Ethical Challenges in Engaging Children and Young People in Climate and Health Research: A Systematic Review

Abstract Despite the profound health impacts of climate change on children, their perspectives are understudied. However, the vulnerability of children poses ethical challenges for research which might correct this. This systematic review is conducted to explore ethical issues involving children in health and climate change research in the existing literature. The electronic database search was performed in PubMed, Scopus, Embase, and Google Scholar in January 2025, and was updated in January 2026. No publication year restriction was applied. Eligible studies were reviewed and thematically analysed. Following critical appraisal, data on study settings, subjects, and ethical challenges were extracted. Of the 1,373 studies that were identified, a total of eleven studies were included in the review. Four areas of ethical challenges in engaging young people in climate and health research emerged, including: 1) research concept complexity and the limited assent capacity of youths, 2) misconception of research objectives and risks, 3) power dynamics and ethical tensions in autonomous participation, and 4) emotional and moral burdens of climate narratives. Our results highlight a set of core principles for the future development of an ethical framework for engaging younger populations in climate and health research. Such a framework should incorporate: 1) iterative and developmentally tailored assent approaches, 2) clear and engaging explanations to address misconceptions, and 3) participatory designs with embedded relational and psychological support.