Perspectives

Toward a New Ethic in Global Health Practice: Perspectives from Central America

Authors: William Ventres, MD, MA

Abstract

Consider these situations involving physicians and other healthcare professionals from high-income countries—
also known as the “global north,” represented principally by practitioners from the United States, Canada, and Western European countries—working in the lower-middle-income countries of Central America:

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Koplan JP, Bond TC, Merson MH, et al. Towards a common definition of global health. Lancet 2009;373:1993-1997.
2. Tervalon M, Murray-Garcia J. Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education. J Health Care Poor Underserved 1998;9:117-125.
3. Nichter M. Global Health: Why Cultural Perceptions, Social Representations, and Biopolitics Matter. Tucson:University of Arizona Press; 2008.
4. Vicini A. Social justice and the promotion of the common good in medical missions to low-resourced countries. Ann Glob Health 2019;85:83.
5. Crisp N. Turning the World Upside Down: The Search for Global Health in the 21st Century. London: Royal Society of Medicine Press; 2010.
6. Donkin A, Goldblatt P, Allen J, et al. Global action on the social determinants of health. BMJ Glob Health 2017;3:e000603.
7. Villar E. Los determinantes sociales de salud y la lucha por la equidad en salud: desafíos para el estado y la sociedad civil [The social determinants of health and the struggle for health equity: challenges for states and civil society]. Saude Soc 2007;16:7–13.
8. Napier AD, Ancarno C, Butler B, et al. Culture and health. Lancet 2014;384:1607-1639.
9. Flood D, Rohloff P. Indigenous languages and global health. Lancet 2018;6:e134-135.
10. Ventres WB. The joys of global medicine and the lesson of relationship. Am J Med 2016;129:771-772.
11. Ventres WB, Wilson BK. Rethinking goals: transforming short-term global health experiences into engagements. Acad Med 2020;95:32-36.
12. Oliveira MJ, Osman EMRO. Bioethical pluralism: Latin American contributions to bioethics from a decolonial perspective. Rev Bioetica 2017;25:52-60.
13. Garcia RH. La bioética en perspectiva Latinoamericana, su relación con los derechos humanos y la formación de la consciencia social de futuros profesionales [Bioethics in Latin American perspective, its relation to human rights and social awareness training of future professionals]. Rev Latinoam Bioetica 2012;12:44–51.
14. Vasquez EE, Perez-Brumer A, Parker RG. Social inequities and contemporary struggles for collective health in Latin America. Glob Public Health 2019;14:770-790.
15. Almeida-Filho N, Silva Paim J. La crisis de la salud pública y el movimiento de  salud colectiva en Latinoamérica [The crisis of public health and the collective health movement in Latin America]. Cuad Med Soc 1999;75:5–30.
16. Kreiger N. Latin American social medicine: the quest for social justice and public health. Am J Public Health 2003;93:1989-1991.
17. Leon FJ. Justicia y bioética ante las desigualdades en salud en Latinoamérica [Justice and bioethics between health’s inequities in Latin America]. Rev Colomb Bioetica 2010;5:85–99.
18. Schramm FR. Bioethics of protection: a health practice evaluation tool? Cienc Saude Colet 2017;22:1531-1538.
19. Garrafa V, Porto D. Intervention bioethics: a proposal for peripheral countries in a context of power and injustice. Bioethics 2003;17:399-416.
20. Feitosa SF, Nascimento WF. The bioethics of intervention in the context of contemporary Latin American thinking. Rev Bioetica 2015;23:276-283.
21. Luna Orosco JE. Bioética de intervención: del discurso a la praxis [Intervention bioethics: from discourse to praxis.]. Jurispr Arg 2010;4:43–50.
22. Melby MK, Loh LC, Evert J, et al. Beyond medical “missions” to impact-driven short-term experiences in global health (STEGHs): ethical principles to optimize community benefit and learner experience. Acad Med 2016;91:633-638.
23. Rowthorn V, Loh L, Evert J, et al. Not above the law: a legal and ethical analysis of short-term experiences in global health. Ann Glob Health 2019;85:79.
24. Farmer PE, Nizeye B, Stulac S, et al. Structural violence and clinical medicine. PLoS Med 2006;3:3449.
25. Arya AN, Evert J, eds. Global Health Experiential Education: From Theory to Practice. New York: Routledge; 2018.
26. Downing R. Global Health Means Listening. Nairobi, Kenya: Manqa Books; 2018.
27. Bui T, Evert J, McCarthy V, et al., eds. Reflection in Global Health: An Anthology. San Francisco: Global Health Collaborations Press; 2015.
28. Purkey E, Hollaar G. Developing consensus for postgraduate global health electives: definitions, pre-departure training and post-return debriefing. BMC Med Educ 2016;16:159.
29. Benatar S, Daar AS, Singer PA. Global health ethics: the rationale for mutual caring. Int Aff 2003;79:107-138.
30. Adams LV, Wagner CM, Nutt CT, et al. The future of global health education: training for equity in global health. BMC Med Educ 2016;16:296.
31. MacPhee M, Chang L, Lee D, et al. Global health care leadership development: trends to consider. J Healthc Leadersh 2013;5:21-29.
32. Farmer PE. On suffering and structural violence: a view from below. Daedalus 1996;125:261-283.
33. Holmes SM, Greene JA, Stonington SD. Locating global health in social medicine. Glob Public Health 2014;9:475-480.
34. Friel S, Marmot MG. Action on the social determinants of health and health inequities goes global. Ann Rev Public Health 2011;32:225-236.
35. Commission of the Pan American Health Organization on Equity and Health Inequalities in the Americas. Just Societies: Health Equity and Dignified Lives. Report of the Commission of the Pan American Health Organization on Equity and Health Inequalities in the Americas. Washington, DC:Pan American Health Organization;2019. https://iris.paho.org/handle/10665.2/51571. Accessed March 31, 2020.
36. Varma S, Stone MK. Glocal: global health through local engagement. Clin Pediatr Emerg Med 2019;20:83-88.
37. Ventres WB, Wilson CL. Beyond ethical and curricular guidelines in global health: attitudinal development on international service-learning trips. BMC Med Educ 2015;15:68.
38. Hughes V, Delva S, Mkimbeng M, et al. Not missing the opportunity: strategies to promote cultural humility among future nursing faculty. J Prof Nurs 2020;36:28-33.
39. Taylor A, Siddiqui F. Bringing global health home: the case of global to local in King County, Washington. Ann Glob Health 2016;82:972-980.
40. Ventres WB, Haq C. Toward a cultural consciousness of self-in-relationship: from “us and them” to “we.” Fam Med 2014;46:691-695.
41. Morias TCA, Monteiro PS. Concepts of human vulnerability and individual integrity in bioethics. Rev Bioetica 2017;25:311-319.
42. Ventres WB, Fort MP. Eyes wide open: an essay on engaged awareness in global medicine and public health. BMC Int Health Hum Rights 2014;14:29.