Sarah S. Willen The United States is rough terrain for those aiming to stake health-related human rights claims on domestic soil. Less than a decade ago, the passage of the 2010 Patient Protection and Affordable Care Act (ACA), which was designed as a massive expansion of insurance-based health coverage, led some health and human rights scholars to wax optimistic. The ACA—the Obama administration’s signature piece of legislation—passed by a razor-thin…
STUDENT PAPER Addressing Ethical Quandaries in Undergraduate Student-Led Global Health Trips: Design, Implementation, and Challenges of Guidelines by Students for Students
Jacob Roble, Laura Block, Mason Flannagan, Eric Obscherning, and Lori Diprete Brown Introduction Interest in global health at American universities has increased dramatically over the past 15 years.1 International fieldwork is an integral component of global health programming, with students traveling for humanitarian reasons, learning opportunities, and a need to meet graduate program admissions requirements.2 For example, 73% of American medical schools require or encourage clinical experience by applicants despite…
STUDENT PAPER Ethical Challenges in Medical Community Internships: Perspectives from Medical Interns in the Philippines
Aimee Lorraine C. Capinpuyan and Red Thaddeus D. Miguel Abstract The Philippine community internship program, originally created to supplement the country’s thinning health workforce while providing training to student doctors, poses a legal and ethical challenge for medical interns. Inherent characteristics of the program—such as financial disparities and burdens, the lack of supervision by senior doctors, the competence of student doctors, and short rotation times—can predispose interns to cause harm…
COMMENTARY #MeToo Meets Global Health: A Call to Action
A Statement by Participants of the Global Health Fieldwork Ethics Workshop, April 2018 This statement arose from discussions during the Global Health Fieldwork Ethics Workshop held in Atlanta, Georgia, USA in April 2018, co-sponsored by Agnes Scott College, The Taskforce for Global Health, and Emory University Rollins School of Public Health. As participants from a wide range of academic and global health implementation organizations discussed ethics challenges in fieldwork settings,…
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COMMENTARY Where There Is No Hashtag: Considering Gender-Based Violence in Global Health Fieldwork in the Time of #MeToo
Rachel Hall-Clifford In global health, we prioritize work where there is no doctor—often in remote and sometimes dangerous places—and certainly where there is no #MeToo hashtag, no groundswell of activism to support women’s rights. In such contexts, women in the field face distinct challenges. Through sharing my own experiences, I hope to encourage open dialogue and action to address gender-based violence within global health. Gender-based violence in an evidence-based field…
The Lived Experience of Global Public Health Practice: A Phenomenological Account of Women Graduate Students
Corey McAuliffe, Ross Upshur, Daniel W. Sellen, and Erica Di Ruggiero Abstract There is a dearth of research that aims to understand graduate students’ lived experience of global health practice. Difficulties, distress, and trauma occur before and after these students’ placement abroad, and they often increase when returning home. Moreover, few articles address the increased vulnerabilities faced by women, such as sexual violence and gender-based discrimination. We conducted a phenomenological…
Witnessing Obstetric Violence during Fieldwork: Notes from Latin America
Arachu Castro Abstract Violence against women in labor occurs frequently in Latin America, based on observations from my extensive ethnographic fieldwork in various Latin American countries. In this article, focused on Mexico and the Dominican Republic, I contextualize obstetric violence within the larger context of social exclusion and discrimination against women. I establish associations between maternal deaths and health care systems characterized by a lack of continuum of care, a…
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Documenting the Impact of Conflict on Women Living in Internally Displaced Persons Camps in Sri Lanka: Some Ethical Considerations
Shana Swiss, Peggy J. Jennings, K. G. K. Weerarathne, and Lori Heise Abstract Women’s Rights International works with rural women and girls who are living in countries at war or with ongoing political violence. In 2005, The Asia Foundation invited Women’s Rights International to Sri Lanka to evaluate the feasibility of a random-sample survey of women to document the impact of the decades-long conflict. The significant imbalance in the risks-to-benefits…
Ethical Considerations for Disseminating Research Findings on Gender-Based Violence, Armed Conflict, and Mental Health: A Case Study from Rural Uganda
Jennifer J. Mootz, Lauren Taylor, Milton L. Wainberg, and Kaveh Khoshnood Abstract Gender-based violence (GBV) is a major public health problem that is exacerbated in armed conflict settings. While specialized guidelines exist for conducting research with GBV, guidance on disseminating findings from GBV research is scant. This paper describes ethical considerations of designing and disseminating research findings on GBV, armed conflict, and mental health (including alcohol misuse) in conflict-affected settings…
Results Communication in Breast Milk Biomonitoring Studies: A Scoping Review and Stakeholder Consultation
Alyssa Mari Thurston, Federico Andrade-Rivas, and Jerry M. Spiegel Abstract Researchers investigating breast milk contamination face substantive ethical dilemmas regarding how biomonitoring results should be conveyed, with limited guidance available to help them. To identify effective processes for undertaking such research, we sought to critically assess practices being followed in reporting results. To consider how researchers have reported on this and related ethical issues, we searched three English-language databases for…