Objective: International non-governmental organizations frequently provide emergency assistance in settings where armed conflict or natural disaster overwhelm the capacity of local and national agencies to respond to health and related needs of affected communities. Health care practice in humanitarian settings presents distinct clinical, logistical and ethical challenges for clinicians and differs in important ways from clinical practice in the home countries of expatriate health care professionals. The aim of this research was to examine the moral experience of health care professionals who participate in humanitarian relief work. Design: I conducted a qualitative research study using interpretive description methodology. Participants: Fifteen Canadian health care professionals, and three human resource or field coordination officers for non-governmental organizations were interviewed. Results: In this paper, I present findings related to expatriate health care professionals’ experiences of resources and constraints for addressing ethical issues in humanitarian crises. Resources for ethics deliberation and reflection include: opportunities for discussion; accessing and understanding local perspectives; access to outside perspectives; attitudes such as humility, open-mindedness and reflexivity; and development of good moral “reflexes.” Constraints for deliberation and reflection relate to three domains: individual considerations, contextual features of humanitarian relief work, and local team and project factors. Conclusion: These findings illuminate the complex nature of ethical reflection, deliberation and decision-making in humanitarian health care practice. Health care professionals and relief organizations should seek to build upon resources for addressing ethical issues. When possible, they should minimize the impact of features that function as constraints.
- health care professionals,
- humanitarian emergencies,
- natural disasters,
- non-governmental organizations,
- qualitative research
Available at: http://works.bepress.com/matthew_hunt/9/