title: The Development of a Humanitarian Health Ethics Analysis Tool.
abstract: Introduction Health care workers (HCWs) who participate in humanitarian aid work experience a range of ethical challenges in providing care and assistance to communities affected by war, disaster, or extreme poverty. Although there is increasing discussion of ethics in humanitarian health care practice and policy, there are very few resources available for humanitarian workers seeking ethical guidance in the field. To address this knowledge gap, a Humanitarian Health Ethics Analysis Tool (HHEAT) was developed and tested as an action-oriented resource to support humanitarian workers in ethical decision making. While ethical analysis tools increasingly have become prevalent in a variety of practice contexts over the past two decades, very few of these tools have undergone a process of empirical validation to assess their usefulness for practitioners.
  
  
  METHODS
  A qualitative study consisting of a series of six case-analysis sessions with 16 humanitarian HCWs was conducted to evaluate and refine the HHEAT.
  
  
  RESULTS
  Participant feedback inspired the creation of a simplified and shortened version of the tool and prompted the development of an accompanying handbook.
  
  
  CONCLUSIONS
  The study generated preliminary insight into the ethical deliberation processes of humanitarian health workers and highlighted different types of ethics support that humanitarian workers might find helpful in supporting the decision-making process.
authors.affiliation: 1Centre for Clinical Ethics,St-Joseph's Health Centre,Toronto,Ontario,Canada.
authors.forename: Veronique
authors.initials: V
authors.lastname: Fraser
authors.affiliation: 3School of Physical and Occupational Therapy,McGill University,Montreal,Quebec,Canada.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Hunt
authors.affiliation: 5Faculty of Information and Media Studies,Western University,London,Ontario,Canada.
authors.forename: Sonya
authors.initials: S
authors.lastname: de Laat
authors.affiliation: 6Clinical Epidemiology and Biostatics,McMaster University,Hamilton,Ontario,Canada.
authors.forename: Lisa
authors.initials: L
authors.lastname: Schwartz
mesh_terms: D000533:Altruism; D001675:Bioethics; D003657:Decision Making / Q000941:ethics*; D003695:Delivery of Health Care / Q000941:ethics; D003906:Developing Countries; D006282:Health Personnel / Q000941:ethics; D006801:Humans; D016730:Program Development; D012066:Relief Work / Q000941:ethics*
keywords: HCW health care worker; HHEAT Humanitarian Health Ethics Analysis Tool; NGO nongovernmental organization; ethical analysis tools; ethical deliberation; ethics; humanitarian aid