title: Ethical challenges in mental health research among internally displaced people: ethical theory and research implementation.
abstract: Millions of people undergo displacement in the world. Internally displaced people (IDP) are especially vulnerable as they are not protected by special legislation in contrast to other migrants. Research conducted among IDPs must be correspondingly sensitive in dealing with ethical issues that may arise. Muslim IDPs in Puttalam district in the North-Western province of Sri Lanka were initially displaced from Northern Sri Lanka due to the conflict in 1991. In the backdrop of a study exploring the prevalence of common mental disorders among the IDPs, researchers encountered various ethical challenges. These included inter-related issues of autonomy, non-maleficence, beneficence, confidentiality and informed consent, and how these were tailored in a culture-specific way to a population that has increased vulnerability. This paper analyses how these ethical issues were perceived, detected and managed by the researchers, and the role of ethics review committees in mental health research concerning IDPs. The relevance of guidelines and methodologies in the context of an atypical study population and the benefit versus risk potential of research for IDPs are also discussed. The limitations that were encountered while dealing with ethical challenges during the study are discussed. The concept of post-research ethical conduct audit is suggested to be considered as a potential step to minimize the exploitation of vulnerable populations such as IDPs in mental health research.
authors.affiliation: Health Services & Population Research Department, Institute of Psychiatry, King's College London, London SE5 8AF, UK. chesmal.siriwardhana@kcl.ac.uk
authors.forename: Chesmal
authors.initials: C
authors.lastname: Siriwardhana
authors.forename: Anushka
authors.initials: A
authors.lastname: Adikari
authors.forename: Kaushalya
authors.initials: K
authors.lastname: Jayaweera
authors.forename: Athula
authors.initials: A
authors.lastname: Sumathipala
mesh_terms: D026686:Beneficence; D003256:Community Participation; D003219:Confidentiality / Q000941:ethics; D003906:Developing Countries; D026689:Ethical Analysis; D032984:Ethics, Research; D006801:Humans; D007258:Informed Consent / Q000941:ethics*; D001523:Mental Disorders; D008603:Mental Health; D026684:Personal Autonomy; D012036:Refugees; D012106:Research; D012108:Research Personnel / Q000941:ethics; D013188:Sri Lanka; D035862:Vulnerable Populations