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Ethics & palliative care during international humanitarian action
This project aims to; clarify ethical and practical possibilities and challenges of humanitarian organisations addressing patients’ and families’ palliative care needs; inform realistic, context-sensitive and stakeholder-informed guidance, education, and practices; and develop a baseline of current palliative care provisions
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Principal Investigators: Lisa Schwartz, McMaster & Matthew Hunt, McGill
Research snapshot: Palliative care in two refugee camps in Rwanda
Get an overview of the research relating to palliative care in two refugee camps in Rwanda in this research snapshot.
This qualitative study aimed to investigate provision of palliative care within humanitarian response, including the ethical dimensions for health care providers and experiences of affected individuals and care-givers. The study explores four case studies based on different types of humanitarian settings, and includes a literature review, an organisation-based survey, and key informant interviews.
Outcomes
The study successfully completed a literature review, an organisation-based survey and qualitative interviews with humanitarian policy-makers, healthcare providers (local and international), individuals living with palliative care needs, and their caregivers. Case studies were developed from the emergency response for displaced Syrian refugees in Jordan, a protracted refugee setting in Rwanda, the 2014-15 Ebola outbreak in Guinea, as well as from global emergency response to natural disasters.
Key findings
The literature review highlighted a lack of evidence on palliative care provision in emergency contexts, itself a reflection that this is often an overlooked aspect of humanitarian response.
The moral experience of humanitarian responders was grounded in values of compassion in the provision of care, and justice in accessing it. Themes included easing suffering, upholding dignity, prioritisation, systemic constraints, and the weight of responsibility.
Obstacles were identified to implementation of palliative care by humanitarian organisations.
Patient and healthcare provider participants overwhelmingly spoke of the crucial importance of low-cost, low-specialty care such as accompaniment.
There always remains ‘something to offer’ in terms of palliative care in international humanitarian action, however such interventions should in no way diminish attempts to offer curative care where/when possible, working towards improvements of local and global health systems, and advocating for equity, justice and rights to health and healthcare.
The study “Aid When there is ‘Nothing Left to Offer’” included a case study focusing on palliative care in Ebola Treatment Centres (ETCs) in Guinea during the 2014-16 outbreak. Its…
Making space for palliative care in humanitarian action: Reflections on obstacles to the integration of palliative care approaches in humanitarian healthcare
Oct 2017
Many situations arise in humanitarian crises when curative care is not the primary, or the only, mode for humanitarian healthcare: a woman with advanced cancer who has been forced to…
Out of the shadows: Palliative care in humanitarian healthcare
Mar 2017
On February 9th, the Humanitarian Health Ethics Research Group launched the first global survey on palliative care in humanitarian situations. This survey forms part of a larger R2HC-funded study led…
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