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research are permissible? And what are the ethics of doing research on interventions that are not sustainable after repatriation occurs?

Judith Lichtenberg of the University of Maryland, College Park, began the discussion of the ethical dilemmas that researchers face. One major ethical quandary has to do with the risks and benefits of research. Should an action be judged only by its ultimate effects, or should it be judged by its means and its end? In emergency settings, as in other settings, research may often benefit future populations of refugees but be of little immediate value to the research subjects themselves. Is it ethical to do research when the participants are not the immediate beneficiaries? Philosophically, this is a key issue in the current debate. Some researchers advocate that it is enough for a researcher to simply “do no harm,” while others argue that research must benefit participants or others. But if this is the case, who must the research benefit—individual research participants, the group of refugees at the research site, refugees everywhere? There are many other ethical concerns, including the process of informed consent, the sustainability of research, the security of data used for research, and the question of who owns and profits from the use of data and research.

Workshop participants benefited from a brief presentation by Jonathan Shay of Tufts University Medical School and the Department of Veterans Affairs Outpatient Clinic in Boston, Massachusetts. He addressed two issues; first, in conflict-affected settings, the researcher and the sponsoring organization have a duty to make a safety assessment: Are the research subjects still vulnerable to coercion or retribution? In many such settings, the confidentiality and security of the original research records cannot be ensured, despite the researcher’s good intentions. Second, psychosocial interventions are becoming more widespread in refugee camps, raising awareness of the mental health of refugees. However, the mental health of humanitarian field workers and researchers can be damaged by intense exposure to both the physical and psychological consequences of complex humanitarian emergencies. “Secondary” or “vicarious” trauma can damage the research and the researcher. Age, experience, or professional training may not provide adequate protection from secondary trauma. Shay discussed the dangerous phenomenon of “baseline creep,” which can occur when researchers become gradually habituated to and thus fail to protect themselves emotionally from the horrors and risks of working in dangerous settings with research subjects who have experienced atrocities. Both researchers and research subjects can become inured to violence, tending to minimize both its continued probability and its impact. Neither good



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