Ethical Challenges in Short-Term Global Health Training

Bryce is a public health student interested in surveillance for emerging diseases in Asia. Locals seem less interested. Click image to start video.

CASE 9: Selecting a Research Project

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Vignette 1: Bryce is a public health student interested in surveillance for emerging diseases. As part of his thesis, he has proposed a research project evaluating disease surveillance strategies in an Asian country. His research advisor has a long standing collaboration there focused on the environmental impact of local farming practices. Bryce is aware that there is some suspicion that a novel influenza virus could be arising in certain “hot spots” near these local farms and he is excited about evaluating this possibility. His home advisor thinks the local community would be supportive of such a project and he helps Bryce organize a short-term training program to do so.

However, shortly after Bryce arrives, his local supervisor is no longer interested in the disease surveillance project. A group of local farmers, too, has heard about the project and opposes it. Bryce’s local supervisor asks him to change his research proposal, but Bryce is concerned that this might be against the terms of his funding sponsor.

What should Bryce do?

Insist on completing his influenza protocol. This is what he was funded to do, and he is obligated to do so because of his funding source.
Bryce does have obligations toward his research sponsor. However, at this point, being insistent in spite of the obvious reservations on the part of his local colleagues is not likely to be fruitful. Choose a different answer.
Change his research proposal to whatever his local advisor asks him to do. He can always tell the sponsors later what happened.
This might be the easiest approach, however, Bryce has obligations toward his research sponsor. At the very least, he has an obligation to attempt to inform the sponsor about such a dramatic change in scope. Choose a different answer.
Terminate the relationship. The local advisor and community are making unreasonable demands.
In rare cases, differences between a trainee and the local community could require termination of the training experience. However, that does not appear to be the case here. Such a drastic measure would destroy what otherwise appears to be a working collaboration between this community and Bryce’s advisor at home. Choose a different answer.
Discuss the situation with his local advisor, then consider bringing the issue up in the local community and discuss how to compensate appropriately.
This is correct. Unless other extenuating circumstances were to exist (such as concern for personal safety), an appropriate first step would be for Bryce to try and understand the concerns of the local community. Perhaps his research could be simply modified to reflect their concerns and/or postponed to a later date. This will also give him information he will need as he engages his advisor at home and his funding source.
© Stanford University Center for Global Health and the Johns Hopkins University Berman Institute of Bioethics.

Project funding provided by Doris Duke Charitable Foundation (DDCF)