Cole Madeleine, Healey Gwen
Qikiqtani General Hospital, Iqaluit, Nunavut, Canada.
Int J Circumpolar Health. 2013 Aug 5;72. doi: 10.3402/ijch.v72i0.21326. eCollection 2013.
There exists a need throughout the North to increase capacity to address issues of health ethics and for community members to better understand and share their perspectives on this topic. Ethics comes down to weighing rights and wrongs, evaluating differing needs and understandings, acknowledging the many shades of grey and doing our best to come up with the just, fair and moral approach to the question at hand. Northern regions must collaborate to share capacity, successes and experiences in order to meet the unique needs of northern health care institutions and move forward on this issue. While guidelines for ethical research with indigenous populations exist, little has been published about an Inuit approach to health ethics more broadly.
To fill a critical need and to meet accreditation standards, the Qikiqtani General Hospital (QGH) in Iqaluit, Nunavut, Canada, is in the process of building an Ethics Committee. Capitalizing on partnerships with other bodies both in northern and southern Canada has proved an efficient and effective way to develop local solutions to challenges that have been experienced both at QGH and other jurisdictions.
The Ottawa Hospital Ethics Office and the active ethics committee at Stanton General Hospital in Yellowknife, NT, contributed expertise and experience, and helped provide some direction for the QGH ethics committee. At the local level, based on our shared commitment to health care ethics, the Qaujigiartiit Health Research Centre is an invaluable partner whose parallel efforts to develop a northern Health Research Ethics Board (REB) gives great synergy to the QGH Ethics Committee.
Passion and commitment, as well as administrative support and endorsement from health care leaders, are the aspects of successful initiatives that we have identified to date. Using the information from both the experiences of other partners, as well as information gathered at a retreat held in Iqaluit in September 2011, we are working to develop a model for the QGH ethics committee that incorporates multi-level perspectives, from that of community to that of front-line worker.
Ideally, the scope of the QGH Ethics Committee will grow over time to include ethics education, facilitation of clinical ethical consults, ethical review of policy, advice on governance issues and involvement and support of an external northern Health REB.
整个加拿大北部地区都需要提高处理健康伦理问题的能力，让社区成员更好地理解并分享他们对这一主题的看法。伦理归根结底就是权衡是非、评估不同的需求和理解、认识到事物的复杂性，并尽力找到针对手头问题的公正、公平且合乎道德的方法。北部地区必须开展合作，共享资源、成功经验，以满足北部医疗机构的独特需求，并在这一问题上取得进展。虽然存在针对原住民群体的伦理研究指南，但关于因纽特人更广泛的健康伦理方法的公开文献却很少。
为满足关键需求并达到认证标准，加拿大努纳武特地区伊魁特市的基吉塔尼综合医院（QGH）正在组建一个伦理委员会。事实证明，利用与加拿大北部和南部其他机构的合作关系是制定本地应对QGH及其他辖区所面临挑战的有效途径。
渥太华医院伦理办公室以及西北地区耶洛奈夫市斯坦顿综合医院的活跃伦理委员会提供了专业知识和经验，并为QGH伦理委员会提供了一些指导。在地方层面，基于我们对医疗保健伦理的共同承诺，乔吉贾蒂特健康研究中心是一个非常宝贵的合作伙伴，其为建立北部健康研究伦理委员会（REB）所做的并行努力为QGH伦理委员会带来了巨大的协同效应。
热情与承诺，以及医疗保健领导者的行政支持与认可，是我们目前已确定的成功举措的要素。利用其他合作伙伴的经验信息以及2011年9月在伊魁特举行的务虚会上收集的信息，我们正在努力为QGH伦理委员会制定一个模型，该模型纳入了从社区到一线工作人员的多层次视角。
理想情况下，QGH伦理委员会的范围将随着时间的推移而扩大，包括伦理教育、促进临床伦理咨询、政策的伦理审查、治理问题咨询以及对外部北部健康REB的参与和支持。
