Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada.
Prehosp Disaster Med. 2009 Nov-Dec;24(6):518-24. doi: 10.1017/s1049023x00007445.
Expatriate healthcare professionals frequently participate in international relief operations that are initiated in response to disasters due to natural hazards or humanitarian emergencies in low resource settings. This practice environment is significantly different from the healthcare delivery environment in the home countries of expatriate healthcare professionals. Human rights, public health, medicine, and ethics intersect in distinct ways as healthcare professionals provide care and services in communities affected by crisis.
The purpose of this study was to explore the moral experience of Canadian healthcare professionals during humanitarian relief work.
This is a qualitative study with 18 semi-structured individual interviews based on Interpretive Description methodology. There are two groups of participants: (1) 15 healthcare professionals (nine doctors, five nurses, and one midwife) with more than three months experience in humanitarian work; and (2) three individuals who have experience as human resource or field coordination officers for humanitarian, non-governmental organizations. Participants were recruited by contacting non-governmental organizations, advertisement at the global health interest group of a national medical society, word of mouth, and a snowball sampling approach in which participants identified healthcare professionals with experience practicing in humanitarian settings who might be interested in the research.
Five central themes were identified during the analysis: (1) examination of motivations and expectations; (2) the relational nature of humanitarian work; (3) attending to steep power imbalances; (4) acknowledging and confronting the limits of what is possible in a particular setting; and (5) recognition of how organizational forms and structures shape everyday moral experience.
Humanitarian relief work is a morally complex activity. Healthcare professionals who participate in humanitarian relief activities, or who are contemplating embarking on a humanitarian project, will benefit from carefully considering the moral dimensions of this work. Humanitarian organizations should address the moral experiences of healthcare professionals in staff recruitment, as they implement training prior to departure, and in supporting healthcare professionals in the field.
侨居海外的医疗专业人员经常参与国际救援行动，这些行动是针对自然灾害或人道主义紧急情况在资源匮乏环境下发起的。这种实践环境与侨居海外医疗专业人员的本国医疗服务环境有很大的不同。在受危机影响的社区提供医疗保健和服务时，人权、公共卫生、医学和伦理学以不同的方式交汇。
本研究旨在探讨加拿大医疗保健专业人员在人道主义救援工作中的道德体验。
这是一项基于解释性描述方法的定性研究，共有 18 次半结构化个人访谈。有两组参与者：（1）15 名医疗保健专业人员（9 名医生、5 名护士和 1 名助产士），他们有超过三个月的人道主义工作经验；（2）3 名有过人道主义、非政府组织人力资源或现场协调员经验的个人。参与者是通过联系非政府组织、在国家医学协会的全球健康利益小组做广告、口口相传以及通过参与者确定有兴趣参与研究的人道主义环境中实践经验的医疗保健专业人员的滚雪球抽样方法招募的。
在分析过程中确定了五个中心主题：（1）审查动机和期望；（2）人道主义工作的关系性质；（3）关注严重的权力失衡；（4）承认并面对在特定环境中可能存在的限制；（5）认识到组织形式和结构如何塑造日常道德体验。
人道主义救援工作是一项道德复杂的活动。参与人道主义救援活动或正在考虑开展人道主义项目的医疗保健专业人员将受益于仔细考虑这项工作的道德层面。人道主义组织应在招聘人员时考虑到医疗保健专业人员的道德体验，在出发前实施培训，并在现场支持医疗保健专业人员。
