Ethics in Global Pediatric Surgery: Existing Dilemmas and Emerging Challenges

Overview

Journal World J Surg

Publisher Wiley

Specialty General Surgery

Date 2019 Mar 10

PMID 30850871

Citations 7

Authors

Aaron J Cunningham

Caroline Q Stephens

Emmanuel A Ameh

Philip Mshelbwala

Benedict Nwomeh

Sanjay Krishnaswami

Affiliations

Soon will be listed here.

Abstract

The rapid growth of global pediatric surgery beyond direct care delivery into research, education, and advocacy necessitates re-evaluation of the traditional ethical paradigms which have governed our partnerships in low- and middle-income countries (LMIC). Within this paper, we consider current and emerging ethical challenges and discuss principles to consider in order to promote autonomous systems for pediatric surgical care in LMIC.

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References

Krishnaswami S, Stephens C, Yang G, Nwomeh B, Swaroop M, Nadler E . An academic career in global surgery: a position paper from the Society of University Surgeons Committee on Academic Global Surgery. Surgery. 2017; 163(4):954-960. DOI: 10.1016/j.surg.2017.10.019. View

Isaacson G, Drum E, Cohen M . Surgical missions to developing countries: Ethical conflicts. Otolaryngol Head Neck Surg. 2010; 143(4):476-9. DOI: 10.1016/j.otohns.2010.05.011. View

Adams L, Suresh G, Lahey T . Ethical Issues in Pediatric Global Health. Pediatr Clin North Am. 2015; 63(1):195-208. DOI: 10.1016/j.pcl.2015.09.002. View

Chu K, Jayaraman S, Kyamanywa P, Ntakiyiruta G . Building research capacity in Africa: equity and global health collaborations. PLoS Med. 2014; 11(3):e1001612. PMC: 3949667. DOI: 10.1371/journal.pmed.1001612. View

Bhutta Z . Ethics in international health research: a perspective from the developing world. Bull World Health Organ. 2002; 80(2):114-20. PMC: 2567726. View

Bolton W, Aruparayil N, Quyn A, Scott J, Wood A, Bundu I . Disseminating technology in global surgery. Br J Surg. 2019; 106(2):e34-e43. DOI: 10.1002/bjs.11036. View

Krishnaswami S, Nwomeh B, Ameh E . The pediatric surgery workforce in low- and middle-income countries: problems and priorities. Semin Pediatr Surg. 2016; 25(1):32-42. DOI: 10.1053/j.sempedsurg.2015.09.007. View

Asgary R, Junck E . New trends of short-term humanitarian medical volunteerism: professional and ethical considerations. J Med Ethics. 2012; 39(10):625-31. DOI: 10.1136/medethics-2011-100488. View

Gladding S, McGann P, Summer A, Russ C, Uwemedimo O, Matamoros Aguilar M . The Collaborative Role of North American Departments of Pediatrics in Global Child Health. Pediatrics. 2018; 142(1). DOI: 10.1542/peds.2017-2966. View

10.

Butler M, Drum E, Evans F, Fitzgerald T, Fraser J, Holterman A . Guidelines and checklists for short-term missions in global pediatric surgery: Recommendations from the American Academy of Pediatrics Delivery of Surgical Care Global Health Subcommittee, American Pediatric Surgical Association Global Pediatric.... Paediatr Anaesth. 2018; 28(5):392-410. DOI: 10.1111/pan.13378. View

11.

Lansang M, Olveda R . Institutional linkages: strategic bridges for research capacity strengthening. Acta Trop. 1994; 57(2-3):139-45. DOI: 10.1016/0001-706x(94)90004-3. View

12.

Wesonga A, Fitzgerald T, Kabuye R, Kirunda S, Langer M, Kakembo N . Gastroschisis in Uganda: Opportunities for improved survival. J Pediatr Surg. 2016; 51(11):1772-1777. DOI: 10.1016/j.jpedsurg.2016.07.011. View

13.

Wu V, Poenaru D, Poley M . Burden of surgical congenital anomalies in Kenya: a population-based study. J Trop Pediatr. 2013; 59(3):195-202. DOI: 10.1093/tropej/fmt001. View

14.

Rose A . Questioning the universality of medical ethics: dilemmas raised performing surgery around the globe. Hastings Cent Rep. 2011; 41(5):18-22. DOI: 10.1002/j.1552-146x.2011.tb00136.x. View

15.

Baird R, Poenaru D, Ganey M, Hansen E, Emil S . Partnership in fellowship: Comparative analysis of pediatric surgical training and evaluation of a fellow exchange between Canada and Kenya. J Pediatr Surg. 2016; 51(10):1704-10. DOI: 10.1016/j.jpedsurg.2016.06.002. View

16.

Roth D . An ethics-based approach to global child health research. Paediatr Child Health. 2009; 8(2):67-71. PMC: 2791424. DOI: 10.1093/pch/8.2.67. View

17.

Eberlin K, Zaleski K, Snyder H, Hamdan U . Quality assurance guidelines for surgical outreach programs: a 20-year experience. Cleft Palate Craniofac J. 2008; 45(3):246-55. DOI: 10.1597/07-094.1. View

18.

Patel P, Hoyler M, Maine R, Hughes C, Hagander L, Meara J . An opportunity for diagonal development in global surgery: cleft lip and palate care in resource-limited settings. Plast Surg Int. 2013; 2012:892437. PMC: 3539333. DOI: 10.1155/2012/892437. View

19.

Caballero B . Ethical issues for collaborative research in developing countries. Am J Clin Nutr. 2002; 76(4):717-20. DOI: 10.1093/ajcn/76.4.717. View

20.

Butler M, Ozgediz D, Poenaru D, Ameh E, Andrawes S, Azzie G . The Global Paediatric Surgery Network: a model of subspecialty collaboration within global surgery. World J Surg. 2014; 39(2):335-42. DOI: 10.1007/s00268-014-2843-1. View