J Med Ethics 35:638-643 doi:10.1136/jme.2008.028936
  • Paper
  • Research ethics

Obtaining informed consent: observations from community research with refugee and impoverished youth

  1. R Nakkash,
  2. J Makhoul,
  3. R Afifi
  1. Department of Health Behaviour and Education, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
  1. Correspondence to Dr J Makhoul, Department of Health Behaviour and Education, American University of Beirut, Beirut 1107 2020, Lebanon; jm04{at}
  • Received 16 December 2008
  • Revised 14 May 2009
  • Accepted 26 May 2009


This paper presents challenges facing researchers in applying basic ethical principles while conducting research with youth in a developing country context. A discussion of the cultural and social challenges to adherence to the elements of informed consent: disclosure, comprehension, capacity, voluntariness and consent is presented. The authors argue that the current institutional review board requirements that guide research reflect values and stem from western contexts that may not be fully applicable to non-western contexts. More dialogue is needed among researchers in developing world contexts on challenges of and possible revisions to requirements that maintain respect for persons, beneficence, autonomy and justice, particularly when working with youth.


  • Competing interests None.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

  • Ethics approval Ethics approval was received from the IRB of the American University of Beirut to conduct the two phases of this research study.

  • Patient consent Obtained.

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