Abstract
Global short-term medical volunteerism is growing, and properly conducted, is a tool in the fight for greater global health equity. It is intrinsically “ethical” (i.e., it involves ethics at every step) and depends upon ethical conduct for its success. At present, ethical guidelines remain in their infancy, which presents a unique opportunity. This paper presents a set of basic ethical principles, building on prior work in this area and previously developed guidelines for international clinical research. The content of these principles, and the benchmarks used to evaluate them, remain intentionally vague and can only be filled by collaboration with those on-the-ground in local communities where this work occurs. Ethical review must additionally take into consideration the different obligations arising from the type of institution, type of intervention, and type of relationship involved. This paper argues that frequent and formalized ethical review, conducted from the beginning with the local community (where this community helps define the terms of debate), remains the most important ethical safeguard for this work.
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References
Angell, M. (1997). The ethics of clinical research in the third world. New England Journal of Medicine, 337, 847–849.
Benatar, S., & Brock, G. (2011). Global health ethics. Cambridge: Cambridge University Press.
Board on Global Health. (2009). The U.S. commitment to global health: Recommendations for the public and private sector. Washington, D.C.: The National Academies Press.
Buchanan, A. (1987). Justice and charity. Ethics, 97, 558–575.
Council for International Organisations of Medical Sciences (CIOMS). (2002). International ethical guidelines for biomedical research involving human subjects. Geneva: CIOMS.
Crump, J. A., & Sugarman, J. (2008). Ethical considerations for short-term experiences by trainees in global health. Journal of the American Medical Association, 300(12), 1456–1458.
DeCamp, M. (2007). Scrutinizing global short-term medical outreach. Hastings Center Report, 37(6), 21–23.
Dickert, N., & Wendler, D. (2009). Ancillary care obligations of medical researchers. Journal of the American Medical Association, 302(4), 424–428.
Emanuel, E. J., Wendler, D., Killen, J., & Grady, C. (2004). What makes clinical research in developing countries ethical? The Journal of Infectious Diseases, 189, 930–937.
Hyder, A. A., & Merritt, M. W. (2009). Ancillary care for public health research in developing countries. Journal of the American Medical Association, 302(4), 429–431.
Jesus, J. E. (2010). Ethical challenges and considerations of short-term international medical initiatives: An excursion to Ghana as a case study. Annals of Emergency Medicine, 55(1), 17–22.
Koplan, J. P., Bond, C. T., Merson, M. H., Reddy, K. S., Rodriguez, M. H., Sewankambo, N. K., et al. (2009). Towards a common definition of global health. Lancet, 373, 1993–1995.
Levine, C. (1998). Placebos and HIV. Hastings Center Report, 18(6), 43–48.
Macklin, R. (2004). Double standards in medical research in developing countries. Cambridge: Cambridge University Press.
Montgomery, L. M. (1993). Short-term medical missions: Enhancing or eroding health? Missiology: An International Review, 21(3), 333–341.
National Bioethics Advisory Commission. (2001). Ethical and policy issues in international research: Clinical trials in developing countries. Bethesda, MD: NBAC.
Nelson, B. D., Lee, A., Newby, P. K., Chamberlin, M. R., & Huang, C. C. (2008). Global health training in pediatric residency programs. Pediatrics, 122, 28–33.
Nuffield Council on Bioethics. (2002). The ethics of research related to healthcare in developing countries. London: Nuffield Council on Bioethics.
Ravishankar, N., Gubbins, P., Cooley, R. J., Leach-Kemon, K., Michaud, C. M., Jamison, D. T., et al. (2009). Financing of global health: Tracking development assistance for health from 1990 to 2007. Lancet, 373, 2113–2124.
Singer, P. (1972). Famine, affluence, and morality. Philosophy & Public Affairs, 1(1), 229–243.
Suchdev, P., Ahrens, K., Click, E., Macklin, L., Evangelista, D., & Graham, E. (2007). A model for sustainable short-term international medical trips. Ambulatory Pediatrics, 7, 317–320.
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DeCamp, M. Ethical Review of Global Short-Term Medical Volunteerism. HEC Forum 23, 91–103 (2011). https://doi.org/10.1007/s10730-011-9152-y
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DOI: https://doi.org/10.1007/s10730-011-9152-y