Case studies to explore ethical dilemmas in short-term global health research experiences

In recent years, increasing numbers of US-based health professional students have traveled to low resource settings to conduct short-term research projects. At times, pre-departure training can be inadequate, leaving students unprepared for the ethical challenges posed by these experiences. This is magnified by the lack of attention paid to the burdens and benefits for local staff, institutions, and patient wellbeing in the setting of disproportionate poverty and disease. This presentation explores the ethical challenges posed by US-based students' research experiences through a series of case studies based on the experiences of the student authors. Issues discussed include the burdens that students pose on the hosting organization, limitations of student's clinical knowledge, distributive justice, community involvement in research, informed consent, and the student-advisor relationship. The case studies demonstrate how many of the ethical dilemmas posed by short-term research experiences may be mitigated by building long term partnerships between US medical schools and partners in low-resource settings with the goal of mutual education and training, capacity building, and collaboration. The case studies are designed to serve as foundation for discussion and pre-departure training sessions. Specific recommendations are proposed for students, faculty, and school administrators to ensure that research experiences in low resource settings are both ethical and equitable.