The Ethics of Medical Volunteerism

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Key points

  • Thousands of health care providers volunteer annually for short-term medical service trips.

  • These trips have the potential to both benefit and harm those involved.

  • The context, resource and time limitations, and the language and cultural barriers present ethical challenges to volunteers.

  • Based on published guidelines and program descriptions, we propose some guiding principles that can inform and equip those engaging in medical volunteerism including mission, partnership, preparation, reflection,

Background

In April 2014, the NY Times Opinion Pages hosted a debate titled “Can ‘Voluntourism’ make a difference?.”1 In response to the growing trend of travelers from high-income countries opting to volunteer in low resource settings, the investigators in this series of opinion pieces set forth their answers to the question based on their experience and expertise on the ethics and impact of short-term volunteers. Similarly, National Public Radio labeled “voluntourism” as “one of the fastest growing

Context

There are many contextual features about medical volunteer work that can provide ethical challenges to volunteers. By the very nature of the work, volunteers travel to areas that lack resources including equipment, personnel, and infrastructure. This may be a short-term gap in the setting of a natural disaster or may be a longstanding shortage based on sociopolitical factors. Short-term volunteers may question the impact of MSTs that are only able to address the “symptoms of broader

Lessons from international research

Parallels have been drawn between short-term medical volunteerism and international clinical research including the ethical considerations of each. International research ethics have become established over the last 2 decades. In 1997, a debate on the ethical standards of international research came to the forefront after a placebo-controlled clinical trial that was conducted in developing countries focused on the prevention of mother-to-child HIV transmission. In this case, controversy focused

Principles for medical volunteerism

Meanwhile, the literature on MSTs has been growing with respect to best practices and guidelines. Suchdev and colleagues,54 based on their experience developing the Children’s Health International Medical Project of Seattle, proposed the guiding principles of mission, collaboration, education, service, teamwork, sustainability, and evaluation. The Working Group on Ethics Guidelines for Training Experiences in Global Health’s guidelines, published in 2010, further expanded these principles and

Summary

Those who write and talk about the dream of global health equity can make people think, but can not make them care. It is only through direct involvement with the poor in the developing world (or here at home) that medical students and others in the medical profession at large will find reasons to care and, ultimately, find ways to change the health of the world’s most vulnerable.

—Edward O’Neil25

Gustavo Gutiérrez, the father of liberation theology, once advised people to forget the “head trip”

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    Disclosure: The authors have nothing to disclose.

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