Ethical research in global health emergencies: making the case for a broader understanding of ‘research ethics’

Wright, Katharine

doi:10.1093/inthealth/ihaa053

Cited by 12 publications

(15 citation statements)

References 2 publications

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“…Cronin-Furman and Lake, 2018; Gordon, 2021; Idris, 2019; Moss et al, 2019). While these issues are highly important, this paper is written on the premise that achieving ethical research is not dependent solely on researcher activity at the site of research, but also on decisions made across the entire ecosystem of a project (Mac Ginty et al, 2021; University of Edinburgh, 2019; Wright, 2020). Therefore, the paper defines an ‘ethical research landscape’ as one which actively strives to prevent any unjust action, harm or suffering as a consequence of the research process, while seeking to maximise and create opportunities for fair practices.…”

Section: Introductionmentioning

confidence: 99%

Ethical research landscapes in fragile and conflict-affected contexts: understanding the challenges

Shanks

Paulson

2022

Research Ethics

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As the prevalence of conflict and fragility continue to rise around the world, research is increasingly heralded as a solution. However, current ethical guidelines for working in areas suffering from institutional and social fragility, insecurity or violent conflict have been heavily critiqued as highly abstract; focussed only on data collection; detached from the realities of academia in the Global South; and potentially extractive. This article seeks to respond to that assessment by spotlighting some of the most prevalent challenges researchers face in the pursuit of ethical working practices. It explores the material and epistemic injustices that often shape and underpin research structures and relationships in these contexts. The paper draws on the authors’ experiences of research in conflict-affected and fragile contexts over the last fifteen years and on workshop discussions with researchers based in fragile and conflict-affected contexts conducted in Amman, Bogotá and Dhaka in 2019-2020. The paper works from the premise that achieving ethical research in fragile spaces is not dependent solely on activity at the site of research, but also on decisions made across the entire ecosystem of a research project. It therefore interrogates the full research landscape, from funding models, to research design (including research topics, partnerships, methods, participant selection, and researcher positionality), to dissemination plans and ethical gatekeeping. The paper critically reflects on inequities in the processes of knowledge production about conflict and fragility and the key ethical challenges that researchers encounter. It highlights the need for further guidance, support and accountability to ensure ethical research practices.

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Section: Introductionmentioning

confidence: 99%

Ethical research landscapes in fragile and conflict-affected contexts: understanding the challenges

Shanks

Paulson

2022

Research Ethics

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“…Their team highlight that whether something is ethical (or not) cannot be determined simply in an ethics committee meeting. Wright 2 echoes this sentiment in a short communication summarising a recently published Nuffield Council on Bioethics report: ‘Research in global health emergencies’, arguing that research can only be ethical if it encompasses three core values: equal respect, fairness and helping to reduce suffering, all of which are the responsibility of all the stakeholders or ‘duty bearers’ involved in research. Transnational research partnerships are then scrutinised more broadly under the lens of the Decolonising Global Health movement by Lawrence and Hirsch, 3 who focus particularly on what researchers from high-income settings can and need to do to make partnerships more equitable.…”

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confidence: 99%

Spotlight on global health research

Lawrence

Gyapong

2020

International Health

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“…Particularly, it was unclear when to end the quarantine, isolation, or hospitalization requirements, not only for the patients but also for the exposed healthcare workers. There was also a lack of clear and updated guidelines regarding the use of unapproved COVID-19 treatments such as remdesivir and convalescent plasma therapy ( 39 ). On another hand, participation of health institutions in large research was affected due to a lack of clear and contextual health emergency-focused “research ethics” guidelines ( 40 , 41 ).…”

Section: Discussionmentioning

confidence: 99%

Participatory Approach to Develop Evidence-Based Clinical Ethics Guidelines for the Care of COVID-19 Patients: A Mixed Method Study From Nepal

Bhattarai¹,

Adhikari²,

Rayamajhee³

et al. 2022

Front. Public Health

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During health emergencies such as the COVID-19 pandemic, healthcare workers face numerous ethical challenges while catering to the needs of patients in healthcare settings. Although the data recapitulating high-income countries ethics frameworks are available, the challenges faced by clinicians in resource-limited settings of low- and middle-income countries are not discussed widely due to a lack of baseline data or evidence. The Nepali healthcare system, which is chronically understaffed and underequipped, was severely affected by the COVID-19 pandemic in its capacity to manage health services and resources for needy patients, leading to ethical dilemmas and challenges during clinical practice. This study aimed to develop a standard guideline that would address syndemic ethical dilemmas during clinical care of COVID-19 patients who are unable to afford standard-of-care. A mixed method study was conducted between February and June of 2021 in 12 government designated COVID-19 treatment hospitals in central Nepal. The draft guideline was discussed among the key stakeholders in the pandemic response in Nepal. The major ethical dilemmas confronted by the study participants (50 healthcare professionals providing patient care at COVID-19 treatment hospitals) could be grouped into five major pillars of ethical clinical practice: rational allocation of medical resources, updated treatment protocols that guide clinical decisions, standard-of-care regardless of patient's economic status, effective communication among stakeholders for prompt patient care, and external factors such as political and bureaucratic interference affecting ethical practice. This living clinical ethics guideline, which has been developed based on the local evidence and case stories of frontline responders, is expected to inform the policymakers as well as the decision-makers positioned at the concerned government units. These ethics guidelines could be endorsed with revisions by the concerned regulatory authorities for the use during consequent waves of COVID-19 and other epidemics that may occur in the future. Other countries affected by the pandemic could conduct similar studies to explore ethical practices in the local clinical and public health context.

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Ethical research in global health emergencies: making the case for a broader understanding of ‘research ethics’

Cited by 12 publications

References 2 publications

Ethical research landscapes in fragile and conflict-affected contexts: understanding the challenges

Ethical research landscapes in fragile and conflict-affected contexts: understanding the challenges

Spotlight on global health research

Participatory Approach to Develop Evidence-Based Clinical Ethics Guidelines for the Care of COVID-19 Patients: A Mixed Method Study From Nepal

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