Ethical considerations in global surgery

Steyn, E; Edge, Jenny

doi:10.1002/bjs.11028

Cited by 23 publications

(19 citation statements)

References 12 publications

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“…Global surgical collaboratives may be one effective means to facilitate and train local health workers to engage with such research and quality improvement endeavours,118 119 as at present, research from LMICs represents only about 4% of surgical literature 120. However, a genuine sense of collaboration can be achieved by encouraging locally driven and locally accessible research and quality improvement 121.…”

Section: Future Health Policy and Research In Global Surgerymentioning

confidence: 99%

What is ‘global surgery’? Defining the multidisciplinary interface between surgery, anaesthesia and public health

Bath

Bashford

Fitzgerald³

2019

BMJ Glob Health

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‘Global surgery’ is the term adopted to describe a rapidly developing multidisciplinary field aiming to provide improved and equitable surgical care across international health systems. Sitting at the interface between numerous clinical and non-clinical specialisms, it encompasses multiple aspects that surround the treatment of surgical disease and its equitable provision across health systems globally. From defining the role of, and need for, optimal surgical care through to identifying barriers and implementing improvement, global surgery has an expansive remit. Advocacy, education, research and clinical components can all involve surgeons, anaesthetists, nurses and allied healthcare professionals working together with non-clinicians, including policy makers, epidemiologists and economists. Long neglected as a topic within the global and public health arenas, an increasing awareness of the extreme disparities internationally has driven greater engagement. Not necessarily restricted to specific diseases, populations or geographical regions, these disparities have led to a particular focus on surgical care in low-income and middle-income countries with the greatest burden and needs. This review considers the major factors defining the interface between surgery, anaesthesia and public health in these settings.

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Section: Future Health Policy and Research In Global Surgerymentioning

confidence: 99%

What is ‘global surgery’? Defining the multidisciplinary interface between surgery, anaesthesia and public health

Bath

Bashford

Fitzgerald³

2019

BMJ Glob Health

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“…While conferences and workshops foster collaboration and excitement, a method for structured and systematic local innovation that focuses on engaging professionals and students from low-resource settings lacks. As a result, there is a large gap in which the local individuals who experience the challenges in surgical care and who are potentially best positioned to solve these problems are often not invested in or fully engaged by resource-rich institutions and actors 8. It is the local change agents that global surgery needs the most, and innovation cannot tangibly or sustainability change surgical care and health systems for the better if it is passively ‘transferred’ from high to low-resource settings.…”

Section: The Needmentioning

confidence: 99%

Surgathon: a new model for creating a surgical innovation ecosystem in low-resource settings

et al. 2020

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Innovation ecosystems and emerging technologies can potentially accelerate the access to safe, affordable surgical care in low-resource settings. There is a need to develop localised innovation ecosystems that can establish an initial culture and catalyse the creation, adoption and diffusion of innovation. The surgathon model outlines one approach to seeding surgical innovation ecosystems. International academic institutions collaborated on six global surgery, innovation and ethics-themed hackathons (‘surgathons’) across India and Rwanda between 2016 and 2019. Over 1598 local multidisciplinary students participated, learning about challenges in the delivery of surgical care and ideating solutions that could leverage appropriate technology and resources for impact. Pursuing student ideas and evaluating their implementation past the surgathons continues to be an active effort. Surgathons have unfolded in different permutations based on local faculty, institution and health system context. The surgathon model is a novel method of priority setting challenges in global surgery and utilises locally driven expertise and innovation capacity to derive ethical solutions. The model offers a path for low-resource setting students and faculty to learn, advocate and innovate for improved surgical care.

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“…Ethical issues are to some degree dependent upon the location and culture of the country you are assisting (76). Some cultural beliefs espouse a policy of no withdrawal of life support even in patients declared brain dead.…”

Section: Program Modelsmentioning

confidence: 99%

Pediatric Cardiac Service Development Programs for Low- and Middle-Income Countries in Need of Improving or Initiating Local Services

Novick

Molloy

Bowtell³

et al. 2019

Front. Pediatr.

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Pediatric cardiac services are deficient in most of the world. Various estimates are that between 80 and 90% of the world's children do not receive adequate cardiac care for their congenital or acquired heart disease. We began a modest effort in 1992 to assist in the development of pediatric cardiac services in low- and middle-Income countries (LMIC). Since then, we have provided services in 32 countries based on 3 distinctive development strategies, in order to meet the local needs for pediatric cardiac services. Our goal has always been to provide education, training and sufficient experience so that eventually we leave a site with a fully functional, independently operating pediatric cardiac service that is sustainable over time. The margin between success and failure is dependent upon a number of factors and we hope that this chapter will provide others with the tools for success.

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Ethical considerations in global surgery

Abstract: Six key principles, seven sins

Cited by 23 publications

References 12 publications

What is ‘global surgery’? Defining the multidisciplinary interface between surgery, anaesthesia and public health

What is ‘global surgery’? Defining the multidisciplinary interface between surgery, anaesthesia and public health

Surgathon: a new model for creating a surgical innovation ecosystem in low-resource settings

Pediatric Cardiac Service Development Programs for Low- and Middle-Income Countries in Need of Improving or Initiating Local Services

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