Abstract
Newborn infants are among those most severely affected by humanitarian crises. Aid organisations increasingly recognise the necessity to provide for the medical needs of newborns, however, this may generate distinctive ethical questions for those providing humanitarian medical care. Medical ethical approaches to neonatal care familiar in other settings may not be appropriate given the diversity and volatility of humanitarian disasters, and the extreme resource limitations commonly faced by humanitarian aid missions.In this paper, we first systematically review existing guidelines relating to the treatment and resuscitation of newborns in humanitarian crises, finding little substantive ethical guidance for those providing humanitarian healthcare. We next draw on paradigm cases and published literature to identify and describe some of the major ethical questions common to these settings. We divide these questions into quality of life considerations, allocation of limited resources, and conflicting cultural norms and values. We finally suggest some preliminary recommendations to guide ethical decision‐making around resuscitation of newborns and withdrawal of treatment in humanitarian settings.
Highlights
Humanitarian medicine presents an exceptionally challenging clinical and ethical environment for health professionals
Aid organisations increasingly recognise the necessity to provide for the medical needs of newborns, this may generate distinctive ethical questions for those providing humanitarian medical care
We suggest some preliminary recommendations to guide ethical decision-m aking around resuscitation of newborns and withdrawal of treatment in humanitarian settings
Summary
Humanitarian medicine presents an exceptionally challenging clinical and ethical environment for health professionals. Aid is often called for at short notice in settings of conflict, natural disaster, food insecurity, and population displacement.. In 2016, an estimated 164.2 million people in 47 countries were in need of humanitarian assistance, with 65.6 million displaced worldwide.. Capabilities range from gold-standard, modern day facilities – such as those provided by United States Naval forces during the 2010 Haiti earthquake – to understaffed, basic hospitals that are rapidly inundated with patient numbers beyond their capacity.. Capabilities range from gold-standard, modern day facilities – such as those provided by United States Naval forces during the 2010 Haiti earthquake – to understaffed, basic hospitals that are rapidly inundated with patient numbers beyond their capacity.4,5 This burden is amplified by limited and irregular access to essential equipment supplies and resources, including operating theatres, ventilators and oxygen, medical staff, and food and running water. Missions often rely on a rotating system of short-term
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