Ethical Challenges in Short-Term Global Health Training

Dara is seen here discussing the issue with her local advisor.

CASE 5: Addressing "Ancillary Benefits"

Vignette 2: Before giving her shoes away, Dara decided to ask her local advisor about whether such a gift would be appropriate. Her advisor thanks her for asking such an insightful question. As it turns out, this need has been identified in the past. The local community has set up a system for providing well fitting shoes to people just like the woman Dara saw. Dara can refer this woman to that local resource, and donate her shoes to the local community if she so desires.

Which of the following best describes the ethical rationale behind Dara’s decision to ask her local advisor about how to proceed?

Justice, because the local community seems to distribute the shoes fairly.
Although the distribution system might indeed be just, this is not the main rationale behind Dara’s strategy. Choose a different answer.
Mutual respect, because Dara showed respect for the local community by asking as she did.
This best describes why Dara asked her local advisor how best to proceed. The local community must deal directly with the long-term effects of the actions and behaviors of short-term trainees. In addition, Dara did not know of the shoe bank until she asked. Showing mutual respect in this way helped resolve Dara’s situation.
Beneficence, because Dara is trying to offer her shoes to someone in need.
Giving away shoes might represent beneficence, but the goal may be accomplished in more than one way. In this case, Dara did not know the best way to do so. How can she find out? Choose a different answer.
Autonomy, because Dara is asking someone in the community what she or he would do.
Applying the standard concept of autonomy, which typically applies to individuals, to communities can be challenging. Even if it does apply here, the best rationale behind Dara’s decision has more to do with how she finds the best way to proceed. Choose a different answer.
© Stanford University Center for Global Health and the Johns Hopkins University Berman Institute of Bioethics.

Project funding provided by Doris Duke Charitable Foundation (DDCF)