Selecting a Study Population

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Deciding who to research is an inherently ethical question. Is it ethical to study individuals exposed to a traumatic event like a disaster?

How might this decision change if the individuals involved have pre-existing mental health conditions or social vulnerabilities? What are the ethical ramifications of not launching a study and thus leaving vulnerabilities unexposed? There is no right or wrong answer to these types of questions, but they are important to contemplate.

The concept of vulnerability in research stems from a history of unethical practices in biomedical research​1​ and relates to decision-making capabilities and the susceptibility to coercion or undue influence during research.​2​ In the United States, federal regulations provide guidance on the protection and inclusion of certain groups, often called “vulnerable populations,” including children, prisoners, pregnant women, adults with cognitive or mental impairments, and participants who may be considered economically or educationally disadvantaged.​3​

While not considered legally vulnerable, disaster-affected populations—whether experiencing primary exposure to a disaster (e.g., disaster survivors, first responders) or secondary exposure (e.g., health care providers, mental health specialists, volunteers)—may be more vulnerable than other types of research populations. Disasters can lead to devastating and stressful circumstances, which may increase the risk for poor physical, mental, cognitive, and emotional outcomes.​4,5​ As described by Ferreira and colleagues, “in essence, a disaster might turn otherwise healthy people into a vulnerable population” (p.31).​2​

Certain subgroups of survivors may be especially susceptible to harm or exploitation in research due to historical injustices and contemporary inequalities. Social vulnerability—shaped by age, race/ethnicity, (dis)ability, gender, and socioeconomic status, among other factors—may lead to adverse disaster outcomes and require special research protections for certain populations. The act of participating in disaster research may also increase vulnerability of subjects. For instance, if research reveals that residents in a particular zip code had a higher exposure to a toxin, it could stigmatize them once the results are published, as entities such as insurers may use the information against the interest of the subjects.

Vulnerability of Children in Disaster

Children are considered a vulnerable population because their developing bodies make them highly susceptible to dangerous diseases that can result from exposure to hazardous conditions such as contaminated water, polluted air, and radiation.​6​ ​Past research also demonstrates that children exposed to disaster are at risk for a range of negative psychological outcomes​ and behavioral issues.​5​​ They are a protected class and do not have the same legal autonomy as adults to make decisions about participating in research.​7​

Is it ethical for disaster researchers to study children?

Child covered in dust looking sad

According to Baker & Cormier’s book Disasters and Vulnerable Populations: Evidence-Based Practice for the Helping Professions, it is essential to study response mechanisms of children in order to better prepare them and emergency responders for the next disaster.​4​ The principle of justice demands that research benefit the greater population as a whole, and systematic exclusion of vulnerable groups leads to important knowledge gaps. Researchers should thus develop new strategies to minimize risk when conducting research with potentially vulnerable populations, including children and other underrepresented vulnerable groups.​8,9​

  1. 1.
    Levine C. The concept of vulnerability in disaster research. Journal of Traumatic Stress. 2004;17(5):395-402. doi:10.1023/B:JOTS.0000048952.81894.f3

  2. 2.
    Ferreira RJ, Buttell F, Ferreira SB. Ethical considerations for conducting disaster research with vulnerable populations. Journal of Social Work Values and Ethics. 2015;12(1):1-29. https://jswve.org/download/2015-1/articles/29-JSWVE-12-1-Ethical%20Considerations%20for%20Disaster%20Research.pdf

  3. 3.
    Lavin RP, Schemmel-Rettenmeier L, Frommelt-Kuhle M. Conducting research during disasters. Annual Review of Nursing Research. 2012;30(1):1-19. doi:10.1891/0739-6686.30.1

  4. 4.
    Baker LR, Cormier LA. Disasters and Vulnerable Populations. Springer Publishing Company; 2014.

  5. 5.
    Norris FH, Friedman MJ, Watson PJ. 60,000 disaster victims speak: Part II. summary and implications of the disaster mental health research. Psychiatry: Interpersonal and Biological Processes. 2002;65(3):240-260. doi:10.1521/psyc.65.3.240.20169

  6. 6.
    Peek L, Abramson DM, Cox RS, Fothergill A, Tobin J, H. Rodriguez & JET W Donner. Children and disasters. In: Handbook of Disaster Research. Second. Springer; 2018:243-262.

  7. 7.
    Ferreira RJ, Buttell F, Cannon C. Ethical Issues in conducting research with children and families affected by disasters. Current Psychiatry Reports. 2018;20(6). doi:10.1007/s11920-018-0902-2

  8. 8.
    Packenham JP, Rosselli RT, Ramsey SK, et al. Conducting science in disasters: Recommendations from the NIEHS Working Group for Special IRB Considerations in the Review of Disaster Related Research. Environmental Health Perspectives. 2017;125(9). doi:10.1289/EHP2378

  9. 9.
    Tansey CM, Anderson J, Boulanger RF, et al. Familiar ethical issues amplified: How members of research ethics committees describe ethical distinctions between disaster and non-disaster research. BMC Medical Ethics. 2017;18(1). doi:10.1186/s12910-017-0203-z