Ethical Concerns in Disaster Research—A South African Perspective

Abstract

AbstractSituated at the southern-most tip of the African continent, South Africa is geographically stable with few acute natural disasters. However spurts of political violence create acute man-made disasters from time to time. While disasters typically have a sudden monumental onset they can also have an insidious onset and then escalate to reach catastrophic proportions. Over the past three decades South Africa has had the latter experience of a public health disaster in the form of HIV/AIDS and drug resistant tuberculosis. Irrespective of the mode of onset of the disaster the sequelae are similar: significant physical, psychological, social and environmental harm. Consequently this public health disaster in South Africa created unparalleled opportunities for research. Research ethics regulatory infrastructure and guidelines evolved in response to the public health disaster. When disasters occur in resource depleted settings a situation of escalated vulnerability ensues. South African Research Ethics Committees (RECs) immediately developed guidelines to address this vulnerability. However, acute disaster research ethics is not currently included in national research ethics guidelines or standard operating procedures of RECs in the country. This chapter will revisit the ethical dilemmas that arose in the context of HIV/AIDS research and how these issues were encapsulated in guidelines. It will also examine the approaches to research ethics review that can be implemented in the setting of an acute disaster. These approaches are to be incorporated into South African research ethics guidelines that are currently under revision.KeywordsData Safety Monitoring BoardDisaster ResearchResearch Ethic GuidelineSouth African CommunityCapita Health Care ExpenditureThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.