Summary of applied ethical precepts for the Rwandan context
| Precept | Applied indicators |
|---|---|
| Benefit | ▸ Save more lives ▸ Share benefit: contribute financially to family and community ▸ Advance local medical professionals’ expertise ▸ Develop international professional network ▸ Enhance nation's reputation for medical expertise and leadership in East African region ▸ Cause patients and families to smile |
| Harm | ▸ Poor outcomes, including death ▸ Demand for surgery exceeds available resources ▸ Inadequate access to postoperative services ▸ Divert limited operating-room time to RHD surgery ▸ Limited opportunities for postoperative jobs, education ▸ Prescribed medications incompatible with traditional diet |
| Justice | ▸ Selection criteria exclude certain groups ▸ Consider patient productivity in selection process ▸ Assist with copay ▸ Inability to address background injustices |
| Transparency | ▸ Openly disclose selection criteria ▸ Include multiple stakeholders in designating criteria for RHD surgery |
| Respect | ▸ Refer patients who are not chosen ▸ Follow-up and console patients not selected ▸ Honour family and community roles in patient-directed choice of treatment ▸ Respect choices of women to prioritise childbearing over longevity |
RHD, rheumatic heart disease.