Sunday Times (Sri Lanka)

‘Refrain from unethical research’

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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: Scientific rigour and profession­al competence of the research team for their specific tasks; the highest standards of scientific research and peer review should apply. 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.

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