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Ethics in Global Surgery

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Academic Global Surgery

Abstract

Interest in making contributions to medical practice and research in low and middle income countries (LMIC) has become increasingly prevalent. The greatest strides have been made in preventive and primary care health measures applied toward vaccination strategies for infectious diseases, maternal and child health, and the HIV/AIDS pandemic. However, for many reasons, addressing surgical disease in LMIC’s has been a challenge. Although individual groups continue to deliver surgical care throughout the world, an organized agenda for surgical care has been lacking. Concentrated efforts by organizations such as the World Health Organization Global Initiative for Essential and Emergency Surgical Care (WHO-GIEESC) and more recently, the Lancet Commission on Global Surgery and the advocacy-based Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care (G4 Alliance) are finally yielding benefits by building political priority for surgical care as part of the global development agenda. In May 2015, the World Health Assembly (WHA) passed a landmark resolution on the importance of surgical care in the universal health care plan. The WHA mandate was a significant step towards mobilizing vital surgical initiatives, individuals, institutions, and health care teams. Given the significance of these initiatives, it is imperative and timely, that the ethical issues surrounding global surgery are delineated and better understood. Surgeons who function in this realm carry a significant burden of responsibility to provide safe, cost-effective, culturally-appropriate and good quality care in the most ethical manner possible

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Selected Reading

  • Alkire B, Vincent J, Meara J. Chapter 21. Benefit-cost analysis for selected surgical interventions in low and middle income countries. In: Debas HT, Donkor P, Gawande A, Jamison DT, Kruk ME, Mock CN, editors. Disease Control Priorities. Volume 1: essential. 3rd ed. Washington, DC: World Bank; 2015

    Google Scholar 

  • Alkire B, Vincent J, Meara J. Chapter 21. Benefit-cost analysis for selected surgical interventions in low and middle income countries. In: Debas HT, Donkor P, Gawande A, Jamison DT, Kruk ME, Mock CN, editors. Disease control priorities. Volume 1: essential surgery. 3rd ed. Washington, DC: World Bank; 2015.

    Google Scholar 

  • Beauchamp TL, Childress JF. Moral character. In: Principles of biomedical ethics. 6th ed. New York: Oxford University Press; 2009.

    Google Scholar 

  • Bezruchka S. Medical tourism as medical harm to the third world: why? For whom? Wilderness Environ Med. 2000;11(2):77–8.

    Article  CAS  PubMed  Google Scholar 

  • Chao TE, Sharma K, Mandigo M, et al. Cost-effectiveness of surgery and its policy implications for global health: a systematic review and analysis. Lancet Glob Health. 2014;2:e334–45.

    Article  PubMed  Google Scholar 

  • Crump JA, Sugarman J. Ethical considerations for short-term experiences by trainees in global health. JAMA. 2008;300(12):1456–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Gosselin RA, Heitto M. Cost-effectiveness of a district trauma hospital in Battambang, Cambodia. World J Surg. 2008;32:2450–3.

    Article  PubMed  Google Scholar 

  • Gosselin RA, Thind A, Bellardinelli A. Cost/DALY averted in a small hospital in Sierra Leone: what is the relative contribution of different services? World J Surg. 2006;30:505–11.

    Article  PubMed  Google Scholar 

  • Gosselin RA, Maldonado A, Elder G. Comparative cost-effectiveness analysis of two MSF surgical trauma centers. World J Surg. 2010;34:415–9.

    Article  PubMed  Google Scholar 

  • Grimes CE, Henry JA, Maraka J, Mkandawire NC, Cotton M. Cost-effectiveness of surgery in low- and middle-income countries: a systematic review. World J Surg. 2014;38:252–63.

    Article  PubMed  Google Scholar 

  • Jamison DT, Jha P, Laxminarayan R, Ord T. Infectious disease, injury, and reproductive health. In: Lomborg B, editor. Global problems, smart solutions: costs and benefits. Cambridge: Cambridge University Press for Copenhagen Consensus Center; 2013a.

    Google Scholar 

  • Jamison DT, Summers LH, Alleyne G, et al. Global health 2035: a world converging within a generation. Lancet. 2013b;382:1898–955.

    Article  PubMed  Google Scholar 

  • Kydland F, Mundell R, Schelling T, Smith V, Stokey N. Expert panel ranking. In: Lomborg B, editor. Global problems, smart solutions: costs and benefits. Cambridge: Cambridge University Press; 2013. p. 701–16.

    Chapter  Google Scholar 

  • Mock CN, Donkor P, Gawande A, Jamison DT, Kruk ME, Debas JT. Disease control priorities, DCP3-essential surgery. Washington, DC: World Bank Press; 2015.

    Google Scholar 

  • Montgomery LM. Short-term medical missions: enhancing or eroding health? Missiology Int Rev. 1993;21(3):333–41.

    Article  Google Scholar 

  • Pinto AD, Upshur REG. Global health ethics for students. Dev World Bioeth. 2007:1–10: 7–8. (Blackwell Publishing Ltd.). vol.1

    Google Scholar 

  • Roberts M. Duffle bag medicine. JAMA. 2006;295(13):1491–2.

    Article  CAS  PubMed  Google Scholar 

  • Shrime M, Sleemi A, Ravilla T. Chapter 13. Specialized surgical platform. In: Debas HT, Donkor P, Gawande A, Jamison DT, Kruk ME, Mock CN, editors. Disease control priorities. Volume 1: essential surgery. 3rd ed. Washington, DC: World Bank; 2015a.

    Google Scholar 

  • Shrime M, Verguet S, Johansson KA, Desalegne D, Jamison DT, Kruk ME. Chapter 19. Task-sharing or public finance for the expansion of surgical access in rural Ethiopia: an extended cost-effectiveness analysis. In: Debas HT, Donkor P, Gawande A, Jamison DT, Kruk ME, Mock CN, editors. Disease control priorities. Volume 1: essential surgery. Washington, DC: World Bank; 2015b.

    Google Scholar 

  • Suchdev P, et al. A model for sustainable short-term international medical trips. Ambul Pediatr. 2007;7(4):317–20.

    Article  PubMed  Google Scholar 

  • Wolfberg AJ. Volunteering overseas – lessons from surgical brigades. N Engl J Med. 2006;354(5):443–5.

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Purvi Y. Parikh MD, FACS .

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© 2016 Springer International Publishing Switzerland

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Parikh, P.Y., Nwariaku, F.E. (2016). Ethics in Global Surgery. In: Swaroop, M., Krishnaswami, S. (eds) Academic Global Surgery. Success in Academic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-14298-2_3

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  • DOI: https://doi.org/10.1007/978-3-319-14298-2_3

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-14297-5

  • Online ISBN: 978-3-319-14298-2

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