The Ethical Implications of Student Participation in Short-Term Experiences in Global Health

Abstract

Student interest in short-term experiences in global health (STEGHs) has grown in recent years. Typically, students travel from high-income countries (HIC), standing to benefit from varied clinical exposure and participation beyond what is allowed in their home jurisdictions. Whether STEGHs benefit the hosting low- and middle-income countries (LMICs) are less clear. We seek to mitigate the ethical implications of student participation in STEGHs by examining three domains: (a) the medical scope of practice for students; (b) cultural competency; and (c) reciprocal partnerships. These domains permit further elucidation of key issues relating to ethics, and public policy, to clarify how STEGH initiatives can be evaluated. Our analysis implicates that STEGHs can be described as post-colonial enterprises that perpetuate structural violence in LMICs and may cultivate hubris and savior complexes in learners. Examination of these domains necessitates two points for further analysis and evaluation with respect to STEGHs: (1) a stronger idea of justice and distributive justice that includes considerations of structural violence and reciprocity; and (2) realignment of student global health priorities towards the communities being cared for as opposed to the benefits of high income countries and volunteers. To improve global health knowledge transfer worldwide, we advocate for reciprocity between HIC and LMIC institutions and training in the colonial history of global health. We hope these changes will reduce eurocentrism within student global healthand any potential harms.