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New study highlights ethical quagmire of mental health provision in disaster situations

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A new study co-authored by a researcher at Dublin City University has shed light on the extraordinarily complex ethical challenges faced by mental health professionals working in disaster situations after extreme weather or armed conflicts.

According to the research, entitled ‘Ethical challenges in the Provision of Mental Health Services for Children and Families during Disasters’, the many ethical challenges can be organized into 9 types of issues that can be encountered when providing mental health care in a disaster context. These are:

  1. Ensuring competent care;
  2. Protecting confidentiality and privacy;
  3. Obtaining informed consent and respecting autonomy;
  4. Providing culturally sensitive care;
  5. Avoiding harm;
  6. Allocating limited resources;
  7. Maintaining neutrality and avoiding bias;
  8. Addressing issues of liability and employer responsibilities;
  9. Conducting research ethically.

Commenting on the findings, Dónal O’Mathúna, Associate Professor, School of Nursing and Human Sciences at DCU, one of the study’s authors, said:

“This research reveals the types of ethical difficulties that healthcare professionals, communities, coordinators and policymakers face in administering vital care, both to people with preexisting mental health conditions and to those managing the stresses and trauma of disasters and their aftermath. The study serves as a roadmap for ethical best practice in the provision of mental health support in these exceptional circumstances.”

He added that ethical challenges arose from four main sources, namely (i) scarce resources and their just allocation; (ii) policies and organizational mandates; (iii) professional norms; and (iv) underlying inequalities which may be exacerbated during crises.

The study concludes that: “Overall, mental health professionals need to develop and practice ethical judgment in responding to ethical uncertainty or when facing apparent trade-offs between ethically important concerns: acting as virtuous clinicians, exercising good judgment, and seeking to achieve appropriate ends through the use of ethical means.”

The report, which is published this week in Current Psychiatry Reports, is available here.

RESEARCH TEAM

  • Matthew Hunt, School of Physical and Occupational Therapy, McGill University, Montreal
  • Nicole E. Pal, School of Physical and Occupational Therapy, McGill University, Montreal, and Centre for Interdisciplinary Research in Rehabilitation, Montreal
  • Lisa Schwartz, Department of Health Research Methods, Evidence & Impact, Centre for Health Economics and Policy Analysis, McMaster University, Hamilton
  • Dónal O’Mathúna, School of Nursing & Human Sciences, Dublin City University, Ireland and College of Nursing, The Ohio State University, Columbus, Ohio

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