Annals of Emergency Medicine
Volume 55, Issue 1 , Pages 17-22 , January 2010

Ethical Challenges and Considerations of Short-Term International Medical Initiatives: An Excursion to Ghana as a Case Study

  • John E. Jesus, MD

      Affiliations

    • Corresponding Author InformationAddress for correspondence: John E. Jesus, MD, Beth Israel Deaconess Medical Center, Department of Emergency Medicine, 1 Deaconess Road, Boston, MA 02215; 617-754-2351; Fax 617-754-2350

References 

  1. Drain P, Primack A, Hunt D, et al. Global health in medical education: a call for more training and opportunities. Acad Med. 2007;82:226–230
  2. Crump J, Sugarman J. Ethical considerations of short-term experiences by trainees in global health. JAMA. 2008;300:1456–1458
  3. Levine C, Becker J, Lippert S, et al. International emergency medicine: a review of the literature from 2007. Acad Emerg Med. 2008;15:860–865
  4. Walker D, Tolentino V, Teach S. Trends and challenges in international pediatric emergency medicine. Curr Opin Pediatr. 2007;19:247–252
  5. Ban K, Pini R, Sanchez L, et al. The Tuscan Emergency Medicine Initiative. Ann Emerg Med. 2007;50:726–732
  6. Alagappan K, Schafermeyer R, Holliman J, et al. International emergency medicine and the role for academic emergency medicine. Acad Emerg Med. 2007;14:451–456
  7. Smith J, Shokoohi H, Holliman J. The search for common ground: developing emergency medicine in Iran. Acad Emerg Med. 2007;14:457–462
  8. Suchdev P, Ahrens K, Click E, et al. A model for sustainable short-term international medical trips. Ambul Pediatr. 2007;7:317–320
  9. Beauchamp T, Childress J. Principles of Biomedical Ethics. 6th ed.. Oxford University Press; 2009;
  10. US National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. The Belmont Report: Ethical Guidelines for the Protection of Human Subjects of Research. Washington, DC: US Government Printing Office; 1979;Publication No. (OS) 78-0012
  11. Jacobs E, Chen A, Karliner L, et al. The need for more research on language barriers in health care: a proposed research agenda. Milbank Q. 2006;84:111–133
  12. Padela A, Imran R, Punekar B. Emergency medical practice: advancing cultural competence and reducing health care disparities. Acad Emerg Med. 2009;16:69–75
  13. Arras J. Noncompliance in AIDS research. Hastings Cent Rep. 1990;20:24–32
  14. Nguyen G, LaVeist TA, Harris ML, et al. Patient trust-in-physician and race are predictors of adherence to medical management in inflammatory bowel disease. Inflamm Bowel Dis. 2009;15:1233–1239
  15. Rentmeester CA. Case study (Trust, translation and HAART. Commentary). Hastings Cent Rep. 2008;38:13–14
  16. Gordon R. Languages of Ghana. In:  Paul LM editors. Languages of the World. 15th ed.. Dallas, TX: SIL International; 2005;Available at: http://www.ethnologue.com. Accessed September 10, 2008.
  17. Schiano T. Hepatotoxicity and complementary alternative medicines. Clin Liver Dis. 2003;7:453–473
  18. Ritchie E, Robert M. Military humanitarian assistance: the pitfalls and promise of good intentions. In:  Beam T editors. Military Medical Ethics. Vol 2:Washington, DC: The Surgeon General At TMM Publications. Borden Institute. Walter Reed Army Medical Center; 2004;p. 805–830
  19. Childress J. Triage in response to bioterrorist attack. In:  Moreno J editors. In the Wake of Terror: Medicine and Morality in a Time of Crisis. Cambridge, MA: MIT Press; 2003;p. 72–93
  20. Blumberg H, Burman W, Chaisson R, et al. American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: treatment of tuberculosis. Am J Respir Crit Care Med. 2003;167:603–662
  21. Shin S, Furin J, Bayona J, et al. Community-based treatment of multidrug-resistant tuberculosis in Lima, Peru: 7 years of experience. Soc Sci Med. 2004;59:1529–1539
  22. Wall L, Arrowsmith S, Lassey A, et al. Humanitarian ventures of “fistula tourism?”: the ethical perils of pelvic surgery in the developing world. Int Urogynecol J Pelvic Floor Dysfunct. 2006;17:559–562
  23. Dupuis C. Humanitarian missions in the Third World: a polite dissent. Plast Reconstr Surg. 2004;113:433–435
  24. Bishop R, James L. Medical tourism can do harm. BMJ. 2000;320:1017
  25. Klufio C, Kwawukume E, Danso K, et al. Ghana postgraduate obstetrics/gynecology collaborative residency training program: success story and model for Africa. Am J Obstet Gynecol. 2003;189:692–696
  26. Anderson F, Mutchnick I, Kwawukume E, et al. Who will be there when women deliver? (assuring retention of obstetric providers). Obstet Gynecol. 2007;110:1012–1016
  27. Federation of State Medical Boards. State of the states: physician regulation 2008. http://www.fsmb.org/pdf/States_2008.pdfAccessed April 21, 2008
  28. Roberts M. Duffle bag medicine. JAMA. 2006;295:1491–1492
  29. Council for International Organizations of Medical Sciences. International Ethical Guidelines for Biomedical Research Involving Human Subjects. Geneva, Switzerland: Council for International Organizations of Medical Sciences; 2002;Available at: http://www.cioms.ch/frame_guidelines_nov_2002.htm. Accessed September 10, 2008
  30. Sherwood G, Brown M, Fay V, et al. Defining nurse practitioner scope of practice: expanding primary care services. Internet J Adv Nurs Pract. 1997;1:
  31. American Academy of Nurse Practitioners. Scope of Practice for Nurse Practitioners. Washington, DC: American Academy of Nurse Practitioners; 1993;Revised in 2007. Available at: http://www.aanp.org/NR/rdonlyres/FCA07860-3DA1-46F9-80E6-E93A0972FB0D/0/Scope_of_Practice.pdf. Accessed April 25, 2008
  32. Nyonator F, Awoonor-Williams J, Phillips J, et al. The Ghana Community-based Health Planning and Services Initiative for scaling up service delivery innovation. Health Policy Plan. 2005;20:25–34
  33. Pinto A, Upshur R. Global health ethics for students. Dev World Bioeth. 2009;9:1–10
  34. Decamp M. Scrutinizing global short-term medical outreach. Hastings Cent Rep. 2007;37:21–23
  35. Thompson M, Huntington M, Hunt D, et al. Educational effects of international health electives on US and Canadian medical students and residents: a literature review. Acad Med. 2003;78:342–347
  36. Smith J, Weaver D. Capturing medical students' idealism. Ann Fam Med. 2006;4(suppl 1):S32–S37
  37. Gupta A, Wells C, Horwitz R, et al. The International Health Program: the fifteen-year experience with Yale University's internal medicine residency program. Am J Trop Med Hyg. 1999;61:1019–1023
  38. Miller W, Corey R, Lallinger G. International health and internal medicine residency training: the Duke University experience. Am J Med. 1995;99:291–297

 section editor: Debra E. Houry, MD, MPH

 Supervisng editors: Suzanne L. Lippert, MD, MS; Donald M. Yealy, MD

 Funding and support: By Annals policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article that might create any potential conflict of interest. See the Manuscript Submission Agreement in this issue for examples of specific conflicts covered by this statement. Supported in part by a grant from the University of Virginia Medical Alumni Association; funding also received from the University of Virginia School of Medicine.

 Publication date: Available online August 21, 2009.

 Reprints not available from the author.

PII: S0196-0644(09)01259-1

doi: 10.1016/j.annemergmed.2009.07.014

Annals of Emergency Medicine
Volume 55, Issue 1 , Pages 17-22 , January 2010

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