Neurobiological Stress Markers in Tsunami Survivors: A Commentary

Abstract

Sisira Siribaddana is an Endocrinologist and Physician as well as Project Leader of the Sri Lankan Twin Registry. His research interests include diabetes, osteoporosis, bioethics, mental health and twin research. Buddhika Fernando is an Academic and a member of the Ethics committee at the Institute of Research and Development (IRD), Colombo, the leading research based institution in Sri Lanka. She is a dental surgeon, attorney at law and a chartered financial analyst. Her research interests lie primarily in the legal and ethical aspects of healthcare and healthcare delivery, health finance, and with a special focus on the role economic disparity plays on the fulfilment of healthcare needs of women in Sri Lanka. Raja Goonertne is Senior Lecturer in Law at the Open University of Sri Lanka and an attorney at law. He obtained LL.B (Hon) from University of Colombo and LL.M from Monash University, Australia. He is also a diploma holder in forensic medicine. He has a keen interest in conducting research in bioethics, human rights, law and medicine. He is also a resource person of the Institute for Research and Development. This case study was presented by Dr Nandani Kumar and discussed at the International Ethics Training Workshop organized by the Indian Council for Medical Research (ICMR) held in Chennai from 10 to 15 February 2006 and at the Research Ethics Workshop Shaukat Khanum Research Ethics Workshop Shaukat Khanum Memorial Hospital and Cancer Research Centre, Lahore, on 1 March 2009 by Dr Athula Sumathipala. The Journal of Traumatic Stress published a special section titled "The ethics of disaster research" addressing ethical issues related to conducting research after disasters and terrorist attacks, based on a meeting organised by the New York Academy of Medicine and the US National Institute of Mental health. The guidance given below is based on their recommendations. 1. Competent research participant gives informed consent 2. Capacity assessment tools should be utilised if needed 3. Disaster affected populations should not be necessarily considered vulnerable 4. Specific research proposals should be scrutinised for novel nature of research and risk benefit ratio 5. Additional research is needed in the risks and benefits in the participation in disaster-related research 6. Representatives of the community should be consulted before planning and implementation of research. 7. Informed consent procedure should clear all therapeutic misconceptions 8. Explanation about the research should be done in a safe and controlled environment 9. Confidentiality and privacy of the participants must be ensured 10. Research staff should be trained and supported 11. Participants should be informed about the research findings 12. Coordination among researchers should minimise redundant research and participant burden. 1. Liu, L.-F., P. Lynnett, H. Fernando, B.E. Jaffe, B.H. Fritz, and B. Higman, et al. (2005) Observations by the International Survey Team in Sri Lanka, Science, 308, 1595. 2. Sumathipala, A., S.H. Siribaddana, and C. Perera (2006) Management of dead bodies as a component of psychosocial interventions after the Tsunami: a view from Sri Lanka, International Review in Psychiatry, 18, 249-53. 3. Yamada, S., R.P. Gunatilake, T.M. Roytman, S. Gunatilake, T. Fernando, and L. Fernando (2006) The Sri Lanka tsunami experience. Disaster Manag Response, 4, 38-48. 4. Liu et al., 2005; Inoue, S., A.C. Wijewickrema, H. Matsumoto, H. Miura, P. Gunaratna, M. Madurapperuma, and T. Sekiguchi (2007) Field Survey of Tsunami Effects in Sri Lanka due to the Sumatra-Andaman Earthquake of December 26, 2004, Pure appl. geophys, 164, 395-411. 5. Sumathipala et al., 2006 6. Soejima, M., H. Kimura, and Y. Koda (2004) Two novel FUT3 alleles responsible for Lewisnull phenotypes in Sri Lanka Transfusion, 44, 1534-5. 7. Collogan, K.L., F. Tuma, R. Donald-Sewell, S. Borja, and R. Fleischman (2004) Ethical issues pertaining to research in the aftermath of the disaster, Journal of Traumatic Stress, 17, 363-72. Available at http://www.globalizationandhealth.eom/content/1/1/16