Document Detail


Ethical dilemmas in medical humanitarian practice: cases for reflection from Medecins Sans Frontieres.
MedLine Citation:
PMID:  21084354     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Médecins Sans Frontières (MSF) is an independent medical humanitarian organisation working in over 70 countries. It has provided medical assistance for over 35 years to populations vulnerable through conflict, disease and inadequate health systems. Medical ethics define the starting point of the relationship between medical staff and patients. The ethics of humanitarian interventions and of research in conflict settings are much debated. However, less is known about the ethical dilemmas faced by medical humanitarian staff in their daily work. Ethical dilemmas can be intensified in humanitarian contexts by insecure environments, lack of optimum care, language barriers, potentially heightened power discrepancies between care providers and patients, differing cultural values and perceptions of patients, communities and medical staff. Time constraints, stressful conditions and lack of familiarity with ethical frameworks can prevent reflection on these dilemmas, as can frustration that such reflection does not necessarily provide instant solutions. Lack of reflection, however, can be distressing for medical practitioners and can reduce the quality of care. Ethical reflection has a central role in MSF, and the organisation uses ethical frameworks to help with clinical and programmatic decisions as well as in deliberations over operational research. We illustrate and discuss some real ethical dilemmas facing MSF teams. Only by sharing and seeking guidance can MSF and similar actors make more thoughtful and appropriate decisions. Our aim in sharing these cases is to invite discussion and dialogue in the wider medical community working in crisis, conflict or with severe resource limitations.
Authors:
Julian Sheather; Tejshri Shah
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Publication Detail:
Type:  Journal Article     Date:  2010-11-17
Journal Detail:
Title:  Journal of medical ethics     Volume:  37     ISSN:  1473-4257     ISO Abbreviation:  J Med Ethics     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-02-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7513619     Medline TA:  J Med Ethics     Country:  England    
Other Details:
Languages:  eng     Pagination:  162-5     Citation Subset:  E; IM    
Affiliation:
Médecins Sans Frontières, 67-74 Saffron Hill, London, EC1N 8QX, UK. tejshrishah@gmail.com.
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