Applying global standards to short-term global health clinical experiences: the case of Project Salud y Paz
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Applying global standards to short-term global health clinical experiences: the case of Project Salud y Paz Paul H. Caldron1,2
Abstract This case study was extracted from an administrative report generated for Project Salud y Paz (SYP), a non-governmental organization (NGO) that supports short term global health clinical experiences (STGHCE) in Guatemala. As a basis to generate criticisms and offer recommendations, the analysis used the shared themes of two sets of standards recently published by Globalization and Health (GH) and the American College of Physicians (ACP). These standards respectively address the ethical responsibilities of organizations and of physicians in the conduct of STGHCE. Information used in the original quality analysis and quality improvement consultation for SYP was gathered from interviews, medical committee minutes, output statistics, and observations in the course of a realtime trip. This case study describes how the standards served as a useful lens to assess SYP and as a platform from which to make recommendations for improved compliance with global conventions. Additionally, the standards provide SYP a body of consensus wisdom for holding itself accountable to patients, host communities, volunteers, and the donor community on a continuing basis. While the shared themes of these standards are intentionally broad and require context in their application, NGOs that support STGHCE may find it instructive to benchmark them to assure their own compliance with global standards for both the organization and their volunteer physicians. Keywords: Short term, Global health, Position statement
Background In the first quarter of 2018, Lasker et al published in Globalization and Health (GH) an overarching set of six core principles distilled from an analysis of 27 published sets of non-specialty-related guidelines aggregated in a scoping review [1]. Contemporaneously, the Annals of Internal Medicine (AIM) published an American College of Physicians (ACP) position statement derived by consensus of an expert panel regarding ethical obligations of physicians participating in short term global health clinical experiences (STGHCE) [2]. Broadly speaking, the GH principles are more relevant to the behavior of non-governmental organizations (NGOs) that conduct and support STGHCE while the ACP positions relate to physician conduct. Shared themes can readily be seen between the positions and principles of these two benchmarks (Table 1). ACP position 3, Correspondence: [email protected] 1 Midwestern University Arizona College of Osteopathic Medicine, Glendale, AZ, USA 2 Phoenix, USA
i.e., “The ethical principle of respect for persons, including being sensitive to and respectful of cultural differences”, may be viewed as integral in part to 4 of the 6 themes of the GH principles. How these two sets will be utilized to affect the conduct of STGHCE remains to be seen. This case study provides an early example of the utilization of these positions and principles, herein re
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