Background
Methods
Search strategy
Inclusion criteria
Analysis
Results
Ethical principle | Themes | Sub-themes | Source reference papers |
---|---|---|---|
Scientific research design | Selection of research question | Necessity | |
Researcher inherent biases | |||
Risk/benefit evaluation | Emergency = heightened risk | ||
Benefits relative to burdens | |||
Appropriate methodology | Lack of methodological rigor | ||
Methodological transparency | |||
Methods implemented well | |||
Critical reflection | Continuous reflexivity | ||
Collective learning | |||
Participation | Meaningful opportunity for contributing to research design and conduct | Shared understanding | |
Partnership model | |||
Advising on management of ethical issues | |||
Fair selection of participants | Selection according to research objectives | [36] | |
Risks of targeted selection | [21] | ||
Informed by local knowledge | |||
Informed consent: | Informed consent as an accepted ethical norm | ||
As a contested concept | |||
As (flexible) process | |||
Procedural considerations | |||
i. Information provided | Consent as “informed” | ||
Information provided | |||
ii. Comprehension of information | Strength of information exchange process | ||
Barriers to comprehension | |||
Strategies to verify comprehension | |||
iii. Voluntariness | Factors influencing | ||
Potential coercion due to emergency context | |||
Autonomy and capacity | Normative connections | ||
Decision-making capacity debate | |||
Limiting potential exploitation | |||
Procedural considerations | |||
Confidentiality and anonymity | Increased importance of in emergencies | ||
Limits in emergencies | |||
Harms if breached | |||
Duty to safeguard | |||
Management of data | |||
Safety | Participant vulnerability i. Protection needs | Protection framework | |
Vulnerability: contested concept | |||
Individual situational approach | |||
Serious mental disorders | |||
Potential for exploitation | |||
Accountability i. Fair selection and specialist training of research and auxiliary staff | Adequate preparation | ||
Answerable to stakeholders | |||
Transparent staff selection | |||
Specialist training | |||
Tensions in collaborative partnerships | [22] | ||
Researcher self-care | Protecting against negative reactions to emergency context and/or research topic | ||
Self- and team-care strategies | |||
Environmental, political and health safety | Working “in-extremis” | ||
Procedures to respond | |||
Neutrality | Access and exit strategies i. Gatekeepers and power | Coordinating with existing systems | |
Power & knowledge asymmetries | |||
Gatekeepers: benefits and critique of | |||
Transparency towards power | |||
Coordination with other researchers and organisations | Mutual respect /trust | ||
International collaborations and power | |||
Networked with emergency response | |||
Risk of poor coordination | |||
Declaration of researcher interests | Transparency about | ||
Funding | Power of | ||
Impact of emergency upon budget / funding | |||
Advocacy to funders | |||
Purpose and benefit | Sustainable benefit | Levels of benefits | |
Haphazard process of accruing | |||
Long-term collaborations & sustainable benefit | |||
Dissemination | Right to results | ||
Potential risks in | |||
Forms of | |||
Of data collection tools and methods | |||
Ethical review | As accepted norm | ||
Responsibilities of reviewers | |||
Lack of specificity to emergencies |
Scientific research design
Selection of research questions
Risk and benefit evaluation
-
communication of risks and benefits in informed consent, identifying risks that matter to participants in/following a particular emergency [39].
Appropriate methodology
Critical ethical reflection
Participation
Meaningful opportunities for contributing to research design and conduct
Fair selection of participants
Informed consent
Safety
Participant vulnerability and protection needs
Bioethics
| • Vulnerable populations are more susceptible to abuse and require additional protections [19] • The “vulnerable” are those likely to be misled, mistreated or taken advantage of, which imposes duty on researchers and ethical review boards (ERB’s) to ensure protections are in place [46]. |
Social Sciences
| • Vulnerability is conceptualised as group status: powerlessness and potential for exploitation, those who lack the power and / or resources to speak out and make voluntary choices [46]. • Requires attention to individual and social vulnerabilities [46]. • Factors that influence vulnerability include exposure to disaster, individual capacity to cope, and the potential for serious crisis to occur as a result of exposure [46]. • Awareness of how displacement status (e.g., refugee or IDP), may affect individual vulnerability [32]. |
Mental Health
| • Vulnerability defined in opposition to resilience: from a biomedical perspective, populations are seen as inherently vulnerable to adverse mental health reactions following disaster; whereas from a social sciences perspective the focus is upon the interactions between individual and community levels which may give rise to vulnerabilities [46] • Assumptions of participant capacity and autonomy are unjustified in emergencies, requiring extra protections to avoid exploitation [51]. |
Accountability
• Identifying those at risk or considered vulnerable [45]; |
• Mental health skills including recognising severe mental illness [65]; |
• Risk management [39]; |
• Data management procedures and dissemination arrangements [14]; |
• Background to the research topic [14]; |
• Specialist training in any tools, instruments and documents, including interviewers engaging and developing rapport with respondents [14]; |
Researcher self-care
Environmental, political and health safety
Neutrality
Access, exit strategies, gatekeepers, and power
Coordination with organisations and researchers
Declaration of researcher interests
Funding
Purpose and benefit
Sustainable benefit
Dissemination
Ethical review
Consensus and unresolved debates
Issue: | |
➢ What constitutes fair benefits? ➢ How should informed consent be operationalised? ➢ Is there a role for decision making capacity (DMC) assessments? ➢ How do approaches to risk management impact upon the construction of ethical research? ➢ How can ethical reflection best be achieved? ➢ Are ethical review boards (ERB’s) equipped to judge the ethical and scientific merit of emergency MHPSS research? |