Special Section: Clinical Research in Ukraine

Ethics: Giving Voice to the Unheard
Part 2:
Ethical Consideration for Children in Wartime

Thalia Arawi
American University of Beirut Medical Center

hallenges abound in conducting research with children who have experienced war. Risks (physical and otherwise), awakening of traumatic experiences, informed consent, power relations, personal attachments, and methodological challenges must all be addressed with this vulnerable population.

Sayed Bakr, who survived a ditch bombing that killed four boys in July 2014, told The Telegraph (UK): “I used to dream that I was dead. Even today I’m in continuous fear. Whenever I hear a loud noise, I feel terror.”

The most difficult part, and where we must focus, is what happens after the war.

Social and behavioral sciences research is now increasing in areas of conflict, with particular emphasis on qualitative studies. This is in part because conflict is all over the world, albeit in different forms. Armed conflict is rampant in the Middle East in particular; Yemen, Syria, Iraq, and Palestine are only some examples.

Children living in war-torn areas, including Ukraine, are exposed to violence and death and may observe traumatic events first-hand. They often have post-traumatic stress disorders and flashbacks of pain, which are as serious as the event itself.

Children also face circumstantial troubles during war and must often face life lacking even the lowest of Maslow’s hierarchy of needs. Their homes have been demolished, physically and morally. They have no food, no shelter, no healthcare, no security. Children who lose their parents, or whose parents are not able to work because of health issues or maiming, must work so that their siblings and family can eat, which means no school attendance.

The effects linger on, physically and mentally, for years. Oftentimes, the effects are concealed or hidden in the subconscious, and doing research with these children can find deep-rooted traumas.

Children are at a double disadvantage because of their vulnerability during war, and special consideration should be given to this population. Ensuring the presence of a local psychiatrist is imperative when conducting research that involves children who have been exposed to war.