Ethics of conducting research in conflict settings Nathan Ford

Humanitarian agencies are increasingly engaged in research in conflict and post-conflict settings. This is justified by the need to improve the quality of assistance provided in these settings and to collect evidence of the highest standard to inform advocacy and policy change. The instability of conflict-affected areas, and the heightened vulnerability of populations caught in conflict, calls for careful consideration of the research methods employed, the levels of evidence sought, and ethical requirements. Special attention needs to be placed on the feasibility and necessity of doing research in conflict-settings, and the harm-benefit ratio for potential research participants. Introduction Despite the fact that conflicts are widespread in several parts of the world and continue to affect the daily lives of many thousands of people, there is a relative dearth of published information on the plight, health status and challenges facing such populations. This is largely due to the fact that in countries affected by armed conflict, local medical and health research efforts are often compromised by limited infrastructure, lack of human resources (both in terms of numbers and capacity) and insecurity. Medical and health policy research is thus limited. When it is done, it is often conducted by international non-governmental and humanitarian aid organizations who are the main actors on the scene. There are several issues of ethical concern specific to the design and conduct of research in conflict settings. First, many developing countries with fragile political climates, and particularly conflict-affected countries, often lack capacity to provide adequate scientific and technical guidance and monitor research ethics. As a consequence, international agencies may apply divergent ethical standards, some of which may not be in accordance with international human rights or humanitarian law [1]. (This has been a particular concern with respect to the activities of pharmaceutical companies that have been accused of deliberately circumventing their own national ethical standards and taking advantage of loosely enforced or poorly elaborated ethical guidelines in developing countries [2].) Second, humanitarian organizations who might need to conduct qualitative and quantitative surveys as part of their relief operations are often not trained in the ethical appraisal of research as this is often not perceived as being part of their core mandate. Third, lack of infrastructure and human resources, as well as the presence of violence, can limit both access to populations over time and the ability to conduct research. As a consequence, conventional research methodologies when Published: 10 July 2009 Conflict and Health 2009, 3:7 doi:10.1186/1752-1505-3-7 Received: 30 June 2009 Accepted: 10 July 2009 This article is available from: http://www.conflictandhealth.com/content/3/1/7 © 2009 Ford et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.