In Focus: Stephanie Nixon
Stephanie is a physiotherapist who has been an HIV activist and researcher for 20 years. She completed her BHSc in Physiotherapy at McMaster University in 1996, and then moved to the University of Toronto for her MSc (Rehabilitation Science, 2000) and PhD (Public Health and Bioethics, 2006). Stephanie’s PhD used a critical public health ethics lens to examine the Government of Canada’s international response to HIV. She then conducted her post-doc at the Health Economics and HIV/AIDS Research Division (HEARD) at the University of KwaZulu-Natal in South Africa from 2006-2008.
She is now an Associate Professor in the Department of Physical Therapy and Dalla Lana School of Public Health, and Director of the International Centre for Disability and Rehabilitation, at the University of Toronto. Recently, she was awarded the 2015 Faculty of Medicine Graduate Teaching Award for Early Career Excellence in Graduate Teaching and Mentorship for Physical Therapy at the University of Toronto.
Currently, she leads two programmes of research: (1) HIV, disability and rehabilitation in Sub-Saharan Africa and Canada, and (2) education scholarship on how to develop critical analysis skills among health care providers (with a particular interest in racism, ableism and colonization).
In Focus: Ross Upshur
Ross Upshur is dedicated to exploring complex health ethics issues and considers them from a pan-global perspective rather than separating them into local or global arenas. For Ross, healthcare is a social justice issue shaped by various political, socio-cultural, historical, and economic forces. These elements impact healthcare delivery as much as do technological innovations and distribution.
Completing the first Primary Care Health Services Atlas of primary care service delivery in Ontario, directing research focused on complex chronic diseases particularly in seniors, co-leading a team that published a white paper report, Stand on Guard for Thee, in response to the absence of attention to ethical issues in national plans for pandemic influenza response, initiating a line of enquiry into assumptions of evidence based medicine, and co-authoring research that has led to the establishment of global Task Force with the World Health Organization on drug resistant tuberculosis in high HIV burdened populations, are just a few of the many accomplishments credited to HumEthNet member, Ross Upshur. Ross is the Canada Research Chair in Primary Care Research at the University of Toronto and is a Professor at the Department of Family and Community Medicine and Dalla Lana School of Public Health. He is also an Adjunct Associate Professor in the School of Geography and Earth Sciences and Associate Member of the Institute of Environment and Health at McMaster University. He is the former Director of the University of Toronto Joint Centre for Bioethics (2006-2011) and was a staff physician at the Department of Family and Community Medicine, Sunnybrook Health Sciences Centre from 1998-2013.
In 2013, he co-edited, with Andrew Pinto, the Introduction to Global Health Ethics (Routledge). Billed as an “introductory textbook [to support] students to understand and work through key areas of concern”, the text is an invaluable resource for students undertaking any number of health-related undergraduate or graduate courses in ethics or considering placements overseas. With a forward by James Orbinski, the text covers such topics as human rights, global health governance, indigenous health, global health partnerships, and global health advocacy.
For Ross, the HumEthNet represents an important opportunity for rigorous inquiry into the very complex ethical issues raised by humanitarian work. Having had extensive involvement with the Ethics committee of Doctors Without Borders and as a founding board member of Dignitas international informs his understanding of the on-the-ground realities faced by humanitarian organizations. Research is fundamental to better humanitarian practice and attention to the ethical issues is fundamental in this regard.
In Focus: Nyamiye Hermenegilde
Human Health Aid – Burundi is a Non-Governmental Organization that was created in 2005 and registered under 530/1349 on December 23, 2008. It was created by a group of academics, medical practitioners, psychologists, an anthropologist and a social worker. Its mission focuses on emergency response and it provides research that aims to enhance the performance of humanitarian work in affected countries.
Human Health Aid – Burundi has completed a range of projects in the field of WASH with innovation, Assist Refuges and Asylum Seekers through Asylum Seekers Relief Services. We are committed to responding to emergency needs where these arise, as well as assessing needs for decisions makers, NGOs and other institutions. We carry out relief activities in deprived and remote areas where no other NGOs are present, and facilitate monitoring, evaluation and research of the interventions we provide. We are committed to strengthening individual and institutional capacity in health aid, to be more efficient and effective in responding to humanitarian health needs and crises.
In Focus: Lisa Eckenwiler
Lisa Eckenwiler is Associate Professor of Philosophy in the Departments of Philosophy and Health Administration and Policy at George Mason University. She served as Director of Health Care Ethics at George Mason from 2007 – 2012. She teaches courses in Bioethics, Public Health Ethics, Global Health Ethics, and Research Ethics.
Eckenwiler’s research interests are broad. She has published widely on research ethics, and currently, serves, with Matthew Hunt and others, as a co-investigator on a project funded by the Canadian Institutes for Health Research examining research ethics in low resource disaster settings. One work in progress proposes the ideal and practice of “real time responsiveness” for ethical oversight in disaster research. She also chaired the Committee on the Declaration of Helsinki for the International Network for Feminist Approaches to Bioethics, which submitted proposed revisions of this internationally renowned research ethics code to the World Medical Association in 2007-08.
Her first book, The Ethics of Bioethics: Mapping the Moral Landscape (co edited with Felicia Cohn), was published by Johns Hopkins University Press in 2007. In her current research, Eckenwiler focuses on ethical issues at the intersection of long-term care, health worker migration, especially nurses and care workers, and global health inequities. Her second book, Long Term Care, Globalization, and Justice (Johns Hopkins University Press, 2012) addresses these issues. She is also a co-investigator on another CIHR funded project examining the root causes of health worker migration and the implications for so-called source countries.
Writing about the moral links between immigration policies and elder-care in the United States, Eckenwiler has written also for more general audience including the Huffington Post of which this is an excerpt: “We might be said to be responsible for addressing harms migrant care workers (and their countries’ health systems and ill and aging populations) suffer because of our shared humanity, or our participation in processes that generate injustice. Another way of thinking about this is in terms of their intimate and crucial contribution to our identities. The care provided by migrant workers — nannies, nurses, home care aides and others — is now an increasingly integral part of who are — as beneficiaries of care, members of families and elder-care support systems, and citizens of an affluent country who benefit from economic and labor policies that rely on low wage workers.
In Focus: Chiara Lepora
Dr. Chiara Lepora is Programme Manager for operations in the Middle East of Médecins sans Frontiéres /Doctors Without Borders. Trained as a medical practitioner at the Universities of Pavia and Lisbon and the London School of Hygiene and Tropical Medicine, she has worked with MSF in various capacities across Africa and the Middle East since 2002. Earlier work she conducted includes writing an interactive tutorial that underpins e-learning software used by the World Health Organization and the UN High Commissioner for Refugees for clinical management of rape in humanitarian emergencies
Dr. Lepora’s early work with MSF, along with that of three other volunteer doctors, is depicted in the 2008 critically acclaimed documentary Living in Emergency: Stories of Doctors Without Borders (http://www.livinginemergency.com). The film has been praised for its unflinching portrayal of the reality of aid work and the dilemmas facing MSF staff in the field. It is these dilemmas – the ethical aspects of humanitarian and medical interventions in war contexts that are the focus of Dr. Lepora’s academic work and writing.
During a 2008-2010 mid-career Fellowship in Bioethics at the National Institutes of Health, Dr. Lepora published articles on the duty of care towards terrorists (No Exceptionalism Needed to Treat Terrorists, The American Journal of Bioethics, Lepora, Danis, Wertheimer, September 2009), complicity (The Tortured Patient A Medical Dilemma, The Hastings Center Report, Lepora, Millum, May 2011 and Grading Complicity in Rwandan Refugee Camps, Journal of Applied Philosophy, Lepora, Goodin, June 24, 2011), and compromise (On Compromise and Being Compromised, The Journal of Political Philosophy, September 2011).
Dr. Lepora taught Global Health and Humanitarian Affairs at the Josef Korbel School of International Studies of the University of Denver for a year before returning to MSF. Drawing on this research, her recent book, On Complicity and Compromise (Oxford University Press, 2013), co-authored with Robert E. Goodin (Distinguished Professor of Philosophy at Australian National University and Professor of Government at University of Essex), looks at the many ways individuals and organizations, including doctors and humanitarian aid groups, can become tied up in the wrong-doing of others.
For a review of On Complicity and Compromise by Slim Hugo, Senior Research Fellow, Oxford Institute for Ethics, Law and Armed Conflict in Ethics and International Affairs (January 7, 2014), visit http://www.ethicsandinternationalaffairs.org/2014/on-complicity-and-compromise-chiara-lepora-and-robert-e-goodin/.
In Focus: John Pringle
Since early 2010, an unprecedented lead-poisoning outbreak in northern Nigeria has killed hundreds of children and poisoned thousands of others. I went at the start of the outbreak as an epidemiologist with MSF. I had been in northern Nigeria a few years earlier for meningitis outbreaks, but this was altogether different. Since returning from the field, I have seen there is struggle to make sense of the situation. For some, the disaster is biomedical, and for others, it is socio-economic. While it is important to understand how and why the disaster occurred, it is also important to critically examine the response. What does the response tell us about the workings and failings of international humanitarianism? What are its implications for global health?
My current doctoral research examines the international response to the northern Nigerian lead-poisoning outbreak as a case study in contemporary international humanitarianism, with a lens from global health ethics. It is a qualitative study, which is new to me. I am interviewing key international responders and conducting a media and document analysis, situating the data (a la Michel Foucault) within the deeper political, economic, and historical context. I have interviewed twenty-one participants and collected close to three hundred related news articles and published documents. This study highlights ethical issues and challenges within an international response to an economy-generated environmental disaster. My findings will offer insight into the apparent poverty of global public health and the urgent need for international humanitarianism.
In Focus: Dónal O’Mathúna
Dónal P. O’Mathúna (Ph.D.) is Senior Lecturer in Ethics, Decision-Making & Evidence in the School of Nursing and Human Sciences, Dublin City University (DCU), Ireland. He is an Affiliated Scholar with the DCU Institute of Ethics, Chairperson of the DCU Research Ethics Committee and the ethicist on St. James’s Hospital, Dublin ethics committee. Dónal has degrees in pharmacy and bioethics, and his research interests include: disaster bioethics (ethical issues delivering healthcare and conducting research after disasters); nanotechnology ethics; emotions and ethics, especially the role of literature and narrative in ethics teaching and training; Christian ethics; and systematic reviewing of healthcare interventions. Dónal has published peer-reviewed articles and book chapters on bioethics (see http://www.BioethicsIreland.ie) and Cochrane systematic reviews. Current book projects include editing Disaster Bioethics: Normative Issues when Nothing is Normal (Springer) and an evidence-based book on herbal remedies based on his Irish Times columns. Dónal has authored Nanoethics: Big Ethical Issues with Small Technology (Continuum, 2009), and Alternative Medicine: The Christian Handbook, updated and expanded edition (Zondervan, 2007).
DISASTER BIOETHICS ACTION
As of last year, Dónal has been the lead investigator for the European Union funded COST Action (IS1201) on Disaster Bioethics. Launched in October 2012 with a four-year budget of just over €500,000, this Action draws on the strengths of European scholars, international humanitarian agencies, medical relief personnel, and others in 25 participating countries to advance research and training and improve decision-making in disasters. Triage practices and long-term consequences of humanitarian healthcare interventions on beneficiaries are key issues the team will address. Ensuring aid sent in disasters is appropriate is another concern. As Dónal notes in a recent Irish Times article, “Just because we want to do good and feel a lot of compassion for people, it doesn’t necessary mean they need what we want to send them,” (November 13, 2012). The work of the Action is being carried out within four Working Groups focused on: (1) Healthcare ethics, (2) Bioethics, culture and moral theory, (3) Disaster research ethics, and (4) Ethics and governance. The Action’s first working meeting will be at DCU on 25-26 April 2013, focused on identifying disaster ethics issues. Anyone interested in Disaster Bioethics can request to join the Action by emailing DisasterBioethics@dcu.ie. Further information on the Disaster Bioethics Action can be found at: http://www.cost.eu/domains_actions/isch/Actions/IS1201 and at http://disasterbioethics.com/.
Humanitarian Health Ethics 