Ethical challenges for psychologists conducting humanitarian work.

Abstract

This article describes the ediical challenges that psychologists face when doing international humanitarian aid work. It is based on personal experience and uses the framework of the Canadian Code of Ethics for Psychologists to reflect on the unique challenges when doing such work. The article is organized around themes of ediical challenges under the following headings: limitation of resources, local political pressure, local cultural and social realities, challenges to confidentiality, problems in obtaining consent, sequelae of colonial history, individual versus population interests, and tolerance of differences in standards. Examples illustrate these points. Keywords: humanitarian work, ethical conflicts, principles of ethics, standards Resume Cet article decrit les difficultes d'ordre ethique avec lesquelles doivent composer les psychologues s'adonnant a du travail humanitaire international. Il s'appuie sur des experiences personnelles et utilise les fondements du Code canathen de deontologie professionnelle des psychologues pour examiner les defis particuliers que presente ce genre de travail. L'article s'articule autour des themes suivants, qui se rapportent aux problemes d'ethique : limites des ressources, pressions politiques locales, realites culturelles et sociales locales, difficultes relatives a la confidentialite, problemes pour l'obtention du consentement, sequelles du colonialisme, interets personnels versus interets collectifs, et tolerance a l'egard des ecarts par rapport aux normes. Des exemples illustrent ces divers sujets. Mots-cles : travail humanitaire, conflits ethiques, principes ethiques, normes.' Is it possible to maintain ethical standards while working on humanitarian missions? Humanitarian work for psychologists, although personally fulfilling, is also full of professional challenges. While working with Medecins Sans Frontieres on a number of missions, I was confronted regularly with ethical dilemmas that at times allowed for adaptive solutions but at other times remained persistent and unresolved. The key objective of this article is to review the types of ethical challenges that psychologists face when they are involved in humanitarian work on a mission. These challenges are presented in light of the Canadian Code of Ethics for Psychologists (CPA, 2000). To achieve this objective, the article offers real-life examples to illustrate some of the dilemmas the humanitarian worker has to face. The examples include how certain solutions were attempted, which might have been quite different if applied in the Canadian context at home. Recently, a vast number of humanitarian crises have engaged the energies of international aid organisations, also referred to as nongovernmental organisations (NGOs). These NGOs provide health care and support for physical and psychological needs to populations suffering from human-made or natural disasters. Little research has been done on the ethical challenges encountered by medical and nursing professionals participating in humanitarian aid work, and even less is available on the specific challenges faced by psychologists on a mission. The involvement of psychologists in humanitarian missions is a fairly new concept. Medecins Sans Frontieres was founded in 1971 after the Biafran famine by a group of French physicians and journalists; however, it was only in the late nineties that mental health workers were systematically recruited as well. A main target of mental health worker assignments was dealing with the sequelae of rape. Rape tragically has become a weapon of war - an attempt to create disequilibrium. In recent years, this has applied to African countries such as the Congo, Sudan, and even more close to home, now in Haiti. Such a situation creates a role for mental health workers that goes beyond mere medical crisis management. Psychologists' work on a mission can be quite varied. To provide a context for understanding the inherent ethical challenges, below is a list of the types of work I was engaged in; namely, when working one-on-one with patients: * identify target groups needing psychological services * set up a triage system to assess and respond to needs * assess available psychological resources and prepare intervention strategies * provide psychological treatment and support to survivors * coordinate outreach to the identified target group * identify and maintain a local referral network * provide psycho-education and social-education material. …