Jennifer Ranford

Ethical issues encountered by medical students during international health electives

Medical Education 2011: 45: 704–711

Ethics in humanitarian aid work: learning from the narratives of humanitarian health workers

Little analysis has been made of ethical challenges encountered by health care professionals (HCPs) participating in humanitarian aid work. This is a qualitative study drawing on Grounded Theory analysis of 20 interviews with health care professionals who have provided humanitarian assistance. We collected the stories of ethical challenges reported by expatriate HCPs who participated in humanitarian and development work. Analysis of the stories revealed that ethical challenges emerged from four main sources: (a) resource scarcity and the need to allocate them, (b) historical, political, social and commercial structures, (c) aid agency policies and agendas, and (d) perceived norms around health professionals’ roles and interactions. We discuss each of these sources, illustrating with quotes from the respondents the consequences of the ethical challenges for their personal and professional identities. The ethical challenges described by the respondents are both familiar and distinct for bioethics. The findings demonstrate a need to provide practical ethics support for humanitarian health care workers in the field.

Preventing Fetal Alcohol Spectrum Disorder in Aboriginal Communities: A Methods Development Project

The authors describe their three-year project working collaboratively with Aboriginal communities to prevent fetal alcohol spectrum disorder.

Walking a tightrope: oncologists’ perspective on providing information to women with recurrent ovarian cancer (ROC) during the medical encounter

PurposeWomen with ovarian cancer (OC) must make treatment decisions. The first step in this process involves information giving about potential management choices. In this study, our objectives were to (1) describe the key issues that are reviewed by the oncologist when a woman presents with recurrent OC and (2) understand the extent to which physicians have different methods of giving information to patients.MethodsA descriptive qualitative study of 19 gynecologic and medical oncologists in Ontario, Canada was undertaken using a semi-structured interview guide.ResultsOncologists felt that the process of information giving was an important part of the medical encounter. The main themes that emerged from our data were (1) Oncologists varied in their approach to giving information about the disease and management; (2) oncologists felt that giving management choices to the patients helped engage patients in dealing with their disease and moving forward; (3) oncologists felt it was important to foster patients hope; and (4) oncologists struggled with how much clinical outcome information to give to patients.ConclusionsOncologists tried to achieve a difficult balance between providing patients with several management choices in order to help them keep hope alive and providing them with realistic clinical information suggesting poor patient outcomes. Areas for future research include exploring (1) how physicians can best walk this tightrope of information giving, (2) how to assess physician “success” in doing so, and (3) the meaning of fostering hope to patients and physicians in the context of treatment decision making.

(A113) Ethics in the Delivery of Humanitarian Health Response: Learning from the Narratives of Health Care Workers

Prehospital and Disaster Medicine Vol. 26, Supplement 1 hospital or community-based care setting for a limited period of time and then return to their homes for convalescence. Of particular importance are that these protocols applicable to all public health emergencies and do not rely on the active presence of physicians at the alternate care site to render care. Conclusion: The development of consistent standards of care and the ability to care for patients in an out-of-hospital setting during a pandemic or public health emergency is essential to preserve the sustained operation of acute care hospitals and the entire healthcare system. Diverting patients to a community-based alternate care site or encouraging the early discharge of patients to these locations can assist in managing the large numbers of casualties anticipated during a pandemic or public health crisis. Prehosp Disaster Med 2011;26(Suppl. 1):s31–s32 doi:10.1017/S1049023X11001142