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Title: Ethical dilemmas in medical humanitarian practice: cases for reflection from Médecins Sans Frontières.
Authors: Sheather, Julian
Shah, Tejshri
Affiliation: British Medical Association, Ethics Department, BMA House, London, UK.
Citation: Ethical dilemmas in medical humanitarian practice: cases for reflection from Médecins Sans Frontières. 2011, 37 (3):162-5 J Med Ethics
Journal: Journal of Medical Ethics
Issue Date: Mar-2011
DOI: 10.1136/jme.2010.038448
PubMed ID: 21084354
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.
Language: en
MeSH: Altruism
Attitude of Health Personnel
Cross-Cultural Comparison
Delivery of Health Care
Developing Countries
Ethics, Medical
International Agencies
Medical Missions, Official
Patient Rights
ISSN: 1473-4257
Rights: Archived with thanks to The British Medical Association and the Journal of Medical Ethics
Appears in topics: Ethics

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