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Moral Experience of Canadian Healthcare Professionals in Humanitarian Work

Published online by Cambridge University Press:  28 June 2012

Matthew R. Hunt
Matthew R. Hunt*
Affiliation:
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
*
Department of Clinical Epidemiology and BiostatisticsMcMaster University1200 Main Street WestHSC 3V43B Hamilton, Ontario, Canada L8N 3Z5 E-mail: 1matthew.hunt@gmail.com
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Abstract

Introduction:

Expatriate healthcare professionals frequently participate in international relief operations that are initiated in response to disasters due to natural hazards or humanitarian emergencies in low resource settings. This practice environment is significantly different from the healthcare delivery environment in the home countries of expatriate healthcare professionals. Human rights, public health, medicine, and ethics intersect in distinct ways as healthcare professionals provide care and services in communities affected by crisis.

Purpose:

The purpose of this study was to explore the moral experience of Canadian healthcare professionals during humanitarian relief work.

Methods:

This is a qualitative study with 18 semi-structured individual interviews based on Interpretive Description methodology. There are two groups of participants: (1) 15 healthcare professionals (nine doctors, five nurses, and one midwife) with more than three months experience in humanitarian work; and (2) three individuals who have experience as human resource or field coordination officers for humanitarian, non-governmental organizations. Participants were recruited by contacting non-governmental organizations, advertisement at the global health interest group of a national medical society, word of mouth, and a snowball sampling approach in which participants identified healthcare professionals with experience practicing in humanitarian settings who might be interested in the research.

Results:

Five central themes were identified during the analysis: (1) examination of motivations and expectations; (2) the relational nature of humanitarian work; (3) attending to steep power imbalances; (4) acknowledging and confronting the limits of what is possible in a particular setting; and (5) recognition of how organizational forms and structures shape everyday moral experience.

Discussion:

Humanitarian relief work is a morally complex activity. Healthcare professionals who participate in humanitarian relief activities, or who are contemplating embarking on a humanitarian project, will benefit from carefully considering the moral dimensions of this work. Humanitarian organizations should address the moral experiences of healthcare professionals in staff recruitment, as they implement training prior to departure, and in supporting healthcare professionals in the field.

Keywords

emergencyethicshealthcare professionalhumanitarianmoral experiencenatural hazardnon-governmental organization
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 24 , Issue 6 , December 2009 , pp. 518 - 524
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2009

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References

1. Brennan, RJ, Nandy, R: Complex humanitarian emergencies: A major global health challenge. Emerg Med J 2001;13:147–156.Google Scholar
2. Toole, MJ: Mass population displacement: A global public health challenge. Infect Dis Clin North Am 1995;9:353–365.Google Scholar
3. Sondorp, E, Kaiser, T, Zwi, A: Beyond emergency care: Challenges to health planning in complex emergencies. Trop Med Int Health 2001;6(12):965–970.CrossRefGoogle ScholarPubMed
4. Banatvala, N, Zwi, AB: Public health and humanitarian interventions: Developing the evidence base. BMJ 2000;321:101–105.CrossRefGoogle ScholarPubMed
5. Pantuliano, S, O'Callaghan, S: The ‘protection crisis’: A review of field-based strategies for humanitarian protection in Darfur. Overseas Development Institute: London. Humanitarian Policy Group. Discussion Paper, 2006.Google Scholar
6. Bjerneld, M, Lindmark, G, Diskett, P, Garrett, MJ: Perceptions of work in humanitarian assistance: Interviews with returning Swedish health professionals. Disaster Manag Response 2004;2:101–108.CrossRefGoogle ScholarPubMed
7. Petrasek, D: Moving Forward on the development of minimum humanitarian standards. Am J Int Law 1998;92(3):557–563.CrossRefGoogle Scholar
8. Sphere Project: The Humanitarian Charter and Minimum Standards in Disaster Response. Available at http://www.sphereproject.org. Accessed 04 August 2008.Google Scholar
9. Humanitarian Accountability Partnership–International. Available at http://www.hapinternational.org. Accessed 25 August 2008.Google Scholar
10. Moore, J, (ed): Hard Choices: Moral Dilemmas in Humanitarian Intervention. Lanham, Maryland: Rowman and Littlefield Publishers, 1998.Google Scholar
11. International Federation of Red Cross and Red Crescent Societies (IFRC): World Disasters Report 2003. Focus on ethics in aid. Geneva: IFRC, 2003.Google Scholar
12. Slim, H: Doing the right thing: Relief agencies, moral dilemmas, and moral responsibility in political emergencies and war. Disasters 1997;21(3):244–257.CrossRefGoogle ScholarPubMed
13. Hunt, MR: Ethics beyond borders: How health professionals experience ethics in humanitarian assistance and development work. Dev World Bioeth 2008;8(2):59–69.CrossRefGoogle ScholarPubMed
14. Fox, RC, Goemaere, E: They call it “patient selection” in Khayelitsha: The experience of Médecins sans Frontières–South Africa in enrolling patients to receive antiretroviral treatment for HIV/AIDS. Camb Q Healthc Ethics 2006;15:302–312.Google Scholar
15. Michael, M, Zwi, AB: Oceans of need in the desert: Ethical issues identified while researching humanitarian agency response in Afghanistan. Dev World Bioethics 2002;2(2):109–130.Google Scholar
16. Carnevale, FA, Canouï, P, Hubert, P, et al. : The moral experience of parents regarding life-support decisions for their critically-ill children: A preliminary study in France. J Child Health Care 2006;10:69–82.CrossRefGoogle ScholarPubMed
17. Thorne, S: Interpretive Description. Walnut Creek, CA: Left Coast Press, 2008.Google Scholar
18. Thorne, S, Reimer Kirkham, S, O'Flynn-Magee, K: The analytic challenge in interpretive description. Int J Qualitative Methods 2004;3(1):1337–1352.CrossRefGoogle Scholar
19. Glaser, BG, Strauss, AL: The Discovery of Grounded Theory: Strategies for Qualitative Research. Chicago, IL: Aldine, 1967.Google Scholar
20. Lincoln, YS, Guba, EG: Naturalistic Inquiry. Beverly Hills, CA: Sage, 1985.Google Scholar
21. Hilhorst, D, Schmiemann, N: Humanitarian principles and organizational culture: Everyday practice in Médecins sans Frontières-Holland. Development in Practice 2002;12(3–4):490–500.CrossRefGoogle Scholar
22. Birch, M, Miller, S: Humanitarian assistance: Standards, skills, training, and experience. BMJ 2005;330:1199–1201.Google Scholar
23. Moresky, RT, Eliades, MJ, Bhimani, MA, et al. : Preparing international relief workers for healthcare in the field: An evaluation of organizational practices. Prehosp Disaster Med 2001;16(4):257–262.Google Scholar