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Ethical Issues in Global Health Education and “Immersion” Experiences

Global health programs provoke a great deal of institutional interest among health professions students. More than 25% of surveyed students report having participated in a global health experience during medical school.1 Students drawn to these experiences often incorporate inclusive practices in their future work, which enhances their cultural sensitivity and clinical skills.2,3,4 Initially, learners tend to take part in these experiences to understand challenges of global health care and gain exposure to advanced or rare pathologies while developing and ultimately practicing clinical skills in serving many with limited access to health care.5 These trips can help students and patients, but some students return questioning the quality of the care they helped administer and the sustainability of the programs in which they participated. Mismanaged trips can lead to student distress, resource depletion, and inadequate care. Academic institutions and international nonprofit organizations should consider the value of these trips to communities they seek to serve as they continue to promote students’ learning. This theme issue of the AMA Journal of Ethics aims to reflect on the ethics of global health immersion experiences. In particular, it addresses ethical questions about standards of care and the impact these trips have on local communities, including patients’ access to care and technology and whether and when some care is better than no care.