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International and Humanitarian Disaster Management

Week 5 – Ethical and Legal Considerations

Teaching Points

During international/humanitarian disasters we as responders are subject to myriad differences in regard to cultural norms and other issues, one of which is ethics. Ethics are closely linked to culture and can differ significantly from our respective cultural ethics and we must strive to remember that culture and subsequently ethics are different and not necessarily better or worse than our own. An example of this difference is from a real-world case that I was involved while away on a medical missions trip. A young mother brought her extremely ill child into the clinic for care. The child was critically ill and it was clear that she needed far more advanced care than what our meager clinic could provide. As medical providers we began to make decisions to have the child transported from the remote clinic to hospital. Who would go with the child? How would they get back? What supplies were needed? What could be provided in meantime? And so on. As our translator explained our intentions to the child’s mother, she explained that she has no means to pay for the care and that she would not permit her child to be taken to the hospital. We implored her to reconsider even explaining that her child would more than likely die without better care than we could provide. This did not change her decision and she took her child home with the little supplies we could provide her to treat her child.

Clearly, had a similar event occurred in the United States there would have been a much different outcome. However, we were not in the United States and a reasonable question to ask is did we act ethically? This type of scenario and others are common in the international response community and they can be extremely difficult to navigate. It is important to remember that when ethics collide at least one party will not be happy with the decision but, it is our responsibility to maintain the idea of providing the best ethical decision for the situation at hand.

Ethics, in the context of disaster response, also guides our decision-making, the division of resources and our conduct. It is a safe assumption that we as responders bring with us supplies, medical aid, food, water and other resources that are in short supply. We in very literal terms have the “keys” to all these needed resources and have the sole ability to determine the allocation of these resources. Ethics plays a large role in the distribution of resources in that we must allocate resources to provide the greatest good for the greatest number. Of course, this statement over simplifies the matter and there are certainly many caveats than numbers alone. However, we must do our best to eliminate factors that serve to disrupt our ability to make sound ethical decisions. For example, a community’s infrastructure and food supplies have been severely damaged from a wildfire and subsequent landslide. Your local liaison encourages you to direct resources to a significantly less impacted area because this area is home to his tribal community. How do we manage this situation ethically and also maintain a good working relationship with our liaison?

It is important to understand that this discussion only scratches the surface of ethics. There are semester long classes dealing with various aspects of ethics and I would encourage you to learn more about this topic. I hope that you are beginning to understand the complexity of international/humanitarian disasters, especially as they relate ethics. Let’s continue to have discussions, ask questions and more importantly find answers.

Readings

Kapur & Smith – Chapter 3 Public Health Law, Chapter 5 Emerging Public Health Systems: Post Conflict and post-Disaster Settings

Coppola – Chapter 10 Participants- Multilateral Organizations and International Financial Institutions

http://ocw.jhsph.edu/courses/refugeehealthcare/PDFs/SphereProjectHandbook.pdf

Reflections on the Humanitarian Charter

Discussion Bored Question

Please discuss the importance and value of understanding cultural ethics as they relate to international/humanitarian disasters. Similarly, discuss why we as responders must conduct ourselves, and distribute resources ethically.

APA Style

Please answer all discussion question clearly and completely.

Use your thoughts and your critical thinking, Not only summarize.



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