Table 1 Thematic analysis of ethical principles applicable to MHPSS research in emergencies

Scientific research design

Selection of research question

Necessity

[14, 21, 24–32]

Researcher inherent biases

[17, 21, 33, 34]

Risk/benefit evaluation

Emergency = heightened risk

[14, 15, 21, 25, 31, 35, 38–42, 46]

Benefits relative to burdens

[1, 14, 15, 18, 19, 21, 26, 29, 31, 32, 35–37, 43, 44, 46]

Appropriate methodology

Lack of methodological rigor

[22, 37, 38, 47, 48]

Methodological transparency

[17, 18, 21, 24, 28, 30, 35, 45, 49–51]

Methods implemented well

[17, 21, 23, 26, 28, 29, 31, 32, 35, 40, 43, 52–54]

Critical reflection

Continuous reflexivity

[26, 29, 33, 43, 52, 55]

Collective learning

[1, 14, 16, 31, 38, 50, 54]

Participation

Meaningful opportunity for contributing to research design and conduct

Shared understanding

[1, 15, 17, 19–21, 23, 28, 31, 32, 41, 42, 50–52]

Partnership model

[1, 20, 21, 24, 32, 37, 38, 42, 44, 47, 57]

Advising on management of ethical issues

[1, 37, 38, 42, 48, 55]

Fair selection of participants

Selection according to research objectives

[36]

Risks of targeted selection

[21]

Informed by local knowledge

[1, 21, 38, 57]

Informed consent:

Informed consent as an accepted ethical norm

[18, 21, 24, 29, 39, 45, 47, 58, 59]

As a contested concept

[37, 58, 60]

As (flexible) process

[14, 21, 38, 44, 51, 52, 57, 60]

Procedural considerations

[24, 27, 35]

i. Information provided

Consent as “informed”

[15, 21, 37]

Information provided

[15, 58, 61]

ii. Comprehension of information

Strength of information exchange process

[14, 21, 27, 32, 33, 38, 57, 58]

Barriers to comprehension

[18, 37, 39, 40, 52, 62]

Strategies to verify comprehension

[14, 32, 37, 62]

iii. Voluntariness

Factors influencing

[15, 18, 19, 21, 22, 31, 35, 45]

Potential coercion due to emergency context

[1, 15, 18, 19, 21, 31, 37, 44, 51]

Autonomy and capacity

Normative connections

[19, 21, 33, 46, 51, 59]

Decision-making capacity debate

[18, 19, 45, 51, 52]

Limiting potential exploitation

[1, 31, 38, 54]

Procedural considerations

[45, 63]

Confidentiality and anonymity

Increased importance of in emergencies

[14, 28, 31, 35]

Limits in emergencies

[18, 21, 26, 38, 40, 58, 64]

Harms if breached

[28, 31, 35, 44, 65]

Duty to safeguard

[14, 15, 18, 27]

Management of data

[14, 21, 27, 32, 51]

Safety

Participant vulnerability

i. Protection needs

Protection framework

[18, 19, 21, 28, 35, 37]

Vulnerability: contested concept

[19, 32, 46, 51]

Individual situational approach

[35, 46]

Serious mental disorders

[21, 35, 54, 65]

Potential for exploitation

[21, 36, 45]

Accountability

i. Fair selection and specialist training of research and auxiliary staff

Adequate preparation

[20, 23, 24, 26, 29–32, 42–44, 47, 54, 61, 65]

Answerable to stakeholders

[47, 54]

Transparent staff selection

[15, 21, 31, 32, 43, 54–56, 64, 66]

Specialist training

[1, 14, 21, 23, 24, 27, 32, 35, 39, 43, 45, 51, 52, 54, 55, 58, 61, 65]

Tensions in collaborative partnerships

[22]

Researcher self-care

Protecting against negative reactions to emergency context and/or research topic

[1, 14, 21, 23, 24, 31, 34, 35]

Self- and team-care strategies

[24, 31, 34, 43]

Environmental, political and health safety

Working “in-extremis”

[28, 35, 43, 61, 63]

Procedures to respond

[14, 21, 24, 28, 35, 37, 39, 43, 61, 63]

Neutrality

Access and exit strategies

i. Gatekeepers and power

Coordinating with existing systems

[20, 23, 24, 61]

Power & knowledge asymmetries

[21, 22, 28, 32, 35, 64, 67]

Gatekeepers: benefits and critique of

[15, 20, 21, 28, 33, 35, 51, 56, 64, 68]

Transparency towards power

[15, 21, 22, 30, 32, 47, 52, 55]

Coordination with other researchers and organisations

Mutual respect /trust

[38, 66]

International collaborations and power

[21, 30, 41, 47, 55, 64]

Networked with emergency response

[20, 26, 29, 31, 43, 52]

Risk of poor coordination

[20, 21, 52]

Declaration of researcher interests

Transparency about

[1, 18, 22, 24, 30, 37, 41, 52, 64]

Funding

Power of

[1, 21, 22, 42, 52]

Impact of emergency upon budget / funding

[24, 36]

Advocacy to funders

[1, 21, 22, 56]

Purpose and benefit

Sustainable benefit

Levels of benefits

[1, 21, 24, 35, 37, 38, 41, 42, 49, 68]

Haphazard process of accruing

[20, 24, 36–38]

Long-term collaborations & sustainable benefit

[22, 30, 31, 51, 64]

Dissemination

Right to results

[1, 20, 21, 24, 29, 32, 35, 47, 51, 54]

Potential risks in

[21, 22, 28, 41, 42, 58]

Forms of

[1, 14, 24, 30, 63, 67]

Of data collection tools and methods

[49, 69]

Ethical review

As accepted norm

[18, 19, 25, 63]

Responsibilities of reviewers

[22, 24, 37, 38, 46]

Lack of specificity to emergencies

[1, 21, 22, 31, 39]