Humanitarian Research - Ethical?

 

My dad would tell me unbelievable stories about his childhood life in Vietnam during the Vietnam War. There was complete chaos in the city of Saigon, weeks before the end of the Vietnam War. People were fleeing in droves in anticipation of the impeding communist takeover. My grandfather fought for the French army during World War Two and was a POW in a German Nazi prisoner camp. Eventually, he came back to Vietnam and worked as a dentist. Him and his brother were involved with the American CIA during the Vietnam War. Being involved with the French and Americans, he would absolutely be killed by the communists so he tried to flee South Vietnam. However, my aunt was in pain and needed immediate medical assistance, but local hospital immediately turned her away. The hospital was occupied mostly by wounded South Vietnamese soldiers, and they took priority over everyone else. The only way my aunt was to receive treatment was to bribe the doctors. However, she did not receive any medical treatment until they arrived by boat to a U.S. military base in Guam.

Mostly all ethical guidelines are not adhered to during a humanitarian crisis, especially involving research. According to an article Health Research in Humanitarian Crises: An Urgent Global Imperative written by Kohrt, Mistry, Anand, Beecroft, and Nuwayhid in 2019;

“An individualized approach to treating patients may create uncertainty among clinicians in navigating the complex ethical dilemmas faced during humanitarian crises. Research during a humanitarian crisis requires modification in methodology, multisector partnerships, engaging with available public health systems, working with local communities, and a different method for research capacity and multidisciplinary approaches” (Kohrt, Mistry, Anand, Beecroft, Nuwayhid, 2019).

In other words, doctors and researchers are immensely restricted in their treatment and research in a chaotic environment, consequently creating ethical dilemmas. Research is especially important during a humanitarian crisis in order to better facilitate humanitarian aid in future crisis. During a crisis, traditional research designs are not suitable. Identifying a control group may be infeasible with no baseline data to compare to. Limited funding also further constrains research in these settings. This further complicates future effective humanitarian action due to limited evidence-based research from prior crises.

Some people argue that it is unethical to not conduct research during a crisis. Others believe that research may actually harm affected populations. Nevertheless, achieving future optimal humanitarian responses is nearly unachievable without the evidence-based research that we need from the past (which there isn’t much evidence-based research to rely on). Unfortunately, researchers may need default into using unethical research data to help optimized humanitarian aid.

Kohrt, B. A., Mistry, A. S., Anand, N., Beecroft, B., & Nuwayhid, I. (2019). Health research in humanitarian crises: an urgent global imperative. BMJ global health, 4(6), e001870. https://doi.org/10.1136/bmjgh-2019-001870