Formal Training for Ethical Dilemmas in Global Health

Berkley, Holly; Zitzman, Elena; Jindal, Rahul M.

doi:10.1093/milmed/usy246

Cited by 12 publications

(7 citation statements)

References 9 publications

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“…While journalists and social media platforms provide a necessary voice, we, as the providers, have the expertise and the tools to evaluate ourselves. Even as we work towards improving outcomes reporting in HICs, we must also proactively promote safe and ethical surgery56 in LMICs as we join them in building their own surgical infrastructure.…”

Section: Discussionmentioning

confidence: 99%

Accountability in global surgery missions

2018

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Section: Discussionmentioning

confidence: 99%

Accountability in global surgery missions

2018

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“…Several armies have already integrated ethical discussions on the possible dilemmas faced by healthcare professionals in the eld into their training programs for overseas operations [43][44][45]. Operational preparations for French medical teams could be used as an opportunity for applied ethics in the form of moral case deliberation, to promote the ethics of discussion between healthcare personnel on the one hand and between healthcare and combat personnel on the other hand [46].…”

Section: Discussionmentioning

confidence: 99%

Ethical challenges faced by French military doctors deployed in the Sahel (Operation Barkhane): a qualitative study.

Lamblin

Derkenne

Trousselard

et al. 2021

Preprint

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Background French military doctors are currently deployed in the Sahel to support the armed forces of Operation Barkhane, in medical or surgical units. As well as supporting French soldiers, their other missions are diverse and complex: medical assistance to civilians and persons under control (PUC), advice to commanding officers. These tasks can create ethical dilemmas when decisions are forced upon doctors that may be in conflict with medical values or fundamental principles. Little is known about the specific dilemmas experienced by French military doctors in overseas operations. We therefore conducted a qualitative study among doctors and surgeons recently deployed to the Sahel to explore and better understand this question.Method Semi-structured, face-to-face interviews were conducted with 20 French military doctors or surgeons deployed since January 2016 in medical or surgical facilities in Mali and Chad. Results All interviewed doctors reported having faced several ethical dilemmas during missions. All reported dilemmas involved the treatment of civilians (while delivering community medical assistance) or of PUC. The dilemmas involved choices as to which patients to treat, the use of care as a means to an end by military authorities, and the level of care attainable in the absence of any possible hospital follow-up. Questions of delivering care at the risk of their own safety or the mission’s and of treating openly hostile patients were also brought up. Most dilemmas stemmed from the dual loyalty problem, namely the conflict between military doctors’ duty of care to patients and to the military institution. Contextual factors (restricted resources and security constraints) were also associated with many of the reported dilemmas. Conclusion This is the first reported study focusing on the ethical dilemmas encountered by French military doctors in overseas operations. It provides unique insights into their ethical experiences and should prove useful in improving operational training for healthcare personnel deployed on overseas missions.

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“…Overall, implementing community participation will improve the quality of research by ensuring that the interventions that are being tested are feasible, culturally acceptable and equitable, adhere to human rights, and are accessible to all segments of the local community. 13 Community participation will also enable accountability. 1 4 It is an accepted fact that there are limited supervisory systems, regulating poor outcomes after medical and surgical missions in LMICs.…”

Section: Implications Of Community Participationmentioning

confidence: 99%