not above the law download free

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Free PDF Add to table Facebook Tweet. Printed Matter, Inc. Advanced filters. Back to simple search. All fields. Height cm to. Grossman [P. Odum [P. Banwell [P. T Sayers [P. Marchewka [P. Branson [P. Gayakwad [P. Agrios [P. Punmia [P. West [P. Robinson [P. Such an effort would ensure that programs meet agreed upon standards, rather than arbitrarily decide whether or how to follow applicable law. US citizens and organizations involved in clinical care overseas should engage with local authorities and support their enforcement efforts by including such officials in the co-creation of health-related initiatives, even if doing so delays, alters, or prohibits a planned program.

This recommendation presupposes a scenario in which host country authorities are involved in some way in the provision of health care to a particular population, which may not always be the case. STEGH organizations must work thoughtfully with community leaders to determine what regulatory authorities are engaged in local health care and what laws apply to visiting health care organizations.

It is never okay to make assumptions or conclusions about host country laws without a diligent investigation that involves individuals who speak and read the applicable language s and are familiar with the applicable laws.

There are a number of factors motivating US citizens to engage in medical work overseas, one of which is the hope that the experience will result in admittance to university programs or enhance employment prospects. University leaders and advisors must educate their students about ethical engagement with communities, and encourage students to work with organizations that adhere to high ethical standards. Admissions departments should not inadvertently celebrate unsafe, unethical, or illegal activities during the application process.

As an example of good practice, the University of Minnesota is addressing these issues in a variety of ways. Undergraduate students applying to register as a student organization in the Student Unions and Activities Office must sign a document affirming that organization officers and members will not participate in the US or overseas in health delivery activities. Students are provided with an extensive list of activities to guide their response on behalf of the registering organization.

Students in health professional programs must join an entirely different type of student organization a Campus Life Program or CLP that is housed formally in a health profession program or school.

CLPs are required to comply with all university policies including policies relating to overseas activities which prohibit inappropriate patient activities and are subject to oversight. In this creative way, the university can enforce ethical and legal practice by both undergraduate and graduate students.

The university also created the Global Ambassadors for Patient Safety GAPS 90 online workshop for students who are going abroad to volunteer in a health care setting. The program, now available via open access online, includes modules that discuss what students can and cannot do abroad and why.

It also gives students a readily available explanation and excuse not to engage in clinical care if asked to do so. US medical licensure boards can serve as allies to stop STEGH organizations from violating medical practice and drug distribution laws of host countries and play a role in educating current and future licensees regarding the lack of professionalism and risk to patients demonstrated by such practices.

Medical boards are uniquely qualified to speak to the importance of licensure in all settings, as well as the link between licensure, patient safety, and professionalism. Boards frequently educate their licensees on topics of importance through newsletters, webinars, and training sessions, and should be encouraged to share the recommendations set forth in this paper with their licensees.

If licensure boards wanted to take a more aggressive stance on the issue, they could ask applicants both first-time and those seeking renewal to document clinical service or educational experiences overseas, including dates of the activity, actions undertaken during the activity, and the name of the sponsoring organization. Boards may not have the resources to effectively investigate violations i.

The US-based Federation of State Medical Boards and the International Association of Medical Regulatory Authorities should also consider taking a position on this issue by educating their member boards and developing strategies to help end the practice of unlicensed care by STEGH participants by, for instance, adopting model licensure application questions and responses to help boards address this issue.

It would be extremely helpful for FDA to engage in a consultation process with global health advocates in the US and overseas to create a guidance document specifically directed to STEGH organizations.

Such a guidance document should set forth best practices, including the recommendation that all host country drug importation and distribution laws be followed. A potential avenue to address under-regulation of STEGH organizations is a seal of approval or certification program to set standards for the industry and help consumers choose an organization that adheres to high ethical standards.

Relevant certification programs already in existence are those for education abroad programs, 93 summer camps, 94 and hospitals. A fee is often charged to an entity desiring certification to support the administrative costs of the certifier, but it is essential that the certifying agency be independent and not issue certificates simply for payment of a fee. A certifying organization might also consider blacklisting certain organizations for unethical conduct although care would have to be taken to document concrete evidence of bad practices to avoid litigation instigated by blacklisted organizations.

Interviews with health professionals in host countries reveal a growing concern with competition from foreign volunteers who can provide free services and who often disregard or disrespect existing local expertise.

Thus, in addition to the legal and ethical reasons for compliance cited in this article, organizations planning STEGHs should be prepared for this coming effort underway in recipient countries. Unethical and illegal activities by some STEGH organizations may exist because of an outdated charity model of aid that ignores the complex long-term needs of LMIC health care systems, populations, and laws.

Some organizations may also believe that bypassing burdensome legal constraints is a necessary short-cut to meet the needs of underserved communities. We argue that this view is short-sighted and not best in the long run for either volunteers or hosts.

The opportunity costs of creating clinical opportunities and experiences with US participants at the center instead of more sustainable, outcomes-oriented community-based initiatives is considerable and troubling. The recommendations set forth in this paper are designed to move US volunteers and organizations to embrace a model of training and service that puts the needs of communities and health care systems and respect for their laws at the fore — a model that has the best chance at achieving sustainable health care equity across the globe.

How pre-health students delivering babies in Africa is quickly becoming consequentially unacceptable. Health Advisor ; 61 35 : 61— Short-term global health experiences and local partnership models: A framework, Globalization and Health.

Academic Medicine ; 91 : — Global Health. Education for Health. Guidelines for responsible short-term global health activities: Developing common principles. Globalization and Health. Trop Dis Travel Med Vaccines. More harm than good? The questionable ethics of medical volunteering and international student placements, Trop Dis Travel Med Vaccines.

Published online Mar 6. Reconfiguring a one-way street: A position paper on why and how to improve equity in global physician training, Academic Medicine. November A protocol to develop practice guidelines for primary care medical service trips. Annals of Global Health.

Accessed Nov. The ethics of medical brigades in Honduras: Who are we helping? Hoping to help: The promises and pitfalls of global health volunteering ; Sullivan N.

International clinical volunteering in Tanzania: A postcolonial analysis of global health business. Global Public Health. The questionable ethics of medical volunteering and international student placements. Tropical Disease Medicine and Vaccines. Short-term medical service trips: A systematic review of the evidence. American J. Public Health. Brain gains: A literature review of medical missions to low- and middle-income countries.

Clear as mud: Voluntourism, power dynamics, and global health. Arya and J. Evert, eds. Community Development J. Physician shadowing: A review of the literature and proposal for guidelines.

Academic Medicine. Observers in the medical setting. Annals of Emergency Medicine. Future Docs Abroad. See Morrison v. National Australia Bank Ltd. Royal Dutch Petroleum Co.

Public Health ; : — Global health training: Ethics and best practice guidelines for training experiences in global health. American J Tropical Medicine and Hygiene. New supervision standards: Discussion and justification.

Accessed Dec. Other nations have similar temporary licensure laws. The application for a temporary license is on file with the authors.

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