Global Health Ethics for Students

Department of Family and Community Medicine, University of Toronto, 410 Sherbourne Street, Toronto, Ontario, Canada.
Developing World Bioethics (Impact Factor: 2.05). 05/2009; 9(1):1-10. DOI: 10.1111/j.1471-8847.2007.00209.x
Source: PubMed


As a result of increased interest in global health, more and more medical students and trainees from the 'developed world' are working and studying in the 'developing world'. However, while opportunities to do this important work increase, there has been insufficient development of ethical guidelines for students. It is often assumed that ethics training in developed world situations is applicable to health experiences globally. However, fundamental differences in both clinical and research settings necessitate an alternative paradigm of analysis. This article is intended for teachers who are responsible for preparing students prior to such experiences. A review of major ethical issues is presented, how they pertain to students, and a framework is outlined to help guide students in their work.

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    • "Despite the lack of sufficient ethical training for volunteers, there seems to be a consensus with regard to its importance. Thus, Pinto and Upshur (2009) argue that all organizations sending their volunteers on help and rescue missions across the globe should conduct ethical preparation. Cho et al. (2010) warn that without sufficient ethical awareness and relevant ethical skills volunteers can cause potential harm to patients and to the volunteers themselves. "

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    • "They may not understand their obligations or the research process, which could lead to a violation of research participants' rights or interests, harm to the student volunteers or research participants, or harm to the integrity of the research (e.g., protocol violations that might affect the integrity of the data). Inexperienced students are likely to be in no position to know whether or not a study serves the interests of the community or whether informed consent was obtained properly (Pinto and Upshur 2009). Students should be taught to know research when they see it, understand the importance of not participating in research when they are not trained members of the research team, know the basic tenets of research ethics, and have strategies for staying out of inappropriate participation in the conduct of human research. "
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    ABSTRACT: The popularity and availability of global health experiences has increased, with organizations helping groups plan service trips and companies specializing in "voluntourism," health care professionals volunteering their services through different organizations, and medical students participating in global health electives. Much has been written about global health experiences in resource poor settings, but the literature focuses primarily on the work of health care professionals and medical students. This paper focuses on undergraduate student involvement in short term medical volunteer work in resource poor countries, a practice that has become popular among pre-health professions students. We argue that the participation of undergraduate students in global health experiences raises many of the ethical concerns associated with voluntourism and global health experiences for medical students. Some of these may be exacerbated by or emerge in unique ways when undergraduates volunteer. Guidelines and curricula for medical student engagement in global health experiences have been developed. Guidelines specific to undergraduate involvement in such trips and pre-departure curricula to prepare students should be developed and such training should be required of volunteers. We propose a framework for such guidelines and curricula, argue that universities should be the primary point of delivery even when universities are not organizing the trips, and recommend that curricula should be developed in light of additional data.
    Full-text · Article · Jul 2014 · HEC Forum
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    • "What is at stake and what types of justification are required to support these practices? Given the political and historical background, and existing patterns of inequality, these practices require careful scrutiny (Emerson, Singer, & Upshur, 2011; Upshur, Lavery, & Tindana, 2007). "
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    ABSTRACT: Interest in global health is growing among students across many disciplines and fields of study. In response, an increasing number of academic programmes integrate and promote opportunities for international research, service or clinical placements. These activities raise a range of ethical issues and are associated with important training needs for those who participate. In this paper, we focus on research fieldwork conducted in lower income nations by students from more affluent countries and the ethics preparation they would benefit from receiving prior to embarking on these projects. Global health research is closely associated with questions of justice and equity that extend beyond concerns of procedural ethics. Research takes place in and is shaped by matrices of political, social and cultural contexts and concerns. These realities warrant analysis and discussion during research ethics training. Training activities present an opportunity to encourage students to link global health research to questions of global justice, account for issues of justice in planning their own research, and prepare for 'ethics-in-practice' issues when conducting research in contexts of widespread inequality. Sustained engagement with questions of justice and equity during research ethics training will help support students for involvement in global health research.
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