Bioethics Blogs

Global health porn: the case of Extreme Doctors

The last few years have seen a growing interest in the ethics of short-term medical missions in the developing world. Global health initiatives and programs in many universities often involve such missions, where medical students or faculty travel to a faraway lands (relatively resource-constrained, with high disease prevalence and fragile health infrastructure) and provide certain medical services, for awhile. These missions certainly enhance the prestige and attractiveness of Western medical institutions and schools of public health, and can improve the CV’s of those who participate in them. But those working in the field know such missions, particularly when embedded in longstanding partnerships, can also do some good. They also know that such missions can raise a number of serious ethical challenges that need to be addressed in advance, carefully thought through and continuously managed.

These ethical challenges include: students or doctors practicing beyond their competence; inadequate follow-up care for interventions that are provided, particularly for chronic conditions; disruption of local health systems and patient expectations; lack of correspondence between services provided and local health priorities; cultural clashes between Western views of medical need and local conceptions of health and disease. And so on. Further, since medical care is being dispensed by wealthy individuals and organizations to patients and communities that are relatively poor, questions about exploitation are never far away: who really benefits, or benefits the most, from these ‘exchanges’? How can such missions, however well-intentioned, avoid taking unfair advantage of the vulnerable? Efforts have been spent on developing ethical guidance, and while there are best practices for short-term global health missions out there, all this is clearly a work in progress.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.