Ethical Dilemmas in Global Health: Cases That Challenge Ethical Beliefs

Written by Dr. Sahand Arfaie, Critical Care Specialist and Co-Director of the Critical Care Unit at Essential Health-Fargo in North Dakota


Unfortunately, the Intensive Care Unit population here happens to be that of young lives in their twenties going about their day-to-day until they face motor vehicle accidents with little to no personal protection, resulting in severe injuries. Traumatic Brain Injury (TBI) is the bread and butter here in Mulago Hospital.

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Ethical Dilemmas in Global Health: Reader Response

Written by Dr. Lauris C. Kaldjian, Director of the Program in Bioethics and Humanities at the University of Iowa Carver College of Medicine


I recently spent two weeks at a mission hospital in rural Kenya, where detailed cost considerations are part of the daily experience of every patient. It is humbling to learn that a peasant farming family would have to sell two cows, worth about $150 each, to pay for an EGD plus stent to palliate dysphagia and prolong life in the setting of an inoperable esophageal cancer. But it is also highly encouraging to be at a hospital that demonstrates compassion and respect for life, one patient at a time, even in the midst of needs that regularly outpace resources- and where physicians, surgeons, and administrators provide any available emergency care whenever it is needed, even if payment cannot yet be provided (and, perhaps, will not be provided).

Ethical Dilemmas in Global Health: Reader Response

Written by Dr. Cyrus Kapadia, MD, FACP, AGAF, Professor Emeritus of Internal Medicine at Yale University


I was deeply moved by the post “Reading “Ethical Dilemmas in Global Health: Financial Barriers and Interventions” and disagreed with the points of view expressed until I read Dr. Mahsheed Khajavi’s perspective, which is exactly my own. As physicians, we definitely do need to be engaged in discussions that eventually lead to decisions made at a societal level. If we do not, then others will. However, faced with an individual situation involving the sacrosanct trust inherent to the doctor-patient relationship, every physician MUST make a decision that is best for the patient.

Reader Response: Upenyu Hunokosha

Written by Tendai Machingaidze, Associate Site Director for Zimbabwe University


What does it mean to have the ability to save a life and not do so? In Shona, we say “Upenyu hunokosha!” Life is precious! We cannot save the world, but we can certainly save a world – we can save a mother or a father or a child, and in so doing save a family, a world. But who is doing the saving? And how is it perceived?

Ethical Dilemmas in Global Health: The Monitoring of Reflections and Social Media Posts

Written by Dr. Stephen Winters, Director of Global Health at Norwalk Hospital, and Dr. Robert Kalyesubula, Founder of the African Community Center for Social Sustainability, Nakaseke, Uganda


From a series of discussions about ethical dilemmas in global health, with responses from one global health leader in the Global South and one in the Global North. Please leave us your feedback in the comments section below, and send us ethical dilemmas you would like to see discussed.

Reader Response: On Saving Life

Written by Dr. Mahsheed Khajavi, Associate Professor of Clinical Medicine at Florida State University


This ethical dilemma and responses moved me to tears. However, I feel that allowing a human being to die a preventable death is not morally consistent with medical mission work. The very fact that we choose certain countries and see a limited number of patients- as many as humanly possible in the allotted time, which still leaves hundreds unattended- implies that we are already making a decision regarding the allocation of resources. To carry the argument of nonfinancial intervention is antithetical to what is already being implemented: choosing a country and a select group of patients who will receive care.

Ethical Dilemmas in Global Health: Financial Barriers and Interventions

Written by Dr. Stephen Winters, and Dr. Robert Kalyesubula, Founder of the African Community Center for Social Sustainability, Nakaseke, Uganda


From a series of discussions about ethical dilemmas in global health, with responses from one global health leader in the Global South and one in the Global North. Please leave us your feedback in the comments section below, and send us ethical dilemmas you would like to see discussed.

Ethical Dilemmas in Global Health: Gender and Culture

Written by Dr. Stephen Winters, and Dr. Robert Kalyesubula, Founder of the African Community Center for Social Sustainability, Nakaseke, Uganda


From a series of discussions about ethical dilemmas in global health, with responses from one global health leader in the Global South and one in the Global North. Please leave us your feedback in the comments section below, and send us ethical dilemmas you would like to see discussed.

Ethical Dilemmas in Global Health: Bidirectional Safety

Written by Dr. Stephen Winters, and Dr. Robert Kalyesubula, Founder of the African Community Center for Social Sustainability, Nakaseke, Uganda


From a series of discussions about ethical dilemmas in global health, with responses from one global health leader in the Global South and one in the Global North. Please leave us your feedback in the comments section below, and send us ethical dilemmas you would like to see discussed.

Ethical Dilemmas in Global Health: Assessing Student Success and Safety in Global Health Programs

Written by Dr. Stephen Winters, and Dr. Robert Kalyesubula, Founder of the African Community Center for Social Sustainability, Nakaseke, Uganda


From a series of discussions about ethical dilemmas in global health, with responses from one global health leader in the Global South and one in the Global North. Please leave us your feedback in the comments section below, and send us ethical dilemmas you would like to see discussed.