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The war in Syria has lasted for many years and continues to cast a dark shadow over its people, including healthcare workers caring for those injured and in distress. During the war, healthcare workers have been exposed to unprecedented challenges, becoming targets of bombing, killing, siege, arrest, and torture. Moreover, healthcare workers continue to experience difficult situations that require them to make decisions with no clear or easy moral choice. The present study aimed to understand the experiences of healthcare workers and the difficulties and challenges that hinder applying existing ethical frameworks and codes for disasters within Syria’s context of revolution and war. Qualitative analysis of interviews led to classification of the ethical challenges experienced by healthcare workers into four groups: the risks from providing care; stewardship of resources and work challenges; corruption and organizational pressure; and psychological, emotional, and social stress. The study also showed that both Syrian healthcare workers and the developers of ethical frameworks adopt many similar values and principles. Yet, the participants adopted several unique moral values not identified in ethical frameworks as a result of navigating their professional duties under the circumstances of the Syrian war. At last, recognizing the challenges and precarious tasks healthcare workers cope with during wars and other similar disasters could help volunteers, medical personnel, and humanitarian organizations deciding to work in Syria better understand the specific context and obstacles for ethical decision-making. Moreover, attracting attention for and support of Syrian healthcare workers locally and globally presents a long-lasting benefit.
Pervasive violence against hospitals, patients, doctors, and other health workers has become a horrifically common feature of modern war. These relentless attacks destroy lives and the capacity of health systems to tend to those in need. Inaction to stop this violence undermines long-standing values and laws designed to ensure that sick and wounded people receive care. Leonard Rubenstein—a human rights lawyer who has investigated atrocities against health workers around the world—offers a gripping and powerful account of the dangers health workers face during conflict and the legal, political, and moral struggle to protect them. In a dozen case studies, he shares the stories of people who have been attacked while seeking to serve patients under dire circumstances including health workers hiding from soldiers in the forests of eastern Myanmar as they seek to serve oppressed ethnic communities, surgeons in Syria operating as their hospitals are bombed, and Afghan hospital staff attacked by the Taliban as well as government and foreign forces. Rubenstein reveals how political and military leaders evade their legal obligations to protect health care in war, punish doctors and nurses for adhering to their responsibilities to provide care to all in need, and fail to hold perpetrators to account. Bringing together extensive research, firsthand experience, and compelling personal stories, Perilous Medicine also offers a path forward, detailing the lessons the international community needs to learn to protect people already suffering in war and those on the front lines of health care in conflict-ridden places around the world.
Humanitarians are required to be impartial, independent, professionally competent and focused only on preventing and alleviating human suffering. It can be hard living up to these principles when others do not share them, while persuading political and military authorities and non-state actors to let an agency assist on the ground requires savvy ethical skills. Getting first to a conflict or natural catastrophe is only the beginning, as aid workers are usually and immediately presented with practical and moral questions about what to do next. For example, when does working closely with a warring party or an immoral regime move from practical cooperation to complicity in human rights violations? Should one operate in camps for displaced people and refugees if they are effectively places of internment? Do humanitarian agencies inadvertently encourage ethnic cleansing by always being ready to 'mop-up' the consequences of scorched earth warfare? This book has been written to help humanitarians assess and respond to these and other ethical dilemmas.
From natural disaster areas to conflict zones, humanitarian workers today find themselves operating in diverse and difficult environments. While humanitarian work has always presented unique ethical challenges, such efforts are now further complicated by the impact of globalization, the escalating refugee crisis, and mounting criticisms of established humanitarian practice. Featuring contributions from humanitarian practitioners, health professionals, and social and political scientists, this book explores the question of ethics in modern humanitarian work, drawing on the lived experience of humanitarian workers themselves. Its essential case studies cover humanitarian work in countries ranging from Haiti and South Sudan to Syria and Iraq, and address issues such as gender based violence, migration, and the growing phenomenon of ‘volunteer tourism’. Together, these contributions offer new perspectives on humanitarian ethics, as well as insight into how such ethical considerations might inform more effective approaches to humanitarian work.
This text is an introductory overview of healthcare provision in different humanitarian conflicts, designed for healthcare professionals and students from a wide range of backgrounds.
The war in Syria, now in its eighth year, continues to take its toll on the Syrian people. More than half of the population of Syria remains displaced; 5.6 million persons are registered as refugees outside of the country and another 6.2 million are displaced within Syria's borders. The internally displaced persons include 2 million school-age children; of these, less than half attend school. Another 739,000 Syrian children are out of school in the five neighborhood countries that host Syria's refugees. The loss of human capital is staggering, and it will create permanent hardships for generations of Syrians going forward. Despite the tragic prospects for renewed fighting in certain parts of the country, an overall reduction in armed conflict is possible going forward. However, international experience shows that the absence of fighting is rarely a singular trigger for the return of displaced people. Numerous other factors—including improved security and socioeconomic conditions in origin states, access to property and assets, the availability of key services, and restitution in home areas—play important roles in shaping the scale and composition of the returns. Overall, refugees have their own calculus of return that considers all of these factors and assesses available options. The Mobility of Displaced Syrians: An Economic and Social Analysis sheds light on the 'mobility calculus' of Syrian refugees. While dismissing any policies that imply wrongful practices involving forced repatriation, the study analyzes factors that may be considered by refugees in their own decisions to relocate. It provides a conceptual framework, supported by data and analysis, to facilitate an impartial conversation about refugees and their mobility choices. It also explores the diversified policy toolkit that the international community has available—and the most effective ways in which the toolkit can be adapted—to maximize the well-being of refugees, host countries, and the people in Syria.
Legal and Ethical Issues for Health Professionals, Fifth Edition is a concise and practical guide to legal and ethical dilemmas facing healthcare professionals in the real-world today. Thoroughly updated and featuring new case studies, this dynamic text will help students to better understand the issues they will face on the job and the implications in the legal arena. With contemporary topics, real-world examples, and accessible language, this comprehensive text offers students an applied perspective and the opportunity to develop critical thinking skills. Legal and Ethical Issues for Health Professionals provides an effective transition from the classroom to the reality of a clinical environment.
This book provides a current analysis of the legal and ethical challenges in preparing for and responding to chemical, biological, radiological, nuclear and explosive (CBRNE) crises. From past events like the Chernobyl nuclear incident in Russia or the Bhopal chemical calamity in India, to the more recent tsunami and nuclear accident in Japan or the Ebola crisis in Africa, and with the on-going threat of bioterrorism, the need to be ready to respond to CBRNE crises is uncontroversial. What is controversial is whether we are on a path that adequately prepares us for the next event. The ethical and legal scholars in this volume hold that much work remains to be done and offer this book to stimulate further reflection and dialogue around CBRNE crises. This is an indispensable book for both students and scholars of bioethics, international law, public health, as well as for regulators and administrators developing policy and legislation related to public health planning and emergency responses.
The most recent Ebola epidemic that began in late 2013 alerted the entire world to the gaps in infectious disease emergency preparedness and response. The regional outbreak that progressed to a significant public health emergency of international concern (PHEIC) in a matter of months killed 11,310 and infected more than 28,616. While this outbreak bears some unique distinctions to past outbreaks, many characteristics remain the same and contributed to tragic loss of human life and unnecessary expenditure of capital: insufficient knowledge of the disease, its reservoirs, and its transmission; delayed prevention efforts and treatment; poor control of the disease in hospital settings; and inadequate community and international responses. Recognizing the opportunity to learn from the countless lessons of this epidemic, the National Academies of Sciences, Engineering, and Medicine convened a workshop in March 2015 to discuss the challenges to successful outbreak responses at the scientific, clinical, and global health levels. Workshop participants explored the epidemic from multiple perspectives, identified important questions about Ebola that remained unanswered, and sought to apply this understanding to the broad challenges posed by Ebola and other emerging pathogens, to prevent the international community from being taken by surprise once again in the face of these threats. This publication summarizes the presentations and discussions from the workshop.