Ethical issues and challenges in conducting evaluation of military health engagements

There are unique ethical challenges faced by evaluators of military health engagement (MHE) activities. Existing ethical frameworks provide important evaluation considerations but are either (1) not applicable to the breadth of activities that MHEs may involve or 2) do not adequately address ethical considerations necessary in a military setting.

The article examines the shortcomings of literature pertaining to existing ethical frameworks and presents a survey of principles that evaluators supporting MHEs may find germane to their work. These principles-accountability and integrity, beneficence, respect, systematic inquiry and competence and undue influence-are drawn from multiple frameworks and were selected for their relevance to evaluation in the context of MHE.

When considered in tandem, the five selected principles provide a provisional framework that accommodates the specific needs of evaluators while also addressing the distinct ethical considerations required of the military. Alongside each principle, practical guidance is offered to assist military personnel in navigating ethical dilemmas they may encounter in theatre and ensure their evaluations are rigorous, accurate and unbiased.

No single ethical framework sufficiently captures the needs of evaluators supporting an MHE; however, select principles from multiple frameworks will capably aid an evaluator in such a setting. Going forward, those charged with evaluating MHEs should consider the proposed principles when conducting research to make certain that evaluations are both ethically and empirically sound.