Health Care Voluntourism: Addressing Ethical Concerns of Undergraduate Student Participation in Global Health Volunteer Work
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The popularity and availability of global health experiences has increased, with organizations helping groups plan service trips and companies specializing in “voluntourism,” health care professionals volunteering their services through different organizations, and medical students participating in global health electives. Much has been written about global health experiences in resource poor settings, but the literature focuses primarily on the work of health care professionals and medical students. This paper focuses on undergraduate student involvement in short term medical volunteer work in resource poor countries, a practice that has become popular among pre-health professions students. We argue that the participation of undergraduate students in global health experiences raises many of the ethical concerns associated with voluntourism and global health experiences for medical students. Some of these may be exacerbated by or emerge in unique ways when undergraduates volunteer. Guidelines and curricula for medical student engagement in global health experiences have been developed. Guidelines specific to undergraduate involvement in such trips and pre-departure curricula to prepare students should be developed and such training should be required of volunteers. We propose a framework for such guidelines and curricula, argue that universities should be the primary point of delivery even when universities are not organizing the trips, and recommend that curricula should be developed in light of additional data.
KeywordsDeveloping world Global health Resource poor Service trip Students Volunteer Voluntourism
We wish to acknowledge the generous support of the Richter Scholars Program administered through the URECA Center at Wake Forest University. The scholarship enabled Daniel McCall to travel to Nicaragua in the summer of 2012, where he observed first-hand some of the concerns that arise when undergraduate students participate in health related volunteer work in resource poor settings. We also acknowledge the very helpful comments from two reviewers whose insights helped to improve this paper and Dr. Pat Lord of Wake Forest University, with whom we have had many helpful conversations on this topic.
- Association of American Medical Colleges (AAMC) (2011). Guidelines for Premedical and Medical Students Providing Patient Care During Clinical Experiences Abroad. Washington DC. (AAMC). Retrieved from https://www.aamc.org/download/181690/data/guidelinesforstudentsprovidingpatientcare.pdf.
- Association of American Medical Colleges (AAMC). (2012). Medical School Graduation Questionnaire: 2012 All Schools Summary Report. Washington, DC. AAMC. Retrieved from https://www.aamc.org/download/300448/data/2012gqallschoolssummaryreport.pdf.
- Association of Faculties of Medicine of Canada (AFMC) Global Health Resource Group and Canadian Federation of Medical Students Global Health Program. (2008). Preparing Medical Students for Electives in Low-Resource Settings: A Template for National Guidelines for Pre-Departure Training. Retrieved from www.cfms.org/pictures/file/Global%20Health/Pre-departure%20Guidelines%20Final.
- Beamon, C. J., Vik, D., Jill, M., Forcina, H., William, H., & Shumate, J. A., (2006). A Guide to Incorporating Cultural Competency into Health Professionals’ Education and Training. Retrieved from http://njms.umdnj.edu/culweb/medical/documents/CulturalCompetencyGuide.pdf.
- Conant, E., (2007). Having fun doing good. Newsweek. Retrieved October 16, from http://www.newsweek.com/id/49470.
- Deonandan, R., Jinha, A., Benovoy, J., Sarazin, M., & Doswell, J. (2012). A pilot study for case-based learning among undergraduate students in global health. Internet Journal of Medical Education, 2(2).Google Scholar
- Elansary, M., Graber, L. K., Provenzano, A. M., Barry, M., Khoshnood, K., & Rastegar, A. (2011). Ethical dilemmas in global clinical electives. Journal of Global Health, 1(1), 24–27.Google Scholar
- Fischer, K. (2013). Some health programs overseas let students do too much, too soon. The Chronicle of Higher Education. Retrieved November 4, from http://chronicle.com/article/Overseas-Health-Programs-Let/142777/.
- Frontier. (2013). Medical Volunteering. Irvine, CA. The Society of Environmental Exploration. Retrieved from http://www.frontier-usa.org//Volunteer/Medical-Volunteering.aspx?setsite=1.
- Global Health Training Education Consortium (GHTEC). (2011). Training in graduate medical education: A guidebook (2nd ed.). San Francisco: Global Health Education Consortium.Google Scholar
- Gunderson, A. (2005). More vacationers answer the call to help. New York Times. Retrieved February 20, from http://www.nytimes.com/2005/02/20/travel/20volunteer.html?_r=0a.
- Krippendorf, J. (1999). The holiday makers. London: Heinemann.Google Scholar
- Montgomery, L. M. (1993). Short-term medical missions: Enhancing or eroding health? Missiology: An international. Review, 21(3), 333–341.Google Scholar
- Pellegrino, E. D. (1991). Trust and distrust in professional ethics. In E. D. Pellegrino, R. Veatch, & J. Langan (Eds.), Ethics, trust, and the professions: Philosophical and cultural perspective (pp. 69–91). Washington, DC: Georgetown University Press.Google Scholar
- Projects Abroad Inc. (2013). International Volunteer Opportunities of College Students with Projects Abroad. New York, NY: Projects Abroad Inc. Retrieved from http://www.projects-abroad.org/more-info/planning-your-time-abroad/university-students/.
- Rekart, M. L., Rekart, J. T., Patrick, D. M., & Brunham, R. C. (2003). International health: Five reasons why Canadians should get involved. Canadian Journal of Public Health, 94(4), 258–259.Google Scholar
- Unite for Site Inc. (2013). Global Health Course: Module 7. New Haven, CT. Available at: Unite for Site. http://www.uniteforsight.org/global-health-course/module7.
- Wall, A. E. (2006). Ethics for international medicine: A practical guide for aid workers in developing countries. Sudbury: Dartmouth Publishing Inc.Google Scholar
- Wallace, L. J. (2012). Does pre-medical volunteerism improve the health of communities abroad? Journal of Global Health Perspectives, Retrieved from http://jglobalhealth.org/article/does-pre-medical-voluntourism-improve-the-health-of-communities-abroad-3/.
- Wearing, S. (2001). Volunteer tourism: Experiences that make a difference. New York: CABI Publishing.Google Scholar
- White, M., & Cauley, K. (2006). A caution against medical student tourism. Virtual Mentor, 8, 852–854.Google Scholar
- Zaner, R. (1991). The phenomenon of trust and the patient-physician relationship. In E. D. Pellegrino, R. Veatch, & J. Langan (Eds.), Ethics, trust, and the professions: Philosophical and cultural perspective (pp. 45–67). Washington, DC: Georgetown University Press.Google Scholar