: reflections on the Iraq war. Harvard Human Rights Journal, 17. Google Scholar
  9. Donini, A. (2005). Humanitarian agenda of the 00 s Retrieved from http://www.isodarco.it/courses/andalo05/paper/andalo05-donini.pdf.
  10. Goodhand, J. (2000). Research in conflict zones: ethics and accountability. Forced Migration Review, 8, 15–18.Google Scholar
  11. Harroff-Tavel, M. (1989). Neutrality and impartiality: the importance of these principles for the International Red Cross and Red Crescent movement and the difficulties involved in applying them. International Review of the Red Cross, 273, 536–552.CrossRefGoogle Scholar
  12. ICRC. (1996). The fundamental principles of the Red Cross and Red Crescent. Geneva: ICRC.Google Scholar
  13. Internal Displacement Monitoring Centre. (2009). Global statistics: IDP country figures. Retrieved 2/20/2009, 2009, from http://www.internal-displacement.org/8025708F004CE90B/(httpPages)/22FB1D4E2B196DAA802570BB005E787C?OpenDocument&count=1000.
  14. International Organization for Migration. (2002). Emergency operations manual IOM. Retrieved from http://www.unjlc.org/tools/FOM/supporting_docs/FOM_PUB_6_6_10_IOM_Emergency_Operations_Manual_EOM.pdf.
  15. Jacobsen, K., & Landau, L. B. (2003). The dual imperative in refugee research: some methodological and ethical considerations in social science research on forced migration. Disasters, 27(3), 185–206.CrossRefGoogle Scholar
  16. Junod, M. (1951). Warrior without weapons [Le Troisieme Combattant]. London: Jonathan Cape.Google Scholar
  17. Leaning, J. (2001). Ethics of research in refugee populations. Lancet, 357(9266), 1432–1433. doi: 10.1016/S0140-6736(00)04572-4.CrossRefGoogle Scholar
  18. McFate, M. (2005). The military utility of understanding adversary culture. Joint Force Quarterly, (38), 42.Google Scholar
  19. McMaster University. (2009). Centre for peace studies. Retrieved 8/2/2009, 2009, from http://www.humanities.mcmaster.ca/~peace/.
  20. Mfutso-Bengo, J., Masiye, F., & Muula, A. (2008). Ethical challenges in conducting research in humanitarian crisis situations. Malawi Medical Journal, 20(2), 46–49.Google Scholar
  21. MSF. (1997). Refugee health: An approach to emergency situations. London: MacMillan Education Ltd.Google Scholar
  22. MSF. (1999). Nobel lecture: Nobel peace prize, médecins sans frontières Retrieved from http://nobelprize.org/nobel_prizes/peace/laureates/1999/msf-lecture.html.
  23. MSF. (2004). MSF-USA: Press release 07/28/2004. Retrieved 3/2/2008, 2008, from http://www.doctorswithoutborders.org/pr/2004/07-28-2004.cfm.
  24. MSF. (2006). Advocacy and témoignage. Retrieved 06/24, 2009, from http://www.msf.org.uk/advocacy.aspx.
  25. MSF. (2008). Press release: "top ten" humanitarian crises reveal growing insecurity, neglected health needs. Retrieved 2/28/2009, 2009, from http://www.msf.ca/features/2008_top10/pressrelease.html.
  26. MSF. (2009). Condition critical: Voices from the war in eastern Congo. Retrieved 8/2/2009, 2009, from http://www.condition-critical.org/.
  27. OCHA. (2009). United Nations Office for the Coordination of Humanitarian Affairs. Retrieved 2/28/2009http://ochaonline.un.org/.
  28. Pictet, J. (1979). The fundamental principles of the Red Cross proclaimed by the Twentieth International Conference of the Red Cross, Vienna, 1965: Commentary. Geneva: Henry Dunant Institute.Google Scholar
  29. Eds, P Los Medicine. (2009). Ethics without borders. PLoS Medicine, 6(7), e1000119.CrossRefGoogle Scholar
  30. Pringle, J. D. (2008). The military invasion of humanitarian space. Juxtaposition Global Health Magazine, 2(2), 22–25.Google Scholar
  31. Salama, P., Spiegel, P., Talley, L., & Waldman, R. (2004). Lessons learned from complex emergencies over past decade. Lancet, 364(9447), 1801–1813.CrossRefGoogle Scholar
  32. Schopper, D., Upshur, R. E., Matthys, F., Singh, J. A., Bandewar, S. S., Ahmad, A., et al. (2009). Research ethics review in humanitarian contexts: the experience of the independent ethics review board of Médecins Sans Frontières. PLoS Medicine, 6(7), e1000115.CrossRefGoogle Scholar
  33. Schull, M. J., & Shanks, L. (2001). Complex emergencies: expected and unexpected consequences. Prehospital and Disaster Medicine, 16(4), 192–196.Google Scholar
  34. Sletto, B. (1999). Research for the people. Perspectives in Health, 4(1), 27.Google Scholar
  35. Sphere Project. (2004). Humanitarian charter and minimum standards in disaster response: (2004th ed.). Geneva: The Sphere Project.Google Scholar
  36. Spiegel, P., Sheik, M., Gotway-Crawford, C., & Salama, P. (2002). Health programmes and policies associated with decreased mortality in displaced people in postemergency phase camps: a retrospective study. Lancet, 360(9349), 1927–1934.CrossRefGoogle Scholar
  37. Tanguy, J., & Terry, F. (1999). MSF—on neutrality and impartiality. Retrieved 06/19, 2009, from http://www.doctorswithoutborders-usa.org/publications/article_print.cfm?id = 1393.
  38. UNHCR. (2008). 2007 global trends: Refugees, asylum-seekers, returnees, internally displaced and stateless persons. UNHCR. Retrieved from http://www.unhcr.org/statistics/STATISTICS/4852366f2.pdf.
  39. UNHCR. (2009). UN refugee chief cites pressing needs as those uprooted tops 42 million. Retrieved 6/17/2009, 2009, from http://www.unhcr.org/4a37c9076.html.
  40. UNICEF. (2003). A principled approach to humanitarian action: 4.2 UNICEF’s humanitarian principles. Google Scholar
  41. University of Toronto. (2009). Dalla Lana School of Public Health, Centre for International Health. Retrieved 8/2/2009, 2009, from http://intlhealth.med.utoronto.ca/.
  42. WHO. (2008). The global burden of disease 2004 update. WHO Library Cataloguing-in-Publication Data.Google Scholar
  43. York University. (2009). Centre for refugee studies. Retrieved 8/2/2009, 2009, from http://www.yorku.ca/crs/.
  44. Zwi, A. B., Grove, N. J., MacKenzie, C., Pittaway, E., Zion, D., Silove, D., et al. (2006). Placing ethics in the centre: negotiating new spaces for ethical research in conflict situations. Global Public Health, 1(3), 264–277. doi: 10.1080/17441690600673866.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2009

Authors and Affiliations

  1. 1.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada

Personalised recommendations