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The study identifies ethical issues that may obstruct meaningful PPI, disrupt the research process, and negatively affect public contributors while generating moral distress. It presents qualitative thematic case examples and analyzes them using Beauchamp and Childress’ ethical principles alongside PPI-centered values and relational ethics.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/patient-and-public-involvement-with-forced-migrants-an-empirical-exploration-of-ethical-issues/460588/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/patient-and-public-involvement-with-forced-migrants-an-empirical-exploration-of-ethical-issues/460588.png","ImageObject",300,407,{"name":92,"@type":93},"Eliana","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-05","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Why is patient and public involvement (PPI) important in research involving forced migrants?","Question",{"text":112,"@type":113},"PPI can improve understanding, relevance, and outcomes of research, especially when it is meaningful, respectful, and inclusive. Forced migrants can contribute experiential knowledge that complements academic evidence.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What ethical risks does the article highlight for involving forced migrants in PPI?",{"text":117,"@type":113},"The article points to unresolved ethical issues such as risks to autonomy, potential injustice from communication strategies, exclusion linked to payment regulations, exclusion from decision-making, and lack of safety for honest input when trust is not established.",{"name":119,"@type":110,"acceptedAnswer":120},"How does the study analyze the identified ethical issues?",{"text":121,"@type":113},"It uses qualitative data with thematic analysis, then applies ethical principles by Beauchamp and Childress as well as PPI-centered values. 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Unsolved ethical issues risk hindering meaningful involvement and jeopardize the research process, as well as harming the public contributors and causing moral distress. In this article, we aimed to identify ethical issues in PPI with forced migrants and present case examples, based on qualitative data and using thematic analysis, as well as analyse the issues using the ethical principles by Beauchamp and Childress as well as PPIcentred values. The ethical issues identified were“Treating forced migrant public contributors as a vulnerable group can inhibit autonomy”; “Non-inclusive  \nE. Inge (*) · N. Elmi · Y. Omar · G. Warner  \nCHAP, Department of Public Health and Caring Sciences, Uppsala University, Box 564, 751 22 Uppsala, Sweden e-mail: [elin.inge@uu.se](elin.inge@uu.se)  \nN. Elmi  \ne-mail: [nimco.nooli12@outlook.com](nimco.nooli12@outlook.com)  \n[Y](Y). Omar  \ne-mail: [yaasmiin511@hotmail.com](yaasmiin511@hotmail.com)  \nG. Warner  \ne-mail: [georgina.warner@uu.se](georgina.warner@uu.se)  \nU. Kihlbom  \nDepartment of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Inst. LIME, Att:  \nUlrik Kihlbom, Karolinska Institutet, 171 77 Stockholm, Sweden  \n[e-mail: ulrik.kihlbom@ki.se](e-mail: ulrik.kihlbom@ki.se)  \ncommunication strategies can contribute to injustice”;“Regulations around payment risk excluding the most vulnerable from involvement”; “Public contributors risk being excluded from partaking in decision-making,” and “If trust is not established, public contributors do not feel safe sharing honest input.” Further, we discussed the ethical issues using relational ethics, with a focus on how to conduct PPI with forced migrants in an ethical way.  \nKeywords Patient and public involvement · Forced migrants · Empirical ethics · Relational ethics · Qualitative · Thematic analysis  \nBackground  \nPatient and public involvement (PPI) in research can lead to a richer understanding of the research topic and improve the research process and outcomes (Brett et al. 2014) . However, this relies on public involvement being conducted in a meaningful, respectful, and inclusive way, especially when involving representatives from more seldomly involved populations such as forced migrants (Hickey et al. 2022) . Here, we understand PPI as an active partnership between researchers and representatives of the group in focus, who together create and develop research. These representatives of a group, here termed public contributors, are not study participants but collaborators. They have lived experience relevant to the research  \nin focus; in health research, patient partners are common but also representatives of societal groups. They represent the perspective of living in a situation, as opposed to studying it, and contribute with experiential knowledge to complement the academic knowledge. The public contributors can be active collaborators in all stages of the research cycle, from initial idea generation where public contributors can give input on research question and methods, through data collection and analysis, to dissemination and implementation of the findings where public contributors can develop material and reach non-academic audiences. In the literature, many other terms are used for similar approaches with a large variation between academic fields and geographical regions (Dengsø et al. 2023) .  \nThere are two ma","cbCaipG5pvAv9QzN","https://ap.wps.com/l/cbCaipG5pvAv9QzN","pdf",605402,14,"English","# Background\n## Core concept of PPI\n## Two main arguments for PPI\n## Ethical relationship challenges with forced migrants","[{\"question\":\"Why is patient and public involvement (PPI) important in research involving forced migrants?\",\"answer\":\"PPI can improve understanding, relevance, and outcomes of research, especially when it is meaningful, respectful, and inclusive. Forced migrants can contribute experiential knowledge that complements academic evidence.\"},{\"question\":\"What ethical risks does the article highlight for involving forced migrants in PPI?\",\"answer\":\"The article points to unresolved ethical issues such as risks to autonomy, potential injustice from communication strategies, exclusion linked to payment regulations, exclusion from decision-making, and lack of safety for honest input when trust is not established.\"},{\"question\":\"How does the study analyze the identified ethical issues?\",\"answer\":\"It uses qualitative data with thematic analysis, then applies ethical principles by Beauchamp and Childress as well as PPI-centered values. It also discusses the issues through relational ethics to guide ethical conduct of PPI.\"}]","Patient and Public Involvement with Forced Migrants: An Empirical Exploration of Ethical Issues | PDF",1790758832,35]