Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-28T11:01:00.080Z Has data issue: false hasContentIssue false

Chapter 32 - Ethical Dilemmas in Field Hospital Deployments

from Section 5 - Additional Contextual Considerations

Published online by Cambridge University Press:  09 January 2020

By
Ofer Merin ,
Avraham Steinberg  and
Dan Hanfling
Edited by
Elhanan Bar-On ,
Kobi Peleg  and
Yitshak Kreiss
Elhanan Bar-On
Affiliation:
The Israel Center for Disaster Medicine and Humanitarian Response, Sheba Medical Center, Tel Hashomer, Israel
Kobi Peleg
Affiliation:
National Center for Trauma & Emergency Medicine Research, The Gertner Institute for Health Policy and Epidemiology and Tel-Aviv University, Disaster Medicine Department
Yitshak Kreiss
Affiliation:
Sheba Medical Center, Tel Hashomer, Israel
Get access

Summary

Disasters are inevitable. Health-care providers operating in disaster zones must make decisions that are unique and different from those encountered in their routine health-care work environment. Treatment decisions made under disaster conditions must reflect available resources. Clinical practice is mainly concerned with individuals while the focus of humanitarian aid is on populations. In the context of disasters with limited resources there might be a conflict between individual rights and community benefit. Teams operating in devastated zones should be aware that their health-care providers will become fully engaged with such dilemmas. Ethical issues should be identified, and individuals should be prepared to confront them. Preparedness to deal with these will allow: better medical care, higher ethical standards, and better accountability to patients. Awareness and identification of ethical issues will help health care personnel to alleviate some of the burden of confrontation with these expected issues. It is strongly recommended to organizations involved in humanitarian assistance to set clear international standards such as those by Sphere and the WHO and to train personnel to deal with these issues.

Keywords

Disastersethical dilemmaslimited resourcesaccountability
Type
Chapter
Information
Field Hospitals
A Comprehensive Guide to Preparation and Operation
 , pp. 304 - 312
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Clarinval, C, Biller-Andorno, N. Challenging operations: an ethical framework to assist humanitarian aid workers in their decision-making processes. PLOS Currents 2014: 23: 6.Google Scholar
World Medical Association. Statement on medical ethics in the event of disasters adopted by the forty-sixth World Medical Association general assembly. https://www.wma.net/policies-post/wma-statement-on-medical-ethics-in-the-event-of-disasters/Google Scholar
International Federation of Red Cross and Red Crescent Societies (IFRC). Strategy. http://www.ifrc.org/Global/Publications/general/strategy-2020.pdfGoogle Scholar
American Medical Association. The AMA code of medical ethics. Online article. https://www.ama-assn.org/about-us/code-medical-ethicsGoogle Scholar
Beauchamp, TL, Childress, JF. Principles of Biomedical Ethics. Fifth edn. Oxford: Oxford University Press; 2001Google Scholar
Sphere. Minimum standards in health action. https://spherestandards.org/wp-content/uploads/Sphere-Handbook-2018-EN.pdfGoogle Scholar
Code of conduct for the International Red Cross and Red Crescent Movement and non-governmental organizations (NGOs) in disaster relief. http://www.ifrc.org/en/publications-and-reports/code-of-conduct/Google Scholar
Proceedings of the WHO/PAHO technical consultation on international foreign medical teams (FMTs) post sudden onset disasters (SODs). http://reliefweb.int/sites/reliefweb.int/files/resources/Cuba%20Meeting%20Proceedings_FMT.pdfGoogle Scholar
Gerdin, M, Wladis, A, von Schreeb, J. Foreign field hospitals after the 2010 Haiti earthquake: how good were we? Emergency Medicine Journal 2013: 30(1).CrossRefGoogle Scholar
Redmond, AD, Mardel, S, Taithe, B, et al. A qualitative and quantitative study of the surgical and rehabilitation response to the earthquake in Haiti, January 2010. Prehospital and Disaster Medicine 2011: 449–56.Google Scholar
Van Hoving, DJ, Wallis, LA, Docrat, F, De Vries, S. Haiti disaster tourism – a medical shame. Prehospital and Disaster Medicine 2010: 25(3): 201–2.Google Scholar
Norton, I, von Schreeb, J, Aitken, P, Herard, P, Lajolo, C. Classification and minimum standards for foreign medical teams in sudden onset disasters. Geneva: World Health Organization; 2013.Google Scholar
Core humanitarian standard on quality and accountability. https://corehumanitarianstandard.org/files/files/Core%20Humanitarian%20Standard%20-%20English.pdfGoogle Scholar
Roberts, M, DeRenzo, EG. Chapter 2. Ethical considerations in community disaster planning, in Phillips, SJ, Knebel, A. eds. Providing mass medical care with scarce resources: a community planning guide. Prepared by Health Systems Research, Inc., under contract No. 290-04-0010. AHRQ Publication No. 07-0001. Rockville, MD; Agency for Healthcare Research and Quality: 2006: 9–23.Google Scholar
Pesik, N, Keim, ME, Iserson, KV. Terrorism and the ethics of emergency medical care. Annals of Emergency Medicine 2001: 37(6): 642–6.Google Scholar
O’Laughlin, DT, Hick, JL. Ethical issues in resource triage. Respiratory Care 2008: 53: 190–7.Google ScholarPubMed
Society of Critical Care Medicine Ethics Committee. Consensus statement on the triage of critically ill patients. JAMA 1994: 271: 1200–03.Google Scholar
Merin, O, Ash, N, Levy, G, Schwaber, MJ, Kreiss, Y. The Israeli field hospital in Haiti – ethical dilemmas in early disaster response. The New England Journal of Medicine 2010: 362: e38.Google Scholar
Phillips, SJ, Knebel, A (eds.) Mass medical care with scarce resources: a community planning guide. https://archive.ahrq.gov/research/mce/mceguide.pdfGoogle Scholar
Hanfling, D, Altevogt, BM, Viswanathan, K, Gostin, LO. Crisis standards of care: a systems framework for catastrophic disaster response. Washington, DC: Institute of Medicine; 2012. http://www.americanbar.org/content/dam/aba/events/health_law/2015_Meetings/DocLaw/Papers/01_crisis_stds_of_care_iom_01.authcheckdam.pdfGoogle Scholar
Altevogt, BM, Stroud, C, Hanson, SL, et al. (eds.) (2009). Guidance for establishing crisis standards of care for use in disaster situations: a letter report. https://www.ncbi.nlm.nih.gov/books/NBK219954Google Scholar
Schultz, CH, Annas, GJ. Altering the standard of care in disasters – unnecessary and dangerous. Annals of Emergency Medicine 2012: 59(3): 191–5.Google Scholar
Iserson, KV, Heine, CE, Larkin, GL, et al. Fight or flight: the ethics of emergency physician disaster response. Annals of Emergency Medicine 2008: 51(4): 345–53.Google Scholar
AMA code of medical ethics’ opinion on physician duty to treat – physician obligation in disaster preparedness and response. https://journalofethics.ama-assn.org/article/ama-code-medical-ethics-opinion-physician-duty-treat/2010-06Google Scholar
World Health Organization. Ethical considerations in developing a public health response to pandemic influenza. http://www.who.int/csr/resources/publications/WHO_CDS_EPR_GIP_2007_2c.pdfGoogle Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×