Summary:
Dr. Arman Asadour is a Canadian physician who got sent by the non-governmental organization to a town in South Sudan in order to participate in a global vertical aid anti-cholera program. The purpose of the program is designed to treat targeted cohort group with cholera disease. The dilemma raised because while the medical care staff from NGOs are only supposed to treat for one specific disease, refugees also demand other health care items from the stuff due to the scarcity of treatment locally. The physician would need to make a clear decision based on his legal and ethical obligation.
The legal obligation
To understand the issue concerning this topic, it is important to understand the definition of vertical programs. They are called so because they are “directed, supervised, and executed, either wholly or to a great extent, by a specialized service using dedicated health workers”. (Atun, Bennett, Duran) In this case, the physician is directed to work in South Sudan to reach the purpose of eradicating the cholera from the area. By the nature of the vertical aid program, its goal would be to achieve a concrete goal. It would be good for the funders to be aware that their funding would be bringing some changes to the problem. Also, because of the legal obligation bearing on the physician, the right thing to do would be to follow the project rules and obligation, making sure the resources are allocated to the targeted group.
Flaw of Vertical program
It could also argue that vertical program waste resource as it allows the inefficiency to happen within the system. Unable to utilizing the resource because of untargeted sickness is unfair and unjustifiable for the needed. Allocating health resource to one specific illness could reduce the health system effectiveness. Furthermore, the voices and priorities of the locals are also often overlooked rather than to achieve the main goal of the program. (Thomas, Waluchow, and Gedge, 268) Although NGOs would have investigated the demand of people before entering for service, the need for health care could always change in time and vary in situation. While the health care service could be particularly rewarding to the certain targeted group, its policy would reject the treatment of people coming with various risks(such as HIV and cholera at the same time).
The ethical right thing
After all, the main purpose of the project is to aid the humanitarian purpose of the NGO. Leaving people in a worse-off condition without medical treatment would be against the mission. A physician’s duty would be to the patient he faces rather than the sponsor of the program even if the decisions are not legally correct. Balancing the legal obligation and the ethical right thing, Dr. Arman Asadour should follow his obligation first and then the obligation as the employee of the NGO.
Reference:
Thomas, John E., Wilfrid J. Waluchow, and Elisabeth Gedge. Well And Good: A Case Study Approach to Health Care Ethics. N.p.: Broadview, 2014. Print
Beauchamp, Tom L., and James F. Childress. Principles of Biomedical Ethics. New York: Oxford UP, 2001. Print
Atun, Rifat A., Sara Bennett, and Antonio Duran. When do vertical (stand-alone) programmes have a place in health systems? Geneva: World Health Organization, 2008.