ETHICS OF GLOBAL SURGICAL CARE: A FOUR-PART MODEL TO ENHANCE GLOBAL OTOLARYNGOLOGY AND HEAD AND NECK SURGERY CARE

Abstract

Global surgery describes the systematic way to reduce health disparities and realize accessibility and sustainability in surgical care. Nearly five billion individuals lack access to adequate and necessary surgical and peri-surgical care. The contemporary model of global surgery is that of short-term surgical trips, which have origins in European and North American colonialism. The current state of global surgery in the surgical subspecialty of otolaryngology and head & neck surgery (OHNS) care fails to meet an adequate ethical threshold based on traditional bioethical principles. In order to improve the system of global OHNS care to promote sustainability and long-term impact, global OHNS care needs to shift away from providing direct clinical care. This work presents an ethical framework composed of four primary domains—(1) preparation and understanding the local context, (2) education, (3) partnership and exchange, (4) research and evaluation. This model can be used to shephard a future with stronger ethical global OHNS care.