Humanitarian Assistance in Emergencies - Case Study Example

Managing non-governmental organization Number Department Managing non-governmental organization Ethical issues arise in the provision of humanitarian aid to people who are in need of medical assistance. The real contribution of humanitarian groups is largely positive; however, such missions normally come with some unintended consequences. Abu-Sada’s “Dilemmas, Challenges, and Ethics of Humanitarian Action,” attempts to provide solutions to the ethical issues that arise out of humanitarian interventions in societies. As a health care organization providing humanitarian services, MSF attempts to respond to disasters, while keeping its staffs safe. It is also facing the challenges of cultivating effective rapport with government agencies and the locals. Abu-Sada argues that perception is the primary factor affecting the quality of the services and the wellbeing of the teams deployed in disaster-prone areas and therefore needs special attention. The book captures an array of lessons on the perception that provides the understanding and assessments of researchers from a wide range of disciplines including health care, humanitarian lessons, ethics, political science, and communications. In light of the overarching approach of the book to the provision of humanitarian support, Abu-Sada (2012) provides a rare insight into the operations which have attracted more public scrutiny. Background of the ethical issues Acute humanitarian disasters create challenging ethical dilemmas for government agencies and health care organizations, particularly in areas with poor infrastructures for medical care, where the local population relies on external care during an emergency. It is notable, that these ethical predicaments are common in many interventions, including strategies aimed at stopping the spread of infectious diseases. In the first emergency interventions, processes aimed at reducing the spread of infectious conditions such as immunizations ought to be accompanied by the basic needs such as food, water and shelter (Cohen, 2013). This is because infectious illnesses can spread across populations within a short period of time, especially in densely populated areas where these needs are scarce. Hunt (2008) concurs with Abu-Sada by noting that before deploying medical humanitarian intervention teams to a humanitarian mission, organizations normally pause for a moment to find solutions to a number of pertinent issues related to the crisis: these include; the likely costs of the medical condition; medical-related risks; the appropriateness of prevention as the first option and treatment as the last option; the time factor; related expenses; the herd immunity as an adjunct measure to individual safety; and the availability of the logistics, which can support a large-scale medical program. According to Hunt (2008), these medical interventions require the placement of ethics high on the agenda during humanitarian missions, since one action normally affects the other and might yield undesirable impacts on the teams or the victims. Shelving a much-needed vaccination program due to logistical shortages, for instance, may lead to a whole generation of young children being handicapped by polio. To resolve such an issue, Cohen (2013) notes that a country or a region experiencing a medical crisis should first evaluate the epidemiological gangers stemming from a disaster, before looking into the viability of mass treatment campaign and the impacts of such an intervention on the victims. Most of humanitarian interventions normally face the conflict between individual interests and the common good. The conflicts often stem from the deployment of limited medical resources to disaster-prone areas, the trade-off between gains and challenges, and procuring informed consent for the affected parties. Abu-Sada (2012) argues that the primary ethical rules that are applicable during public health emergency interventions are grounded on the rather general moral principles regulating clinical medical practice. Acute humanitarian missions vary widely in disposition, in the risks they precipitate, in the issues surrounding such conditions, and in the nature of programs that must be deployed. Beneficence versus human rights It is the duty of both the international community and national governments to synergize their efforts in ensuring that quality, affordable services for avoiding unnecessary diseases and mortality are accessible to the people who are most affected by the crises (Hunt, 2011). During humanitarian exercises, the rate at which infectious diseases spread is faster. The duty of care provides that under the doctrine of beneficence, government bodies have a duty to avail treatments, vaccination against and management of the most infectious conditions. In addition, organizations and individual parties are under obligation to act swiftly and humanely toward the rescue of the affected parties. The duty to rescue any distinguishable persons facing preventable death is ethical for all stakeholders spearheading a rescue mission. Despite the noble cause to save lives, some communities oppose medical interventions and other emergency activities that are not regularly provided to them under normalcy conditions (Hunt, 2008). The underlying issue premised upon the principles of developmental respite and viability, is that humanitarian measures crafted along those lines will yield a culture of dependency. Nonetheless, the notion suffers a setback if a medical intervention such as mass screenings for HIV, for example, in a community worst-hit by the scourge can prevent new infections or early deaths. In light of this, a higher level of care is necessary during medical crises because failure to do so could result in mass deaths or injuries (Cohen, 2013). It is morally sensible for the amount of preventive medical interventions to deescalate to normal levels after the health risks have ended (Hunt, 2011). Following an acute intervention, a number of medical interventions need continued care. Some interventions such as immunization programs do not need continuous care, but have the potential to yield positive outcomes in the long-run and should be encouraged because it does not require massive logistics in order to achieve. Humanitarian aid has conventionally been perceived as charity, which is in line with the doctrine of beneficence. However, due to human rights concerns, such programs are viewed as a duty. In light of this, concerned parties have a duty to ensure that the human rights of populations bearing the brunt of crises are safeguarded and fostered (Narruhn and Schellenberg, 2013). Regardless of the morals underlying the provision of humanitarian aid, medical donations can guarantee opportune access to vaccines and cure during emergencies. The delivery of medical supplies and services to affected parties should be done in a suitable, sustainable manner with the victims being granted the right to an informed choice, and proper documentation, but in the real sense some of these acceptable donation practices are overlooked in extraordinary circumstances requiring emergency services (Zachary, 2008). Non-maleficence According to Zachary (2008), the doctrine of non-maleficence posits that all choices made during humanitarian interventions should involve a trade-off between acting in good faith and minimizing or preventing harm. Only medicines and equipment that have been tried and tested should be considered for public administration when responding to public health care crisis. Such medical supplies should not only safeguard people against particular medical conditions; when deployed to treat masses of populations, they should bring about extra gains of providing herd immunity. The doctrine of non-maleficence, therefore, advocates for thorough research on the risk factors to diseases and carry out only necessary vaccination as a way of reducing opportunity costs and keeping the people safe from the side-effects. This implies the risk of infection must necessitate vaccination. Abu-Sada (2012) proposes four variables for determining the magnitude of risks: the kind of the disease and its signs and symptoms; the likelihood of infection; its severity and the duration within which it would strike (Sommers-Flanagan, 2007). If a crisis takes place in a situation that has been saturated with immunization programs or where there is low risk of outbreak, for instance, more immunizations should be avoided because they may yield poor outcomes. Rigorous medical interventions for pregnant women, for instance, should be avoided because they may affect the unborn baby and or the mother. Medical interventions normally precipitate benefits and negative impacts in the form of individual and or social harm. Nilsson et al (2011) note that side-effects of medication may cause harm to an individual consumer. These impacts may range from normal body reactions like irritation and aches at the point of injection, to more serious complications. Proven medications, which are usually employed during humanitarian aid missions, have well-established side-effects on the victims. Children who suffer from deficiency diseases are normally vulnerable to side-effects of medical interventions, and when they are hidden by their parents during humanitarian aid missions, the teams will be forced to circumvent the doctrine of informed consent in order to save their lives. In addition, humanitarian medical teams should explore the most appropriate medical interventions for health complications for special groups so as to limit the severity of the side-effects. Distributive justice Abu-Sada (2012) recommends the implementation of distributive justice when humanitarian teams are experiencing scarcity of basic resources such as food, clothing, shelter, safe water and medical supplies. She says an inadequate supply of medicine could be fairly disbursed via a lottery, but with particularly vulnerable parties being given the first priority. Alternatively, individuals or groups who are most likely to become incapacitated or die or spread the disease should be considered first during such missions. On his part, Hunt (2011) notes that different rules guide policymaking processes and priority-setting when crises strike. In light of these rules of engagement, distribution of aid in the wake of a crisis is normally not perfect because teams deployed in crisis-hit areas to provide humanitarian aid have a limited mandate to utilize the resources they have in order to achieve the most appropriate outcomes because in such situations imperfect information is rife and the demand for resources normally outweigh the supply. From the perspective of utility and fairness, special groups such as children, the elderly and those with medical preconditions should be given more priority during humanitarian medical interventions because these groups are normally more susceptible than the rest of the population to health risks and diseases (Moodley et al, 2013). Some communities value geriatrics more than the younger, more productive population segments, while others perceive pregnant women as the most important special groups in need of urgent care during crises. In light of these contradicting perceptions, working teams are normally confronted with ethical dilemmas whose resolution take time and may result in the injury of the victims. From a utilitarian point of view, protecting health workers working in humanitarian assistance teams and vulnerable groups against infections will result in the overall health of the society. Moodley et al (2013) say under the doctrine of reciprocity, health care staffs who risk their own lives by working in crisis-hit hotspots should be given adequate protective gear and vaccination by the agencies they serve for the safety of their patients as well. Conclusion Ethical issues are an imperative part of decision-making when rolling out humanitarian assistance, particularly in emergencies. Adhering to human rights issues and the appropriate procedure of rescue should dictate the conduct of parties charged with the responsibility of administering life-saving medical missions on vulnerable populations facing crises. Justice and morals impose a duty upon members of intervention teams to help those who are in need of humanitarian assistance to distribute the limited resources in a fair manner. Health organizations and policy-makers at national levels have an ethical responsibility to work within their limits, and act reasonably in putting into practice proven interventions to prevent preventable injury and death of the public. The distribution of limited resources in medical supplies requires a proper trade-off between utility and fairness as well as documentation of decision-making processes to facilitate accountability. References Abu-Sada, C. 2012. Dilemmas, Challenges, and Ethics of Humanitarian Action: Reflections on Médecins Sans Frontières Perception Project. New York: MQUP. Cohen, G.I. 2013. The Globalization of Health Care: Legal and Ethical Issues. Oxford: Oxford University Press. Ethics & Behavior, 17(2), pp.187-202. Gaudine et al. 2011. Clinical ethical conflicts of nurses and physicians. Nursing Ethics, 18(1), pp.9-19. Hunt, M.R. 2008. Ethics beyond borders: how health professionals experience ethics in humanitarian assistance and development work. Developing World Bioethics, 8(2), pp.59-69. Hunt, M.R. 2011. Establishing moral bearings: ethics and expatriate health care professionals in humanitarian work. Disasters, 35(3), pp.606-622. Moodley et al. 2013. Ethical considerations for vaccination programmes in acute humanitarian emergencies. Bulletin of the World Health Organization, 91(4), pp.290-297. Narruhn, R., and Schellenberg, I.R. 2013. Caring ethics and a Somali reproductive dilemma. Nilsson et al. 2011. Moral Stress in International Humanitarian Aid and Rescue Operations: A Grounded Theory Study. Ethics & Behavior, 21(1), pp.49-68. Sommers-Flanagan, R. 2007. Ethical Considerations in Crisis and Humanitarian Interventions. Nursing Ethics, 20(4), pp.366-381. Zachary, P. 2008. Humanitarian Dilemmas. Wilson Quarterly, 32(3), pp.44-51. Read More