Ethics and methods in disaster health research: a scoping review

Background: Disaster medicine operates in unstable, high-risk environments where operational, ethical, and contextual constraints frequently undermine traditional research designs. Although global health agendas increasingly emphasise person- and patient-centred care (PCC), these principles remain poorly articulated and rarely operationalised within disaster research. We aimed to examine how ethical tensions and methodological limitations shape the current disaster health research evidence base and explore how PCC might be meaningfully integrated into research design and governance. Methods: We conducted a structured scoping review of peer-reviewed literature across PubMed, Scopus, and Web of Science, focusing on research methodology, ethics, and evidence generation in disaster and humanitarian contexts. We thematically synthesised the extracted data. Results: We included 28 studies, identifying three cross-cutting thematic domains: ethical tensions related to participant vulnerability and governance in crisis settings; methodological constraints limiting the generation of robust, context-sensitive evidence; and inconsistent application of PCC principles. Conclusions: The evidence base for disaster medicine appears conceptually rich but structurally fragile. Ethical and methodological constraints suggest a critical gap in the operationalisation of PCC within disaster research. Advancing the field will likely require adaptive methodologies, context-responsive ethical oversight, and more explicit integration of person-centred principles into research design and evaluation, particularly in protracted crises and recovery settings where resilient systems must integrate health and social care. Registration: Open Science Framework: https://doi.org/10.17605/OSF.IO/3A8CZ.