Ethical Considerations for Short-term Experiences by Trainees in Global Health

Abstract

Global Health Programs are Burgeon-ing. 1According to a recent review of the Web sites of 129 accredited MD-granting US medical schools 2 and their parent universities, almost half (60; 47%) have established initiatives, institutes, centers, or offices for global health.These programs announce goals that include reducing disparities in global health through a combination of research, education, and service.In part responding to student demand and enthusiasm, 3 many programs provide short-term training and service experiences in resource-limited settings.Nevertheless, there are important ethical considerations inherent to sending individuals from resource-replete settings for training and service experiences in resource-limited settings.7][8] We describe some of these issues so they can be addressed explicitly by those engaged in global health education and service initiatives to facilitate the goals of providing medical students, residents, and other trainees in disciplines related to global health the opportunity for international experience while minimizing unintended adverse consequences. Global Health Educational OpportunitiesEnormous variation in life expectancy and risk for preventable illness and death is observed both in country-level comparisons and among individuals within countries, with the world's poor bearing the brunt of illness and premature death. 9The goal of reducing such health disparities worldwide through research, education, and service is commendable and has an ethical basis in the principle of justice, as well as the duty to assist. 10,11Accordingly, it makes sense that universities in more prosperous settings might bring to bear their substantial technical expertise, energy, talent, research capability, and resources on global health challenges and disparities.Because a primary function of a university is to educate, one means of embracing a global health agenda is to ensure that students are aware of global health issues and have the