Medical mission trips provide opportunities for students and educators to learn and acquire new skills in an international environment. Nevertheless, the ethicality of global medical volunteering and whether it is advantageous for a host community are questions without a clear answer. My attitude towards short-term experiences in global health (STEGHs) is fluctuating since STEGHs have the potential to improve life quality in a community, but also give numerous opportunities to abuse power and put local populations at risk. In my opinion, it is difficult to be utterly opposed to the notion, as a large percentage of the global population in developing countries may depend on outside help.
Volunteering, especially international, can be seen as the best chance to exercise the code of medical ethics. Sznajder, Chen, and Naughtonv (2019) present a situation where a medical school in the United States advertises a volunteering program in a clinic in South America and depicts it as the most excellent experience and a source of learning. Contrarily, the presence of foreign medical workers diminishes already scarce resources of the clinic, electricity, and running water, for instance, that is barely sufficient for local doctors and patients (Sznajder et al., 2019). These circumstances have started to trouble the participants of the program and have raised concerns among them.
From the perspective of a nurse practitioner, international medical volunteering seems like a great chance to prepare for a more extended stay abroad with professional purposes and the basis for future work with inadequately serviced individuals. Nevertheless, the case study changes the way of seeing STEGHs and challenges the common idea about medical volunteering, which is in danger of becoming voluntourism. Thus, participating in this type of programs requires from a nurse practitioner the ability to see a comprehensive picture of the situation and goals that could be achieved without harming a host community.
The ethical problems of STEGHs are, to a degree, provoked by the behavior of international students that may vary from instances of cultural insensitivity to actions that potentially threaten patients’ lives. Sznajder et al. (2019) name overstepping one’s capabilities while practicing as an example of unethical and dangerous actions. As seemingly there are no specific federal guidelines for STEGHs (researchers, professional, and hospital associations are their primary source), these instances raise legal concerns (Bauer, 2017). In developing countries, laws on medical malpractice and negligence are weaker, and citizens’ access to justice may be limited, permitting the volunteers who exceed their responsibilities to be unpunished (Rowthorn, Loh, Evert, Chung, & Lasker, 2019). The actual system of international help is viewed as flawed, patronizing, and racist, as it tries to fill in gaps rather than build an efficient healthcare system in a local community (Bauer, 2017). In this way, the success of STEGHs depends to a degree on the actions of specific individuals participating as well as the mission’s framework and implementation.
Despite the dangers of STEGHs, millions of people worldwide depend on global health. Merely stopping it would not answer the question, as an array of actions can be taken to ameliorate the situation. For instance, a more rigorous selection process could detect individuals inclined to malpractice and cultural insensitivity. Host communities and foreign healthcare providers may need to identify ways to overcome the power imbalance and establish open communication. Additionally, international medical volunteering discloses ethical issues associated with fund distribution and donations. Administrating resources fairly and the degree of control that each party of STEGHs should possess remain unsolved issues.
As the world becomes more interconnected, the popularity of short-term placement in a foreign medical institution for healthcare workers grows accordingly. Altruism and compassion are qualities that may be often associated with the medical profession and serve as a cornerstone for ethical standards in the domain. Nonetheless, the motivation to participate in STEGHs is not always compatible with these principles, as well as the basis for these short-term programs is not always ethically coherent.
References
Bauer, I. (2017). More harm than good? The questionable ethics of medical volunteering and international student placements. Tropical Diseases, Travel Medicine and Vaccines, 3(1), 1‑12.
Rowthorn, V., Loh, L., Evert, J., Chung, E., & Lasker, J. (2019). Not above the law: A legal and ethical analysis of short-term experiences in global health. Annals of Global Health, 85(1), 79.
Sznajder, K. K., Chen, M. C., & Naughton, D. (2019). How should mission trips be administered?. AMA Journal of Ethics, 21(9), 722–728.