Ethics of Managing Unintended Consequences in Global Health Research: A Case Study

In a study of dietary supplementation among women in Ghana, a disproportionately high number of pregnant study participants were found to no longer be pregnant, leading researchers to suspect that the very early identification of pregnancy status made possible by study participation may have contributed to an elevated incidence of elective abortion among study participants. While abortion is legal in Ghana under certain circumstances, misinformation regarding its legality and persistent stigmatization result in many Ghanaian women choosing abortion methods that are unsafe and often illegal. While the study of the potential benefits of dietary supplementation during pregnancy initially appeared to pose very little risk to participants, the unintended and unforeseen consequence of unsafe abortions required researchers to reevaluate study protocol. In the following discussion of this case, we explore the ethical considerations researchers must address when unintended consequences emerge in global health research.