Harms and benefits, you have a certain judgment on what harms and benefits for
a patient could be, but maybe the patient has a very different assessment of this.
For him, what you may perceive beneficial may not be perceived as such.
Let me go back to the example of an HIV test.
You give an HIV test.
The patient is found positive.
While you may think this is beneficial because now the patient can be put under
treatment before symptoms of AIDS appear, the patient may find this very,
very detrimental because he or she has to go back and inform the partner or
decide not to inform the partner because he fears discrimination or stigmatization.
So you always have to properly inform the patient before and
that the patient can decide what it means by harms and benefits.
On the other hand benefits will be rated to the type of care you can provide.
Now, the problem in many situations such as disasters,
conflict situations is that you have not all means available.
The better drugs you have, the better tests you have available,
the better competence the health professionals who work there have,
the better you will be able to provide quality care.
Finally, there may be certain risky situations which
relate to the law of a country or to habits, customs.
For example, female genital mutilation is very prevalent in certain countries.
And people working in humanitarian organizations have
been asked after delivery to close a vagina again.
Now, can a humanitarian organization do that?
Is that ethically sound?
Another issue is abortion.
In many countries, abortion is prohibited, however,
a woman being pregnant after being raped has the right to abortion.
Now, some humanitarian organizations provide abortion,
even if the law of the country prohibits it.
So these are situations where benefits and
harms have to be weighed also against the rules and laws of a country.