Global Surgery: Ethical And Legal Challenges Facing Surgeons

Global Surgery: Ethical And Legal Challenges Facing Surgeons

Mariam Gaddah
Manchester University, United Kingdom

Introduction:Following The Lancet’s ‘Global Surgery 2030’ report, interest in working in Low Middle Income Countries (LIMC) from surgeons and trainees from around the world, from High-Income Countries (HIC) has increased. However, due to extreme shortages in resources and significant differences in cultural religious and ethical principles in some LMIC, visiting surgeons and trainees may face legal and ethical challenges.

Aim: This project aims to highlight challenges faced by surgeons and trainees, explore guidance available for tackling challenges and possible solutions

Method: Through hypothetical scenarios, in Malawi and Somalia, ethical and legal challenges facing surgeons were analysed. The Malawi scenario illustrated the impact of shortage of staff and resources on a surgical trainee that carried out procedures for which they are not trained to do. The Somalia scenario explored the cultural and moral differences in the practice relating to Female Genital Mutilation (FGM). The paper explores the guidance available regarding the challenges raised.

Findings: The challenges identified related to competency, standard of care, consent, legislationand the moral distinction between doing and allowing harm. Guidance lacks from the General Medical Council and British Medical Association supporting surgeons from HIC working in LMIC. Surgeons may face unexpected scrutiny for work undertaken in these settings.

Conclusion: Guidance and policy should appropriately reflect the described challenges and consider the different working environment in LMICs, considering the growth of medical volunteers. Building strong international relationships through institute collaborations and recognised training pathways, could address practice difference and help with understanding the dilemmas in global surgery.

Keywords: Global surgery, ethics, law