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Vulnerability and justice in global health emergency regulation

Global Health Emergencies (GHEs) are crises that affect health, and that are, or should be, of international concern. These might include infectious outbreaks, humanitarian crises and disasters, conflicts, and forced displacements.

Global Health Emergencies

GHEs are characterised by various forms of urgency and uncertainty, and are known to exacerbate existing inequalities, injustices and vulnerabilities in individuals and communities. This is a Wellcome Seed Award Project entitled, ‘Vulnerability and justice in global health emergency regulation: developing future ethical models’.

Read the project's latest news and commentary on the Global Health Emergencies blog

Agomoni Ganguli-Mitra

Agomoni Ganguli-Mitra (PI) is Lecturer (Assistant Professor) and Chancellor’s Fellow in Bioethics and Global Health Ethics at Edinburgh Law School. She is also a member of the Wellcome Trust-funded Centre for Biomedicine, Self and Society, where she leads on the Centre themes Beyond Global and Beyond Sex. Dr. Ganguli-Mitra’s background is in bioethics, with a special interest in global bioethics, structural and gender justice. She has written on ethical issues related to global surrogacy, sex-selection, biomedical research in low-income countries, social value in research governance and the concepts of exploitation and vulnerability in bioethics.

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Twitter: @GanguliMitra

Ayesha Ahmad

Ayesha Ahmad (PhD) is Senior Lecturer in Global Health at St. George’s University of London and Honorary Lecturer at the Institute for Global Health, University College London. She specialises in transcultural psychiatry with a focus on mental health and gender-based violence during conflict and humanitarian crisis with a  focus on cross-cultural notions of trauma. She is the Co-investigator on an MRC/AHRC funded 2-year project called Story-Telling for Health: Acknowledgement, Expression, and Recovery (SHAER) bringing together collaborators from Kashmir, Afghanistan, Turkey, Tunisia, and South Africa. Her work also includes providing expert reports for asylum seeker cases. She has published widely in academic journals and national and international media outlets as well as speaking at conference and public events worldwide. Her book Humanitarian Action and Ethics co-edited with James Smith was published in 2018 (Zed Publishers).

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Twitter: @AcademicAyesha

Ryoa Chung

Ryoa Chung is Professor in the Department of Philosophy at the Université de Montréal. Her research interests include ethics in international relations, feminist philosophy and applied political philosophy, especially in the field of global health. She is currently working on the critical relation between structural injustice and epistemic injustice in order to examine the production and perpetuation of health inequalities. She is also working on the notion of ‘structural health vulnerability’ in the case of refugees in Canada. Her work is published both in English and in French and was funded by the Canadian Institutes of Health Research, and currently funded by the Canadian Social Sciences and Humanities Research Council.

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Twitter: @RyoaChung

Lisa Eckenwiler

Lisa Eckenwiler is Associate Professor in the Department of Philosophy and the Department of Health Administration and Policy, and former Director of Health Ethics at George Mason University. She is currently the faculty director for the Global Health Fellows Program, a joint program of the Department of Philosophy and Global Affairs. She has published widely on research ethics, including work on the concept of “vulnerability”. She is also the author of Long-Term Care, Globalization and Justice (Johns Hopkins University Press 2012) and lead editor of The Ethics of Bioethics: Mapping the Moral Landscape (Johns Hopkins University Press 2007).

Her research at present focuses on global health inequities, refugees, migrants and other vulnerable populations, and humanitarian health ethics. Current projects examine the understanding and operationalization of “vulnerability” in the work of humanitarian health organizations, the integration of migrants and refugees with disabilities and health justice, the ethics of closing humanitarian projects, and “ethical place-making” and health justice for the chronically displaced. She is on the Board of the International Association of Bioethics.

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Twitter: @lisaaeck

Matthew Hunt

Matthew Hunt is an Associate Professor and the Director of Research in the School of Physical and Occupational Therapy at McGill University, as well as a researcher at the Center for Interdisciplinary Research in Rehabilitation and an affiliate member of the McGill Biomedical Ethics Unit, Department of Family Medicine, and Institute for Health and Social Policy. Previously, he has worked as a physiotherapist in Montreal, the Canadian arctic, North Africa and the Balkans.
Dr Hunt’s research focuses on two areas of inquiry: ethics of global health engagement and ethics and rehabilitation. In the area of global health and ethics, he is currently carrying out research on the ethics of closing humanitarian projects, palliative care in humanitarian crises, and intersection of values and humanitarian innovation. He is co-lead of the Humanitarian Health Ethics Research Group.

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Twitter: @MHuntMcGill

Associated Websites: Humanitarian Health Ethics

Yashar Saghai

Yashar Saghai is Assistant Professor of Philosophy at the University of Twente, Netherlands, and Senior Scholar at the Millennium Project: Global Futures Research and Studies. Previously, he was a researcher at the Johns Hopkins Berman Institute of Bioethics. His research covers two main domains. The first is practical ethics with a focus on public health, biomedical technologies, food, and Artificial Intelligence. The second is the formal practices we use to anticipate the future for instance, to assess the future impact of emerging technologies, create climate change scenarios, or get prepared to face a range of plausible global health emergencies or disasters. His contribution to the project is mainly focused on uncovering how anticipatory practices used in Global Health Emergency contexts can become more sensitive to future vulnerabilities and epistemic injustices. In turn, the anticipatory attitude towards desirable or undesirable futures can inform our ethical reflection and the robustness of our regulations.

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Associated Websites: Yashar Saghai

Lisa Schwartz

Lisa Schwartz, PhD is the Arnold L. Johnson Chair in Health Care Ethics, Professor in the department of Health Research Methods, Evidence & Impact (HEI), Associate Director of the Centre for Health Economics and Policy Analysis (CHEPA), and associate member of the Department of Philosophy McMaster University. Prof Schwartz is senior investigator for Humanitarian Health Ethics (hhe), a program of studies examining the ethical challenges faced by humanitarian healthcare providers and the populations they serve. Dr Schwartz is a member of the Ethics Review Board of Médecins Sans Frontières, and is a member of the World Health Organization’s Public Health Ethics Consultative Group for which she Co-Chaired the authorship of the Guidance for Managing Ethical Issues in Infectious Disease Outbreaks, and contributed to the authorship of Integrating palliative care and symptom relief into responses to humanitarian emergencies and crises: a WHO guide.

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Twitter: @LisaSchwartz224

Associated Websites: Humanitarian Health Ethics

Jackie Leach Scully

Jackie Leach Scully is Professor of Bioethics, and Director of the Disability Innovation Institute at the University of New South Wales, Australia. Her research interests cover a range of topics in bioethics, with a special focus on disability and embodiment. In the context of global health emergencies and humanitarian crises her work considers how social and cultural beliefs about disability, normality, illness and health generate assumptions about disabled and chronically ill people’s vulnerability, dependence or resilience, and how these assumptions become embedded in guidelines and policy.

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Twitter: @JLSbioethics

Associated Websites: The Disability Innovation Institute

DIIU Twitter: @DisabilityUNSW

Verina Wild

Verina Wild is deputy director of the Institute of Ethics, History and Theory of Medicine at Ludwig-Maximilians-University of Munich (LMU), Germany. Her research interests lie in the area of justice and vulnerability in medical care, public health and global health. Over the last years she put a special focus on migrant health.

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Associated Websites: META Project

Rebecca Richards

Rebecca Richards is the Postgraduate Research Assistant on the project. In particular, she is responsible for this project website and produces the ‘Just Emergencies’podcast. She is a PhD candidate at the Edinburgh Law School and her research interests include global health ethics/justice, the medical brain drain, the ethics of global health emergencies, and structural inequalities.

Twitter: @reb_richards

Structural Injustice in Global Health Emergencies

In this animation, we discuss the concept of ‘Structural Injustice’. We look at what it is, how it’s different from other kinds of injustices, and why it’s important in the context of Global Health Emergencies.

The concept of structural injustice, as discussed in this animation is based on the work of philosopher Iris Marion Young.

For more see:

  • Young (2011). Responsibility for Justice. Oxford; New York: Oxford University Press.
  • Young (2006). Responsibility and Global Justice: A Social Connection Model. Social Philosophy and Policy, 23(1).

View the animation transcript

Denaturalizing Natural Disasters

In our second animation, Professor Matthew Hunt talks about how natural disasters and their impacts are not as ‘natural’ as they may first appear and how this should influence how we plan for, and respond to, such disasters.

For more, see:

  • Chung, R., & Hunt, M. (2012). Justice and Health Inequalities in Humanitarian Crises: Structured Health Vulnerabilities and Natural Disasters. In P. T. Lenard (Ed.), Health Inequalities and Global Justice (pp. 197–212). Edinburgh University Press.

View animation transcript

Epistemic Injustice

In our third animation, we discuss the concept of Epistemic Injustice and how this relates to Global Health Emergencies. In particular, we focus on the work of Miranda Fricker and discussion of Testimonial and Hermeneutical Injustice.

For more, see:

View animation transcript

Nature of Emergencies

In our fourth animation, Agomoni Ganguli Mitra discusses the ethical implications of labelling a health event an emergency, disaster, or crisis.

For more, see:

View animation transcript

Vulnerability

In the fifth and final animation, Rebecca Richards explores the different conceptualisations, applications, and complexities of the term ‘vulnerability’. By drawing on the influential work of Samia Hurst, Florenica Luna, and Catriona Mackenzie, Wendy Rogers, and Susan Dodds, Rebecca discusses how these types of vulnerability affected different groups during the Covid-19 pandemic.

For more, see:

  • C. Mackenzie, W. Rogers & S. Dodds Vulnerability: new essays in ethics and feminist philosophy (Oxford University Press, 2013).
  • F. Luna ‘Elucidating the Concept of Vulnerability: Layers Not Labels‘, (2009) International Journal of Feminist Approaches to Bioethics, 2(1).
  • S. Hurst, ‘Vulnerability in research and health care; describing the elephant in the room’, (2008) Bioethics, 22(4), 191-202.

View animation transcript

Just Emergencies: A Global Health Justice Podcast

This podcast delves into what we mean by ‘Global Health Emergencies’, why they matter, and why we care about justice in global health emergencies.

Visit the Just Emergencies Podcast channel on Mediahopper

Find the Just Emergencies Podcast on Apple Podcasts

Episode 1: Research During Global Health Emergencies

In this first episode of ‘Just Emergencies’, Rebecca Richards sat down with Dr Nayha Sethi to talk about research during global health emergencies, how this might be different from research during ‘normal’ times, and what justice and ethical issues we need to think about when conducting such research.

For more information on Dr Sethi and further resources, please take a look at the episode’s Shownotes.

View Episode 1 full transcript

Episode 2: Sexual and Reproductive Health in Global Health Emergencies

For Episode 2 of ‘Just Emergencies’, Dr Catriona McMillan joined Rebecca to talk the impact that global health emergencies have on sexual and reproductive health issues. And unfortunately, it’s generally not good news.

For more information on Dr Catriona McMillan and further resources and links, please take a look at the episode’s Shownotes.

View Episode 2 full transcript

Episode 3: Clowning and Nursing

In Episode 3 of Just Emergencies, Tim Cunningham shares his experiences of working as a clown following the 2010 Haiti earthquake and as a paediatric nurse in Sierra Leone during the Ebola Outbreak.

For more information on Professor Tim Cunningham and further links and resources, please visit the episode’s Shownotes.

View Episode 3 full transcript

Episode 4: Trauma and Storytelling

Ayesha Ahmad talks about her work of using storytelling and poetry as a therapeutic intervention in conflict and crises struck areas.

For more information on Dr Ayesha Ahmad, please visit the episode’s Shownotes.

View Episode 4 full transcript

Episode 5: Ethics of Closing Humanitarian Projects

In Episode 5 of ‘Just Emergencies’, Matthew Hunt talks about the ethics of closing humanitarian projects.

For more information on Associate Professor Matthew Hunt and further links and resources, please visit the episode’s Shownotes.

View Episode 5 full transcript

Episode 6: Vulnerability Part 1

For Episode 6 of ‘Just Emergencies’, Rebecca was joined by Professor Wendy Rogers who explained the taxonomy of vulnerability she developed with C. Mackenzie and S. Dodds. Of particular relevance to the current global health climate is Professor Roger’s exploration of vulnerability in times of a pandemic.

For more information on Professor Wendy Rogers and further links and resources, please visit the episode’s Shownotes.

View Episode 6 full transcript

Episode 7: The Ethics of Humanitarian Action

In Episode 7, Rebecca is joined by Dr. Caroline Clarinval who is currently the WHO Country Office Representative in Kazakhstan. Dr. Clarinval shares her experiences of handling difficult ethical situations in her work and outlines the model she developed to assist other humanitarian actors in ethically challenging situations.

For more information on Dr Caroline Clarinval and further links and resources, please visit the episode’s Shownotes.

View Episode 7 full transcript

Episode 8: COVID-19 & Undocumented Migrant Communities – Vulnerability Part 2

In Episode 8 of Just Emergencies, Josephine Greenbrook discusses how undocumented migrant and asylum seeker communities are affected by the COVID-19 outbreak. This forms the second instalment of our vulnerability series on the Just Emergencies podcast.

For more information on Josephine Greenbrook and further links and resources, please visit the episode’s Shownotes.

View Episode 8 full transcript

Episode 9: COVID-19, Carers & Vulnerability – Vulnerability Part 3

In Episode 9 of ‘Just Emergencies’, Professor Susan Dodds discusses the range of vulnerabilities carers might experience during the COVID-19 pandemic. This is the third instalment of our Vulnerability Series.

For more information on Professor Susan Dodds and further links and resources, please visit the episode’s Shownotes.

View Episode 9 full transcript

Episode 10: COVID-19, Reflections of Vulnerability, Gender, and Care – Vulnerability Part 4

In Episode 10 of Just Emergenices, Dr Verina Wild and Professor Paula-Irene Villa Braslavsky discuss the relationship between ‘Vulnerability, Gender, and Care’ in the context of the ongoing Covid-19 pandemic and through a sociological lens.

For more information on Dr Verina Wild and Professor Dr Paula Villa and further links and resources, please visit the episode’s Shownotes.

View Episode 10 full transcript

Episode 11: COVID-19 and Political Resistance

In Episode 11 of ‘Just Emergencies’, Meena Krishnamurthy talks about the ongoing anti-racist protests around the world, whether there’s an obligation to participate in them – especially during a worldwide pandemic – and how they differ politically and philosophically from the anti-COVID-19 protests that have also sprung up.

For more information on Assistant Professor Meena Krishnamurthy further links and resources, please visit the episode’s Shownotes.

View Episode 11 full transcript

Episode 12: Vulnerability as Greater Likelihood of Being Harmed – Vulnerability Part 5

In Episode 12 ‘Vulnerability Part 5,’ Professor Samia Hurst discusses her conception of vulnerability and what it can tell us about the ongoing COVID-19 pandemic.

For more information on Professor Samia Hurst and further links and resources, please visit the episode’s Shownotes.

View Episode 12 full transcript

Episode 13: Moral Experiences of Healthcare Providers in COVID-19 Research

In Episode 13 of 'Just Emergencies', McGill Research Assistant Eliza Yadav interviews Professor Matthew Hunt and Research Coordinator Ani Chenier about their collective study on the ethics of conducting clinical research during the COVID-19 pandemic.

For more information on the study, its team members, links and resources, please visit the episode’s Shownotes.

View Episode 13 full transcript

Episode 14: Vulnerability as Layers – Vulnerability Part 6

In Episode 14 of ‘Just Emergencies’, Professor Florencia Luna argues that the metaphor of ‘layers’ of vulnerability captures the flexibility of dynamism of how vulnerability presents in and interacts with the real world.

For more information on Professor Luna, as well as further links and resources, please visit the episode’s Shownotes.

View Episode 14 full transcript

Episode 15: Covid-19 and the Migrant Crisis

In Episode 15, Dr Arianne Shahvisi discusses the migrant ‘crisis’, the impact of Covid-19 on refugee populations, vaccine nationalism, and academic activism. Y

To find out more about Dr Shahvisi and discover relevant links and resources, please visit our Shownotes.

View Episode 15 full transcript

Episode 16: Covid-19 and Migrant Care Workers

In Episode 16 of Just Emergencies, Prof Lisa Eckenweiler discusses the impact of Covid-19 on migrant care workers. Migrant care workers are an essential part of many Global North countries’ health systems and have become even more so over the course of the pandemic. Yet, they are disproportionately vulnerable to Covid-19 as well as precarious living and working conditions due to the political and social contexts in which they work. Prof Eckenweiler discusses these issues in light of justice, fairness, and solidarity concerns and extrapolates what we might do about them.

View Episode 16 full transcript

To prepare for upcoming global health emergencies, we need to anticipate the future. A future-oriented stance can be currently found at three levels:

  1. Forecasts, based on trend extrapolation or mathematical modelling, of the future spread and impact of infectious disease outbreaks or other disasters.
  2. Creation of scenarios of plausible future adverse events for on-the-grounds disaster emergency planning (preparedness, coordinated response, recovery). These events cover predictable events whose frequency is known but whose future developments are unknown (volcanic eruptions, storms), as well as events that are unpredictable but might have a significant impact (e.g., outbreak of a new infectious disease; unprecedented flood or drought, war, unexpected technological disaster).
  3. Creation of scenarios of plausible future adverse events for policy-making purposes (infrastructure construction, resources allocation, long-term planning, international collaboration).

We propose to use related foresight/futures studies methods to anticipate:

  1. Potential events that might create new, or exacerbate existing, and avoid or mitigate injustices;
  2. How the introduction of new or emerging technologies might affect injustices in global health emergencies and how these can be avoided or mitigated, and justice promoted when designing or using these technologies. Examples include, electronic and mobile health (eHealth and mHealth) devices, interconnected sensors (smart cities) and powerful geographic information systems (e.g., mapping slums from space using remote sensing).

Further reading

  • Alexander, DE; (2015) Disaster and Emergency Planning for Preparedness, Response, and Recovery. In: Oxford Research Encyclopedia of Natural Hazard Science. (pp. 1-20). Oxford University Press: Oxford
  • Bennett, DeeDee, Brenda D. Phillips, and Elizabeth Davis. “The future of accessibility in disaster conditions: How wireless technologies will transform the life cycle of emergency management.” Futures 87 (2017): 122-132.
  • Brey, Philip. (2017) “Ethics of emerging technology.” In The ethics of technology: Methods and approaches, edited by Sven Ove Hansson, pp. 175-191. London; New York, Rowman and Littlefiled.
  • Enders, Alexandra, and Zachary Brandt. “Using geographic information system technology to improve emergency management and disaster response for people with disabilities.” Journal of Disability Policy Studies 17, no. 4 (2007): 223-229.
  • Garrett, Martha J. Health futures: a handbook for health professionals. World Health Organization, 1999.
  • Glenn, Jerome. C. and Gordon, Theodor. (eds). (2009). Futures research methodology-Version 3-0. T. J. Editorial desconocida. Washington, DC.
  • Gordon, Theodore J. “1,000 futures: testing resiliency using plausible future headlines.” World Future Review 8, no. 2 (2016): 75-86.
  • Heinonen, Sirkka, Osmo Kuusi, and Hazel Salminen, eds. How Do We Explore Our Futures?: Methods of Futures Research. Finnish Society for Futures Study, 2017
  • Lakoff, Andrew. Unprepared: Global health in a time of emergency. Univ of California Press, 2017
  • Lanfranchi, Vitaveska. “Machine Learning and Social Media in Crisis Management: Agility vs Ethics.” In Proceedings of the 14th International Conference on Information Systems for Crisis Response and Management. IMT Mines Albi-Carmaux (École Mines-Télécom), 2017.
  • Masum, Hassan, Jody Ranck, and Peter A. Singer. “Five promising methods for health foresight.” Foresight 12, no. 1 (2010): 54-66.
  • Sliuzas, Richard V. (2018). Grappling with the city – disaster Nexus. Inaugural Lecture, November 22, 2018. University of Twente. View lecture transcript
  • WHO Simulation Exercise Manual. Geneva: World Health Organization; 2017. Licence: CC BY-NC- SA 3.0 IGO. View manual

Articles

Antimicrobial Resistance
Disaster & Public Health Bioethics
  • O’Mathúna, D. (2016). Ideal and nonideal moral theory for disaster bioethics. Human Affairs26(1), 8–17.
Disability in Global Health Emergencies and Humanitarian Crises
Ebola
  • Clinical Trials, 13(1). (February 2016). Clinical Trials During the Ebola Crisis: A Series of Articles and Commentaries Describing the Challenges of Conducting Clinical Research During a Lethal Epidemic.
  • Harman (2016). Ebola, gender and conspicuously invisible women in global health governance. Third World Quarterly, 37(3), 524-541.
  • Koralek, T., Runnerstrom, M. G., Brown, B. J., Uchegbu, C., & Basta, T. B. (2016). Lessons from Ebola: Sources of Outbreak Information and the Associated Impact on UC Irvine and Ohio University College Students. PLoS Currents, 8.
  • Schopper, D., Ravinetto, R., Schwartz, L., Kamaara, E., Sheel, S., Segelid, M. J., … Upshur, R. (2016). Research Ethics Governance in Times of Ebola. Public Health Ethics10(1), 49–61.
  • Dawson, A. J. (2015). Ebola: what it tells us about medical ethics. Journal of Medical Ethics, 41(1), 107–110.
  •  Moon, S., Sridhar, D., Pate, M. A., Jha, A. K., Clinton, C., Delaunay, S., … Garrett, L. (2015). Will Ebola change the game? Ten essential reforms before the next pandemic. The report of the Harvard-LSHTM Independent Panel on the Global Response to Ebola. The Lancet386(10009), 2204–2221.
  • Smith, M. J., & Upshur, R. E. G. (2015). Ebola and Learning Lessons from Moral Failures: Who Cares about Ethics? Public Health Ethics9(3), 305–318.
  • The American Journal of Bioethics, 15(4). (April 9, 2015).
Futures Methods
  • Alexander, DE; (2015) Disaster and Emergency Planning for Preparedness, Response, and Recovery. In: Oxford Research Encyclopedia of Natural Hazard Science. (pp. 1-20). Oxford University Press: Oxford
  • Bennett, DeeDee, Brenda D. Phillips, and Elizabeth Davis. “The future of accessibility in disaster conditions: How wireless technologies will transform the life cycle of emergency management.” Futures 87 (2017): 122-132.
  • Brey, Philip. (2017) “Ethics of emerging technology.” In The ethics of technology: Methods and approaches, edited by Sven Ove Hansson, pp. 175-191. London; New York, Rowman and Littlefiled.
  • Enders, Alexandra, and Zachary Brandt. “Using geographic information system technology to improve emergency management and disaster response for people with disabilities.” Journal of Disability Policy Studies 17, no. 4 (2007): 223-229.
  • Garrett, Martha J. Health futures: a handbook for health professionals. World Health Organization, 1999.
  • Glenn, Jerome. C. and Gordon, Theodor. (eds). (2009). Futures research methodology-Version 3-0. T. J. Editorial desconocida. Washington, DC.
  • Gordon, Theodore J. “1,000 futures: testing resiliency using plausible future headlines.” World Future Review 8, no. 2 (2016): 75-86.
  • Heinonen, Sirkka, Osmo Kuusi, and Hazel Salminen, eds. How Do We Explore Our Futures?: Methods of Futures Research. Finnish Society for Futures Study, 2017
  • Lakoff, Andrew. Unprepared: Global health in a time of emergency. Univ of California Press, 2017
  • Lanfranchi, Vitaveska. “Machine Learning and Social Media in Crisis Management: Agility vs Ethics.” In Proceedings of the 14th International Conference on Information Systems for Crisis Response and Management. IMT Mines Albi-Carmaux (École Mines-Télécom), 2017.
  • Masum, Hassan, Jody Ranck, and Peter A. Singer. “Five promising methods for health foresight.” Foresight 12, no. 1 (2010): 54-66.
  • Sliuzas, Richard V. (2018). Grappling with the city – disaster Nexus. Inaugural Lecture, November 22, 2018. University of Twente. View lecture transcript
  • WHO Simulation Exercise Manual. Geneva: World Health Organization; 2017. Licence: CC BY-NC- SA 3.0 IGO. View manual
Lancet series: Health in Humanitarian Crises (June 8, 2017)

View full series

  • Samarasekera, U., & Horton, R. (2017). Improving evidence for health in humanitarian crises. Lancet, 390(10109), 2223-2224.
  • Waldman, R. J. & Toole, M. J. (2017). Where is the science in humanitarian health? Lancet, 390(10109), 2224-2226.
  • Hawkins, V., & Pérache, A. H. (2017). Humanitarian medicine is more than a technical exercise. Lancet, 390(10109), 2226-2227.
  • O’Mathúna, D., & Siriwardhana, C. (2017). Research ethics and evidence for humanitarian health. Lancet, 390(10109), 2228-2229.
  • Lane, R. (2017). Moses Massaquoi: health leader in humanitarian crises. Lancet, 390(10109).
  • Blanchet, K., Ramesh, A., Frison, S., Warren, E., Hossain, M., Smith, J., … Roberts, B. (2017). Evidence on public health interventions in humanitarian crises. Lancet, 390(10109), 2287-2296.
  • Checchi, F., Warsame, A., Treacy-Wong, V., Polonsky, J., van Ommeren, M., & Prudhon, C. (2017). Public health information in crisis-affected populations: a review of methods and their use for advocacy and action. Lancet, 390(10109), 2297-2313.
  • Colombo, S., & Pavignani, E. (2017). Recurrent failings of medical humanitarianism: intractable, ignored, or just exaggerated? Lancet, 390(10109), 2314-2324.
  • Spiegel, P. B. (2017). The humanitarian system is not just broke, but broken: recommendations for future humanitarian action. Lancet, 390(10109), 2314-2324.
  • Elamein, M., Bower, H., Valderrama, C., Zedan, D., Rihawi, H., Almilaji, K., … AbouZeid, A. (2017). Attacks against health care in Syria, 2015-16: results from a real-time reporting tool. Lancet, 390(10109), 2278-2286.
Pharmaceuticals 
  • Caplan, A. L., & Amrit, R. (2016). The Ethical Challenges of Compassionate Use. JAMA315(10), 979–980.
Research Ethics
  • Haire, B. (2018). Aspects of disaster research ethics applicable to other contexts. BMJ, 44(1), 9–10.
  • Tansey, C. M., Anderson, J., Boulanger, R. F., Eckenwiler, L., Pringle, J., Schwartz, L., & Hunt, M. (2017). Familiar ethical issues amplified: how members of research ethics committees describe ethical distinctions between disaster and non-disaster research. BMC Medical Ethics, 18(1).
  • Clinical Trials, 13(1). (February 2016). Clinical Trials During the Ebola Crisis: A Series of Articles and Commentaries Describing the Challenges of Conducting Clinical Research During a Lethal Epidemic.
  • Chiumento, A., Khan, M. N., Rahman, A., & Frith, L. (2016). Managing Ethical Challenges to Mental Health Research in Post-Conflict Settings: Ethical Challenges to Research in Post-conflict Settings. Developing World Bioethics, 16(1), 15–28.
  • Hunt, M., Tansey, C. M., Anderson, J., Boulanger, R. F., Eckenwiler, L., Pringle, J., & Schwartz, L. (2016). The Challenge of Timely, Responsive and Rigorous Ethics Review of Disaster Research: Views of Research Ethics Committee Members. PLOS ONE, 11(6), e0157142.
  • Venkatapuram, S. (2016). Justice and Global Health Research. The American Journal of Bioethics, 16(10), 46–47.
  • Schopper, D., Dawson, A., Upshur, R., Ahmad, A., Jesani, A., Ravinetto, R., … Singh, J. (2015). Innovations in research ethics governance in humanitarian settings. BMC Medical Ethics, 16(1).
Vulnerability
  • Ho, C. W.-L. (2017). CIOMS guidelines remain conservative about vulnerability and social justice. Indian Journal of Medical EthicsII(3), 175–179.
  • Durocher, E., Chung, R., Rochon, C., & Hunt, M. (2016). Understanding and Addressing Vulnerability Following the 2010 Haiti Earthquake: Applying a Feminist Lens to Examine Perspectives of Haitian and Expatriate Health Care Providers and Decision-Makers. Journal of Human Rights Practice8(2), 219–238.
Zika
  • Borges, A. L. V., Moreau, C., Burke, A., Dos Santos, O.A., & Chofakian, C.B. (2018). Women’s reproductive health knowledge, attitudes and practices in relation to the Zika virus outbreak in northeast Brazil. PLoS ONE, 13(1), e0190024.
  • Stone, J. (2017, July 15). How Brazil’s Zika Epidemic Highlights Women’s Everyday Plight: Human Rights Watch. Forbes. View article
  • de Oliveira, W. K., de França, G. V. A., Carmo, E. H., Duncan, B. B., de Souza Kuchenbecker, R., & Schmidt, M. I. (2017). Infection-related microcephaly after the 2015 and 2016 Zika virus outbreaks in Brazil: a surveillance-based analysis. The Lancet390(10097), 861–870.
  • Diniz, D., Medeiros, M., & Madeiro, A. (2017). Brazilian women avoiding pregnancy during Zika epidemic. The Journal of Family Planning and Reproductive Health Care, 43(10), 80.
  • McNeil, D.G. Jnr. (2017, Jan 16). How the Response to Zika Failed Millions. The New York Times. View article
  • McNeil, D.G. Jnr. (2016, Jun 9). Delay Pregnancy in Areas With Zika, W.H.O. Suggests. The New York Times. View article
  • Watts, J. (2016, Mar 7). Zika epidemic restrictions promote ‘violence against women’ warns report. The Guardian. View article
  • Galli, B. (2016, Feb 3). The Zika Virus Is a Matter of Reproductive Injustice. Rewire News. View article

Books

  • Powers, M., & Faden, R. (Upcoming: late 2019). Structural Injustice: Power, Advantage, and Human Rights. Oxford University Press.
  • Nayeri, D. (2019). The Ungrateful Refugee. Canongate Books.
  • Ahmad, A., & Smith, J. (2018). Humanitarian Action and Ethics. Zed.
  • O’Mathúna, D. P., Dranseika, V., & Gordijn, B. (Eds.). (2018). Disasters: Core Concepts and Ethical Theories. Springer.
  • Walsh, S., & Johnson O. (2018). Getting to Zero: A Doctor and a Diplomat on the Ebola Frontline. Zed Books.
  • Diniz, D. (2017). Zika: From the Brazilian Backlands to Global Threat. Zed Books.
  • Lakoff (2017). Unprepared: Global Health in a Time of Emergency. University of California Press.
  • Caduff, C. (2015). The Pandemic Perhaps: Dramatic Events in a Public Culture of Danger. University of California Press.
  • Slim, H. (2015). Humanitarian Ethics: A Guide to the Morality of Aid in War and Disaster. C Hurst & Co Publishers Ltd.
  • Mackenzie, C., Rogers, W., & Dodds, S. (Eds.). (2014). Vulnerability: New Essays in Ethics and Feminist Philosophy. New York: Oxford University Press.
  • Bradshaw, S. (2013). Gender, Development and Disasters. Edward Elgar.
  • David, E., & Enarson, E. (Eds). (2012). The Women of Katrina
    How Gender, Race, and Class Matter in an American Disaster. Vanderbilt University Press.
  • Huet, M. (2012). The Culture of Disaster. University of Chicago Press.
  • Lenard, P. T., & Straehle C. (Eds.). (2012). Health Inequalities and Global Justice. Edinburgh: Edinburgh University Press.
  • Farmer, P. (2011). Haiti After the Earthquake. PublicAffairs.
  • Enarson, E., & Chakrabarti, P.G. D. (Eds.). (2009). Women, Gender and Disaster: Global Issues and Initiatives. Sage Publications.
  • Barnett, M. & Weiss, T. G. (Eds.) (2008). Humanitarianism in Question: Politics, Power, Ethics. Cornell University Press.
  • Bankoff, G., Frerks, G., & Hilhorst, D. (Eds). (2004). Mapping Vulnerability: Disasters, Development and People. Routledge.
  • Allotey, P. (Ed.). (2003). The Health of Refugees: Public Health Perspectives from Crisis to Settlement. OUP Australia & New Zealand.
  • Larabee, A. (2000). Decade of Disaster. University of Illinois Press.

Policy and governance

Human Rights Watch
  • Human Rights Watch. (2017). Neglected and Unprotected: The Impact of the Zika Outbreak on Women and Girls in Northeastern Brazil (Report). View report
Nuffield Council on Bioethics
  • Ganguli Mitra, A., & Sethi, N. (2016). Conducting research in the context of global health emergencies: identifying key ethical and governance issues (Background paper). Nuffield Council on Bioethics.
  • Nuffield Council on Bioethics. (2016). Zika: Ethical Considerations (Briefing Note). London: Nuffield Council on Bioethics.
World Health Organization
  • WHO, Zika Virus Disease
  • Council for International Organizations of Medical Sciences & WHO. (2016). International Ethical Guidelines for Health-related Research Involving Humans.Geneva: World Health Organization.
  • WHO. (2016). Guidance for Managing Ethical Issues In Infectious Disease Outbreaks. Geneva: World Health Organization.
  • WHO. (2015). Ethics in Epidemics, Emergencies and Disasters Research, Surveillance and Patient Care: Training Manual. Geneva: World Health Organization.

COVID-19 Outbreak

Country-Specific Resources
Italy

Shaun Lintern, ‘“We are making difficult choices”: Italian doctor tells of struggle against coronavirus’Independent, 14 March, 2020.

Angela Giuffrida, ‘Italian nurse: ‘An experience I would compare to a world war”The Guardian, 13 March 2020.

Haven Orecchio-Egresitz, ‘A shortage of medical supplies and hospital beds in Italy is forcing doctors to choose which coronavirus patients to save — and they’re said to be choosing the young’Business Insider, 10 March 2020.

India

Pragya Tiwari, ‘After the Lockdown, Fear and Chaos in India‘, The New York Times, 25 March 2020. 

United Kingdom

William Hanage, ‘I’m an epidemiologist. When I heard about Britain’s ‘herd immunity’ coronavirus plan, I thought it was satire’The Guardian, 15 March 2020.

Owen Jones, ‘We’re about to learn a terrible lesson from coronavirus: inequality kills’The Guardian, 14 March 2020.

Gov.co.uk, ‘Guidance: Pandemic Flu’, 24 November 2017.

United States

Philip Oltermann,’Trump ‘offers large sums’ for exclusive US access to coronavirus vaccine’The Guardian, 15 March 2020.

Responses and (their) Ethics

Feminist Alliance for Rights, ‘Action: Call for a Feminist COVID-19 Policy. Statement of Feminists and Women’s Rights Organizations from the Global South and marginalized communities in the Global North’, FAR. 

The Hastings Center, ‘Ethics Resources on the Coronavirus (COVID-19)’.

Foreign Affairs, ‘The Global Response to the Coronavirus: Foreign Affairs Coverage of a Growing Epidemic,’ Foreign Affairs. 

Nick Turse, ‘In West African Coronavirus Hotspot, War has left 700,000 Homeless and Exposed’The Intercept, 26 March 2020.

David Shaw and others, ‘Don’t let the ethics of despair infect the intensive care unit‘, BMJ Blog, 26 March 2020.

Rucira Ooi, ‘Rucira Ooi: Even hospitals are not immune to xenophobia amid a pandemic’BMJ Blog, 18 March 2020.

Hugo Slim, ‘This age of COVID-19 demands new emergency ethics’The New Humanitarian, 18 March 2020.

Nancy Berlinger and others, ‘Ethical Framework for Health Care Institutions & Guidelines for Institutional Ethics Services Responding to the Coronavirus Pandemic’The Hastings Center, 16 March 2020.

Max Fisher and Emma Bubola, ‘As Coronavirus Deepens Inequality, Inequality Worsens Its Spread’The New York Times, 16 March 2020. 

500 Women Scientists, ‘HOPE IS NOT A STRATEGY: WHAT WE CAN DO IN THE WAKE OF COVID-19′500 Women Scientists, 13 March 2020.

Cahal Moran, ‘Take care of the people, and the economy will take care of itself’Open Democracy, 12 March 2020.

Bonnie Berkowitz, ‘What coronavirus fears are doing to people with anxiety disorders’The Washington Post, 11 March 2020.  

Isaac Chotiner, ‘The Medical Ethics of the Coronavirus Crisis’The New Yorker, 11 March 2020.

Yasha Mounk, ‘Cancel Everything: Social distancing is the only way to stop the coronavirus. We must start immediately’, The Atlantic, 10 March 2020. 

Pagel et al., ‘Covid-19: How to triage effectively in a pandemic’thebmjopinion, 9 March 2020.

Partners in Health, ‘Harvard Professor Issues FAQ on Coronavirus’Partners in Health, 9 March 2020.

Zhang Wanqing, ‘Domestic Violence Cases Surge During COVID-19 Epidemic’Sixth Tone, 4 March 2020. 

Podcasts

The Guardian’s Today in Focus, ‘The Race to Contain Coronavirus’

Sam Harris, ‘How Should We Respond to Coronavirus? A Conversation with Nicholas Christakis’

Websites and organisations

British Red Cross – International Work

Centres for Disease Control and Prevention (CDC) – Emergency Preparedness and Response

Humanitarian Health Ethics (HHE)

Nuffield Council on Bioethics

World Health Organization (WHO)

Blogs

HHE – Dispatches from the Field

HHE – Picturing Humanitarian Health Care

International Committee of the Red Cross (ICRC) – Humanitarian Law & Policy