http://hdl.handle.net/10144/75857 Tue, 18 Jun 2013 23:18:12 GMT 2013-06-18T23:18:12Z http://hdl.handle.net/10144/228079 Title: Why ethics is indispensable for good-quality operational research [Short communication] Authors: Edginton, M.; Enarson, D.; Zachariah, R.; Reid, T.; Satyanarayana, S.; Bissell, K.; Hinderaker, S. G.; Harries, A.D. Thu, 01 Mar 2012 00:00:00 GMT http://hdl.handle.net/10144/228079 2012-03-01T00:00:00Z http://hdl.handle.net/10144/220022 Title: Ethical dilemmas in medical humanitarian practice: cases for reflection from Médecins Sans Frontières. Authors: Sheather, Julian; Shah, Tejshri Abstract: 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. Tue, 01 Mar 2011 00:00:00 GMT http://hdl.handle.net/10144/220022 2011-03-01T00:00:00Z http://hdl.handle.net/10144/77453 Title: Research Ethics and International Epidemic Response: The Case of Ebola and Marburg Hemmorrhagic Fevers Authors: Calain, P; Fiore, N; Poncin, M; Hurst, S Abstract: Outbreaks of filovirus (Ebola and Marburg) hemorrhagic fevers in Africa are typically the theater of rescue activities involving international experts and agencies tasked with reinforcing national authorities in clinical management, biological diagnosis, sanitation, public health surveillance and coordination. These outbreaks can be seen to be as a paradigm for ethical issues posed by by epidemic emergencies, through the convergence of such themes as: isolation and quarantine, privacy and confidentiality and the interpretation of ethical norms across different ethnocultural settings. With an emphasis on the boundaries between public health investigations and research, this article reviews specific challenges, past practices and current normative documents relevant to the application of ethical standards in the course of outbreaks of filovirus hemorrhagic fevers. Aside from the commonly identified issues of informed consent, and institutional review process, we argue for more clarify over the specification of which communities are expected to share benefits, and we advocate for the use of collective definitions of duty to care and standard of care. We propose new elaborations around existing normative instruments, and we suggest some pathways toward more comprehensive approaches to the ethics of research in outbreak situations. Description: To access this article, click on "Additional Links". Sat, 01 Aug 2009 00:00:00 GMT http://hdl.handle.net/10144/77453 2009-08-01T00:00:00Z http://hdl.handle.net/10144/75860 Title: Research ethics review in humanitarian contexts: the experience of the independent ethics review board of Médecins Sans Frontières. Authors: Schopper, Doris; Upshur, Ross; Matthys, Francine; Singh, Jerome Amir; Bandewar, Sunita Sheel; Ahmad, Aasim; van Dongen, Els Wed, 15 Jul 2009 00:00:00 GMT http://hdl.handle.net/10144/75860 2009-07-15T00:00:00Z