AbstractsMedical & Health Science

Ethical theory and ethical analysis tools in humanitarian healthcare aid

by Veronique Fraser

Institution: McGill University
Department: Department of Medicine
Degree: MS
Year: 2014
Keywords: Health Sciences - Medicine and Surgery
Record ID: 2042979
Full text PDF: http://digitool.library.mcgill.ca/thesisfile123072.pdf


It is increasingly recognized that because humanitarian healthcare workers are trusted to provide support and assistance to vulnerable groups and populations, they have a fiduciary responsibility rendering it important for them to be explicit and thoughtful about how and why they make ethical choices. This thesis explores the ethics of humanitarian healthcare aid and examines how health care professionals can best engage with these issues, from the realm of ideal ethical theory, to the realm of applied ethical analysis tools. It begins with a brief introduction outlining important elements in the history, ideology and ethics of humanitarian healthcare aid. The second chapter provides an overview of how ethical theory, notably: deontology, consequentialism and virtue ethics, underlies and informs humanitarian healthcare aid responses. I argue that familiarity with ethical theory improves moral clarity and enhances ethical deliberation. The realm of ideal ethical theory is at times abstract and so ethical analysis tools have been developed to assist clinicians in day-to-day ethical deliberation. Many argue that ethical analysis tools facilitate more comprehensive and systematic deliberation of ethical issues arising in a variety of healthcare contexts. However, the strengths and limitations of these tools have received little scrutiny or empirical investigation. Chapter three, provides an analysis of the strengths and limitations of analysis tools, and proposes questions for further research and development in four key areas: for what purpose is the tool developed, who is it designed for, when should tools be used, and what is the structure of the tool? I argue that responding to these questions is a requisite step if ethics analysis tools are to continue to be developed and published. Chapter four unites themes from Chapters two and three by presenting a research study investigating the usefulness of a humanitarian healthcare ethical analysis tool (HHEAT) designed to assist humanitarians in the field. Participants in this study were unanimous that the HHEAT helped ensure comprehensive and more organized ethical deliberation, and expressed a preference for a shorter, more concise tool. This study is notable in presenting one of the few attempts to empirically investigate the usefulness of an ethics analysis tool. Based on participant feedback, the HHEAT was shortened and an accompanying handbook was developed. In Chapter five, I conclude that ethical theory and applied analysis tools present mutually reinforcing approaches to ethical deliberation. When used in tandem, each has the potential to enhance ethical deliberation, analysis and justification, which are essential to humanitarian healthcare practice. On reconnaît de plus en plus que les travailleurs humanitaires, auxquels on fait confiance pour fournir soutien et assistance aux populations et groupes vulnérables, ont une responsabilité fiduciaire et qu'il est important pour eux d'être explicites et réfléchis sur le comment et le pourquoi lorsqu'ils font des…