guidelines for disaster research are also needed,” he outlines. The priority in disaster response remains with the immediate medical and humanitarian issues, yet Dr O’Mathúna believes it is also important to gather evidence to inform future responses. The COST project is looking at the ethical aspects of disaster research and response. “Our project is examining the ethical aspects of responding to disaster victims, helping to ensure that the people who are injured have their dignity upheld as much as possible, and that they are involved in ethical decision-making as much as is practically feasible given the conditions,” says Dr O’Mathúna. “There are ethical issues for the doctors and nurses who go into these situations.” Highly trained medical and healthcare staff sometimes find that they’re unable to act according to their normal ethical standards in a disaster setting. This creates what’s called ‘moral distress’, feelings of anxiety and distress about how they are making those decisions – or being prevented from doing what they believe is right. “We’re developing training tools that will help responders prepare, so that they will be aware of the types of issues that they may have to face when they get out into these settings,” outlines Dr O’Mathúna. “These ethical dilemmas are still going to be difficult to handle in and of themselves,
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but at least we can help prepare people a little better to face those decisions.” The nature of these decisions will vary according to the exact circumstances people face. If responders travel to a nation with very different values to their own there may also be cultural differences, which Dr O’Mathúna says must at least be acknowledged as part of an ethical response. “There may be significant
a situation completely different to anything they’ve experienced before, which reinforces the importance of preparation. “Some of the NGOs [nongovernmental organisations] that we have talked to have noted that up to half of the responders they train for such missions will not go on a second one,” says Dr O’Mathúna. “In many cases that’s because of the ethical dilemmas that they’ve had to
Our project is examining
the ethical aspects of responding to disaster victims, helping to ensure that the people who are injured have their dignity upheld as much as possible, and that they are involved in ethical decision-making as much as is practically feasible given the conditions differences regarding who makes medical decisions in different cultures,” he points out. “If it’s the way things are done in another culture then that person needs to be prepared to think those issues through, and to have a way of processing them. They may even need to decide ahead of time whether they are willing to work according to somebody else’s ethical values in certain situations.” These types of situations can occur where there is quite a broad-based international response to a disaster. In many cases these responders are entering
face - they feel like those were so overwhelming that they never want to be part of another response team again.” That can be a great loss of experience and training resources to the organisations. Effective training is crucial to preparing people well, and also to ensuring that they have skills relevant to the situations they’re going to face. There is often intense publicity around natural disasters and people understandably want to help, but aid should be targeted at actual needs, which has not always been the case in the past. “People have arrived from other countries
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