Health Research in Complex Emergencies: A Humanitarian Imperative John D. Pringle & Donald C. Cole # Springer Science + Business Media B.V. 2009 Abstract Health researchers, research trainees, and ethics reviewers should be prepared for the special application of research ethics within complex humanitarian emergencies. This paper argues that as a precursor to published ethical guidelines for conducting research in complex emergencies, researchers and research ethics committees should observe the following primary ethical considerations: (1) the research is not at the expense of humanitarian action; (2) the research is justified in that it is needs-driven and relevant to the affected populations; and (3) the research does not compromise the humanitarian principles of neutrality, impartiality and independence. These primary considerations are in harmony with the humanitarian goals of saving lives, alleviating suffering, and témoignage. Furthermore, there is an important role for research in supporting humanitarian action, and the extreme vulnerability of research participants in complex emergencies demands intense research ethics scrutiny. It is important to discern which ethical considerations are essential, and which are merely desirable, as excessive research ethics requirements may impede life-saving research. Keywords Complex emergencies . Displaced populations . Humanitarian aid . Humanitarian principles . Nongovernmental organizations . Refugee health . Research ethics . War Setting the Scene: Complex Emergencies War is persistent in devastating and displacing civilian populations. The Global Burden of Disease Study predicts that by 2030, injury from war and civil conflict, particularly among young adults, will account for 0.63 to 1.04 % of disability-adjusted life years (DALYs) globally. As a comparison, this is only slightly below tuberculosis which will account for 0.95 to 1.11 % of DALYS (WHO 2008). However, the actual percent of DALYs attributable to war is likely much higher, as the Global Burden of Disease Study does not J Acad Ethics DOI 10.1007/s10805-009-9095-y J. D. Pringle (*) : D. C. Cole Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 6th Floor, 155 College Street, Toronto, ON M5T 3M7, Canada e-mail: john.pringle@utoronto.ca