Ethics in Global Surgery

Abstract

Interest in making contributions to medical practice and research in low and middle income countries (LMIC) has become increasingly prevalent. The greatest strides have been made in preventive and primary care health measures applied toward vaccination strategies for infectious diseases, maternal and child health, and the HIV/AIDS pandemic. However, for many reasons, addressing surgical disease in LMIC’s has been a challenge. Although individual groups continue to deliver surgical care throughout the world, an organized agenda for surgical care has been lacking. Concentrated efforts by organizations such as the World Health Organization Global Initiative for Essential and Emergency Surgical Care (WHO-GIEESC) and more recently, the Lancet Commission on Global Surgery and the advocacy-based Global Alliance for Surgical, Obstetric, Trauma, and Anaesthesia Care (G4 Alliance) are finally yielding benefits by building political priority for surgical care as part of the global development agenda. In May 2015, the World Health Assembly (WHA) passed a landmark resolution on the importance of surgical care in the universal health care plan. The WHA mandate was a significant step towards mobilizing vital surgical initiatives, individuals, institutions, and health care teams. Given the significance of these initiatives, it is imperative and timely, that the ethical issues surrounding global surgery are delineated and better understood. Surgeons who function in this realm carry a significant burden of responsibility to provide safe, cost-effective, culturally-appropriate and good quality care in the most ethical manner possible