Matthew R Hunt

• PT, PhD
• Professor at McGill University

A common recommendation to improve the management of low back pain (LBP) is the use of interdisciplinary teams. However, many challenges remain in establishing interdisciplinary care, particularly in community-based primary care settings. This study explored patients’ experiences with interdisciplinary care for LBP using an applied phenomenological...

There is a scarcity of health human resources worldwide. In occupational therapy (OT), physical therapy (PT), and speech-language pathology (S-LP), attrition and retention issues amplify this situation and contribute to the precarity of health systems. Therefore, we aimed to investigate retention strategies for rehabilitation professionals in Quebe...

Humanitarian innovation is occurring in a wide range of organisational contexts, from innovation labs and hubs, to specialised units within humanitarian organisations, to small social innovation startups and through intersectoral partnerships. Ethical considerations associated with innovation activities have been the source of increased discussion,...

BACKGROUND: Health human resources are scarce worldwide. In occupational therapy (OT), physical therapy (PT), and speech-language pathology (S-LP), attrition and retention issues amplify this situation and contribute to the precarity of health systems. OBJECTIVE: To investigate the phenomena of attrition and retention with OTs, PTs and S-LPs who st...

After often gruelling journeys, some refugees arrive at secure locations with severe injury or illness. Others find themselves shortly thereafter facing a life-limiting health condition. Palliative care has been the focus of recent research, and of academic and aid sector dialogue. In this study, we ask: What are experiences and needs of patients a...

Humanitarian health projects generate extensive amounts of data as part of their activities. In many situations, this data will endure long after the projects have ended. Careful attention is needed within project closure planning and implementation to decisions of when and how to share, store, return to the individuals from whom it was collected,...

The humanitarian sector continually faces organizational and operational challenges to respond to the needs of populations affected by war, disaster, displacement, and health emergencies. With the goal of improving the effectiveness and efficiency of response efforts, humanitarian innovation initiatives seek to develop, test, and scale a variety of...

Introduction: Access to palliative care, and more specifically the alleviation of avoidable physical and psychosocial suffering is increasingly recognized as necessary in humanitarian response. Palliative approaches to care can meet the needs of patients for whom curative treatment may not be the aim, not just at the very end of life but also more...

Children with disabilities were especially vulnerable during the COVID-19 pandemic, and policies designed to mitigate its effects were limited in addressing their needs. We analyzed Canadian policies related to children with disabilities and their families during the COVID-19 pandemic to identify the extent to which these policies aligned with the...

Purpose In this paper, the authors propose a new lens to examine international humanitarian organizations' responsibilities in the context of project closure, what authors call “an ethics of the temporary”. The authors offer this as an orienting ethical ideal to facilitate the moral imagination of humanitarian planners, practitioners and stakeholde...

Introduction: Attrition is defined as a permanent departure from one's profession or the workforce. Existing literature on retention strategies, contributing factors to the attrition of rehabilitation professionals and how different environments influence professionals' decision-making to stay in/leave their profession, is limited in scope and spe...

Background: People with disabilities have experienced heightened social risks in the context of the pandemic, resulting in higher rates of infection and mortality. They have also borne elevated burdens associated with public health measures. The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) obliges its 184 state par...

Access to palliative care, and more specifically the alleviation of avoidable physical and psychosocial suffering is increasingly recognized as a necessary component of humanitarian response. Palliative approaches to care can meet the needs of patients for whom curative treatment may not be the aim, not just at the very end of life but alleviation...

Introduction The COVID-19 pandemic brought unprecedented challenges for youth with neurodevelopmental disabilities (NDD) and their families. Although health measures were implemented to contain the COVID-19 virus, they disrupted public service, profoundly impacting youth and their families’ access to services. This study sought to better understand...

Background The global pandemic and subsequent denials, delays, and disruptions in essential daily activities created significant challenges for children with neurodevelopmental disorders (NDDs) and their parents. Public health restrictions during the COVID-19 pandemic limited access to supports and services required by children with NDDs to maintai...

Professional identity is believed to foster self-confidence and resilience in health care professionals. While literature exists describing professional identity in medicine, the relevance of this evidence to rehabilitation professionals (occupational therapy (OT), physical therapy (PT) and speech-language pathology (S-LP)) is limited due to differ...

Background: Individuals with prior experience in international disaster response represent an essential source of expertise to support disaster response in their home countries. Our objective was to explore the experiences of personnel involved in international emergency health response regarding their perceptions of essential disaster response at...

Purpose: This review aims to identify the barriers and facilitators to knowledge use and Knowledge Translation (KT) strategies in rehabilitation in low, lower-middle, and upper-middle-income countries (LMICs). Materials and methods: A scoping review of studies of KT in rehabilitation in LMICs contexts using the Arksey and O'Malley Framework was...

The current humanitarian use of drones is focused on two applications: disaster mapping and medical supply delivery. In response to the growing interest in drone deployment in the aid sector, we sought to develop a resource to support value sensitivity in humanitarian drone activities. Following a bottom-up approach encompassing a comprehensive lit...

When conducting interviews or focus groups, researchers often end with a simple question; “Is there anything else you would like to add?” This article takes responses to this question provided by participants in a study of “West Africans' Perceptions of Ebola research” as its point of departure. A number of participants in that study accepted the i...

It is clear that in the eyes of a growing number of humanitarian fieldworkers and decision-makers, palliative care is something humanitarian organizations should strive to provide as they address the needs of populations affected by crises. What remains less clear are the moral justifications underlying the push to do so. This chapter dives beneath...

With no cure and a high mortality rate, Ebola virus disease (EVD) outbreaks require preparedness for the provision of end-of-life palliative care. This qualitative study is part of a larger project on palliative care in humanitarian contexts. Its goal was to document and deepen understanding of experiences and expectations related to end-of-life pa...

Research is a critical starting point for public policy. For disability policy, calculation of prevalence-the percentage of persons with disabilities in a population-has attracted significant attention. Multiple disability prevalence studies have been conducted in Zambia. We used data from semi-structured interviews about research and the policy pr...

The use of drones (or unmanned aerial vehicles, UVAs) in humanitarian action has emerged rapidly in the last decade and continues to expand. These so-called 'humanitarian drones' represent the first wave of robotics applied in the humanitarian and development contexts, providing critical information through mapping of crisis-affected areas and time...

Objective There is growing recognition of the importance of increasing preparedness for and the provision of palliative care in humanitarian crises. The primary objective of this review is to interpret the existing literature on culture and palliative care to query the recommendation that humanitarian healthcare providers, teams, and organizations...

We have identified the following key findings from this initial analysis. First, the alignment of countries’ responses with the UNCRPD indicates a gradual shift from emergency responses in the beginning of the pandemic (Article 11), to issues related to service provision and programs that accommodate a more “chronic” reality and impacts of restrict...

Project closure is a core feature of humanitarian action. However, how decisions to end projects are made, and how closure is planned and implemented, has implications for upholding ethical commitments, and can have positive or negative consequences for affected communities, local stakeholders, and humanitarian organizations and their staff. To bet...

Background Humanitarian non-governmental organizations provide assistance to communities affected by war, disaster and epidemic. A primary focus of healthcare provision by these organizations is saving lives; however, curative care will not be sufficient, appropriate, or available for some patients. In these instances, palliative care approaches to...

Background: Participatory approaches that engage affected populations are increasingly applied in humanitarian health programs in concert with emerging accountability frameworks and the rapid growth of research in these settings. Participatory initiatives within this domain appear to be largely adopted at an operational level and are infrequently r...

Background: Zambia has created new disability policies and updated existing policies to be consistent with the United Nations Convention on the Rights of Persons with Disabilities. These initiatives require the widespread engagement of ministries and departments to achieve effective policy development and implementation. To pursue widespread engage...

Disability has attracted attention in international human rights and development circles and Zambian domestic policy. The purpose of this research was to explore the perceptions of Zambian disability policy stakeholders about the ways that two international initiatives, namely the United Nations Convention on the Rights of Persons with Disabilities...

Purpose: This project aimed to develop, implement and evaluate a train-the-trainer initiative for community rehabilitation workers (CRWs) and rehabilitation specialists within a community rehabilitation program for children with delayed development in Tamil Nadu, India. Methods: Guided by the Knowledge to Action framework, non-governmental and acad...

Purpose: This study identified the individuals responsible for making decisions about physiotherapy (PT) wait time, frequency of treatment, and treatment duration for persons with low back pain and determined which factors guided these decisions. Method: A cross-sectional survey was sent to Canadian PT professionals treating adult patients with mus...

Humanitarian contexts are complex, rapidly-changing and characterized by uncertainty. Populations affected by crisis are exposed to a wide range of risks. As a result, many challenges arise for humanitarian organizations as they seek to improve their practices and develop new tools. An emergent literature has addressed ethical dimensions of innovat...

Background and purpose Measuring patients’ experiences of health services has become an essential part of quality of care reporting and a means for identifying opportunities for improvement. This study aimed to evaluate change in patient experience in an interdisciplinary primary care program and to estimate the impact on patient experience of soci...

Purpose The purpose of this paper is to explore the ethical dimensions of crisis translation through the lenses of Paul Ricoeur’s philosophical scholarship. In particular, his work on both translation and ethics will be examined in order to draw practical applications for those involved in humanitarian action. Design/methodology/approach The autho...

Language and its translation are important operational concerns in humanitarian crisis response. Information sharing, coordination, collaboration and relationship-building all revolve around the ability to communicate effectively. However, doing so is hampered in many humanitarian crises by linguistic differences and a lack of access to adequate tr...

Purpose: Patients receiving rehabilitation care may act in ways that pose risks to the wellbeing of others. There are numerous situations when patients’ actions might pose risks to others, including family members, other patients, or society. For example, such risks arise if patients wish to return home to living in an apartment but risk starting a...

Health care services provided by workers’ compensation systems aim to facilitate recovery for injured workers. However, some features of these systems pose barriers to high quality care and challenge health care professionals in their everyday work. We used interpretive description methodology to explore ethical tensions experienced by physical the...

This paper presents findings from a systematic review of the literature (2005–2017) on palliative care in humanitarian crises (e.g., disasters, armed conflicts, epidemics). This review set out to describe palliative care needs, practices, barriers, and recommendations in humanitarian crisis settings. It contributes to current discussions within the...

Abstract Wars, disasters, and epidemics affect millions of individuals every year. International non-governmental organizations respond to many of these crises and provide healthcare in settings ranging from a field hospital deployed after an earthquake, to a health clinic in a longstanding refugee camp, to a treatment center during an infectious d...

Background: In recent years, significant efforts have been made to improve the provision of care for compensated injured workers internationally. However, despite increasing efforts at implementing best practices in this field, some studies show that policies overseeing the organisation of care for injured workers can have perverse influences on h...

Introduction: Health-related disaster research is a relatively small; but growing field of inquiry. A better understanding of the scope and scale of health-related disaster research that has occurred in low- and middle-income countries (LMICs) would be useful to funders, researchers, humanitarian aid organizations, and governments as they strive to...

Purpose of the review: As mental health professionals assist individuals and communities affected by disaster, they are likely to encounter ethical issues. We conducted a review of academic and grey literature to identify ethical issues associated with the provision of mental health care during disasters, with particular attention to children and...

Ethics education is the cornerstone of professional practice, fostering knowledge and respect for core ethical values among healthcare professionals. Ethics is also a subject well-suited for interprofessional education and collaboration. However, there are few initiatives to gather experiences and share resources among ethics educators in rehabilit...

In Canada, limited resources and increasing demand place pressure on the public healthcare system, something that is likely to increase. In this context, wait lists in outpatient physiotherapy departments (OPD) will get longer, system inefficiencies will arise, and frustrations and ethical concerns will be experienced by patients and staff. To bett...

Background: Autonomy is a central concept in both bioethics and rehabilitation. Bioethics has emphasized autonomy as self-governance and its application in treatment decision-making. In addition to discussing decisional autonomy, rehabilitation also focuses on autonomy as functional independence. In practice, responding to patients with diminished...

Background: Previous research suggested that physical therapy services can be influenced by patient characteristics (age, sex, socioeconomic status) or insurance status rather than their clinical need. Objective: The aim of this study was to determine whether patient-related factors (age, sex, SES) and the source of reimbursement for physical th...

Background The conduct of research in settings affected by disasters such as hurricanes, floods and earthquakes is challenging, particularly when infrastructures and resources were already limited pre-disaster. However, since post-disaster research is essential to the improvement of the humanitarian response, it is important that adequate research...

Study/Objective This is a critical interpretive synthesis of the ethical and practical limitations inherent to the provision of palliative care by humanitarian organizations during public health emergencies. Developed in dialogue with the SPHERE Project, the Palliative Care in Complex Humanitarian Emergencies network, and the Children’s Palliative...

Study/Objective We aim to clarify the obligations that humanitarian medical organizations hold towards recipients of aid when a decision is made to end a humanitarian project. Background Humanitarian organizations and their staff regularly make and implement decisions to close projects. Such decisions are frequently challenging to make, and may be...

Study/Objective To explore how the notion of “vulnerable populations” is understood and used in the policies and practices of international humanitarian organizations, and to consider its ethical implications for crisis-affected populations and humanitarian actors. Background Humanitarian organizations have responded to evidence that particular gr...

Study/Objective How can humanitarian organizations support ethically and contextually appropriate palliative care in humanitarian crises? This ELRHA (R2HC) funded study explores the ethical complexities of doing so, asking how existing standards of palliative care may be adapted to support delivery of ethically and contextually appropriate palliati...

Study/Objective To explore how policies and ethics inform each other, in order to better understand where problems arise in humanitarian healthcare organizations, and how policy can be improved in this regard. Background Researchers have just begun to understand the range of ways in which humanitarian healthcare organizations’ policies can shape e...

Purpose: This article examines the employment situation and perceptions of graduates from three rehabilitation technician (RT) programs in Haiti. Methods: In this mixed method study, 74 of 93 recent graduates completed a questionnaire, and 20 graduates participated in an in-depth qualitative interview. We analyzed survey results using descriptive s...

Background Situations of disaster that prompt international humanitarian responses are rife with ethical tensions. The 2010 Haiti earthquake caused great destruction and prompted a massive humanitarian response. The widespread needs experienced by the population and the scale of the response inevitably rendered priority-setting difficult, and gave...

Purpose: The aim of this study was to describe the current patterns of service delivery of Canadian physiotherapy (PT) professionals working in adult musculoskeletal (MSK) outpatient practice. Methods: A total of 846 Canadian PT professionals working with an adult MSK outpatient clientele participated in an online survey about how they would treat...

Demographic change and changing population needs are important drivers of increased demand for rehabilitation. These developments place significant stress on access to physical therapy services, as current resources are insufficient to meet the growing demand. This situation presents ethical challenges for physical therapists and others involved in...

Vulnerability is a central concept in humanitarian aid. Discussions of vulnerability in disaster response literature and guidelines for humanitarian aid range from considerations of a universal human vulnerability, to more nuanced examinations of how particular characteristics render individuals more or less at risk. Despite its frequent use, there...

New applications of information and communication technology (ICT) are shaping the way we understand and provide humanitarian medical assistance in situations of disaster, disease outbreak or conflict. Each new crisis appears to be accompanied by advancements in humanitarian technology, leading to significant improvements in the humanitarian aid se...

Background: Research conducted following natural disasters such as earthquakes, floods or hurricanes is crucial for improving relief interventions. Such research, however, poses ethical, methodological and logistical challenges for researchers. Oversight of disaster research also poses challenges for research ethics committees (RECs), in part due...

La recherche interventionnelle en santé mondiale est souvent effectuée au moyen de partenariats scientifiques internationaux. Mais la réalisation de telles recherches, notamment dans les pays à faible revenu où les enjeux de pouvoir, d'argent et de relations interculturelles sont exacerbés, soulève de nombreux défis éthiques, notamment concernant l...

Partnerships involving NGOs and academic researchers (NGO–R partnerships) are increasing in global health research. Such collaborations present opportunities for knowledge translation in global health, yet are also associated with challenges for establishing and sustaining effective and respectful partnerships. We conducted a narrative review of th...

In many settings, the dedication of healthcare workers (HCWs) to the treatment of tuberculosis exposes them to serious risks. Current ethical considerations related to tuberculosis prevention in HCWs involve the threat posed by comorbidities, issues of power and space, the implications of intersectoral collaborations, (de)professionalization, just...

RÉSUMÉ Le vieillissement de la population engendre une augmentation du nombre de conducteurs âgés. Les professionnels de la santé ont la responsabilité de fournir des soins en préservant le secret professionnel tout en assurant la sécurité du public. Cet article traite de l’analyse éthique relative à la prise de décisions en lien avec le signalemen...

Purpose : This article reviews the literature regarding ethics and community-based rehabilitation (CBR) with the goal of identifying and analyzing ethical considerations associated with this approach. Method: We conducted a critical interpretive review of the academic literature related to CBR in low- and middle-income countries and to indigenous...

Purpose: Ethical practice is an essential competency for occupational and physical therapists. However, rehabilitation educators have few points of reference for choosing appropriate pedagogical and evaluation methods related to ethics. The objectives of this study were to: (1) identify priority content to cover in ethics teaching in occupational...

Interventional global health research is often carried out through international scientific partnerships. However, the conduct of such research, especially in low-income countries where issues of power, money and intercultural relations are exacerbated, raises many ethical challenges particularly related to responsible conduct in collaborative rese...

La recherche interventionnelle en santé mondiale est souvent effectuée au moyen de partenariats scientifiques internationaux. Mais la réalisation de telles recherches, notamment dans les pays à faible revenu où les enjeux de pouvoir, d’argent et de relations interculturelles sont exacerbés, soulève de nombreux défis éthiques, notamment concernant l...

On November 7th, 2014 the Humanitarian Health Ethics Workshop was held at McGill University, in Montreal. Co-hosted by the Montreal Health Equity Research Consortium and the Humanitarian Health Ethics Network , the event included six presentations and extensive discussion amongst participants, including researchers from Canada, Haiti, India, Switze...

Disaster research has grown in scope and frequency. Research in the wake of disasters and during humanitarian crises – particularly in resource-poor settings – is likely to raise profound and unique ethical challenges for local communities, crisis responders, researchers, and research ethics committees (RECs). Given the ethical challenges, many hav...

Purpose: The purpose of this study was to examine current approaches and challenges to teaching ethics in entry-level Canadian physiotherapy (PT) and occupational therapy (OT) programs. Methods: Educators responsible for teaching ethics in the 28 Canadian PT and OT programs (n = 55) completed an online survey. Results: The quantity of ethics t...

Following disasters, persons with disabilities (PWD) are especially vulnerable to harm, yet they have commonly been excluded from disaster planning, and their needs have been poorly addressed during disaster relief. Following the 2010 Haiti earthquake, thousands of individuals experienced acute injuries. Many more individuals with preexisting disab...

Humanitarian action is the active provision of aid designed to save lives, alleviate suffering, and restore and promote human dignity in the wake of disasters and during large-scale emergencies. The humanitarian action that is the focus of this entry is the Dunantist tradition of humanitarianism that adheres to the humanitarian principles of impart...

During international deployment in contexts where military, humanitarian and development missions coexist, the roles of military healthcare professionals (referred to as HCP, these include the following: physicians, nurses, medical technicians, allied health professionals) often overlap and at times conflict. Military HCP may be asked to undertake...

Introduction Health care workers (HCWs) who participate in humanitarian aid work experience a range of ethical challenges in providing care and assistance to communities affected by war, disaster, or extreme poverty. Although there is increasing discussion of ethics in humanitarian health care practice and policy, there are very few resources avail...

Background: While client-centred practice has received wide support, it remains difficult to apply in many practice settings. Identified barriers include constraints on time, resources, and services imposed by healthcare policies. Healthcare professionals’ prioritizing of client safety over (other) interests that clients may name may further restri...