Dartmouth Medical School, Lebanon, New Hampshire 03756, USA.
Acad Med. 2012 Feb;87(2):210-5. doi: 10.1097/ACM.0b013e31823f3fb1.
Medical students' interest in global health outreach work is intense and growing. Yet, medical students' global health outreach work is fraught with ethical complexity: Students must make challenging resource allocation decisions in an unfamiliar setting while providing complicated care with evolving expertise across power gradients and geographical as well as cultural boundaries. Inadequate training in the recognition and resolution of the ethical issues inherent in this work likely endangers future service work participation and undercuts the efficacy of medical students' global health outreach work. The author describes how the medical school curriculum can empower medical students to recognize and resolve ethical issues encountered in global health outreach work. To achieve this goal, he proposes a curriculum in the ethics of global health outreach to train students to understand (1) the ethical justifications for global health outreach work, (2) the drivers of global health disparities, (3) the key ethical issues raised by global health outreach, and (4) how to resolve ethical quandaries encountered during global health outreach work through collaboration. Beyond specific topical content, a medical school curriculum in the ethics of global health outreach should emphasize the importance of local collaboration and longitudinal mentorship of medical students. Medical school training in the recognition and resolution of the ethical issues attendant on global health outreach work prepares students not only for more sophisticated work in international settings but also for the ethical complexities of medical practice closer to home.
医学生对全球健康外展工作的兴趣浓厚且与日俱增。然而，医学生的全球健康外展工作充满了伦理复杂性：学生必须在陌生的环境中做出具有挑战性的资源分配决策，同时在权力梯度、地理和文化边界上提供不断发展的专业知识的复杂护理。在识别和解决这项工作中固有伦理问题方面的培训不足，可能会危及未来的服务工作参与，并削弱医学生全球健康外展工作的效果。作者描述了医学院课程如何使医学生能够识别和解决全球健康外展工作中遇到的伦理问题。为了实现这一目标，他提出了一个全球健康外展伦理课程，以培训学生理解（1）全球健康外展工作的伦理依据，（2）全球健康差距的驱动因素，（3）全球健康外展引发的关键伦理问题，以及（4）如何通过合作解决全球健康外展工作中遇到的伦理困境。除了具体的主题内容外，医学院的全球健康外展伦理课程还应强调本地合作和医学生长期指导的重要性。医学院对全球健康外展工作相关伦理问题的识别和解决能力的培训，不仅使学生为在国际环境中更复杂的工作做好准备，也为更接近家乡的医疗实践中的伦理复杂性做好准备。
