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“How Far Do You Go and Where Are the Issues Surrounding That?” Dilemmas at the Boundaries of Clinical Competency in Humanitarian Health Work

Published online by Cambridge University Press:  26 July 2013

Matthew R. Hunt ,
Lisa Schwartz  and
Veronique Fraser
Matthew R. Hunt*
Affiliation:
School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada; and Centre for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
Lisa Schwartz
Affiliation:
Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
Veronique Fraser
Affiliation:
Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada
*
Correspondence: Matthew R. Hunt, PT, PhD School of Physical and Occupational Therapy McGill University Hosmer House 3630 prom Sir-William-Osler H3G 1Y5 Montreal, Quebec, Canada E-mail matthew.hunt@mcgill.ca
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Abstract

You go from here to there, and here you're specialized in one particular sort of thing, there you may be asked to do all sorts of things outside your specialty. How far do you go and where are the issues surrounding that?

Canadian physician discussing experiences in humanitarian aid work

Health professionals working in humanitarian relief projects encounter a range of ethical challenges. Applying professional and ethical norms may be especially challenging in crisis settings where needs are elevated, resources scarce, and socio-political structures strained. Situations when clinicians must decide whether to provide care that is near the margins of their professional competency are a source of moral uncertainty that can give rise to moral distress. The authors suggest that responding ethically to these dilemmas requires more than familiarity with ethical codes of conduct and guidelines; it requires practical wisdom, that is, the ability to relate past experience and general guidance to a current situation in order to render a morally sound action. Two sets of questions are proposed to guide reflection and deliberation for clinicians who face competency dilemmas. The first is prospective and intended to aid clinicians in evaluating an unfolding situation. The second is retrospective and designed to support debriefing about past experiences and difficult situations. The aim of this analysis is to support clinicians in evaluating competency dilemmas and provide ethical care and services.

HuntMR, SchwartzL, FraserV. “How Far Do You Go and Where Are the Issues Surrounding That?” Dilemmas at the Boundaries of Clinical Competency in Humanitarian Health Work. Prehosp Disaster Med. 2013;28(5):1-7.

Keywords

competencyethicshealth care professionalhumanitarian aidscope of practice
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 28 , Issue 5 , October 2013 , pp. 502 - 508
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2013 

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