This scenario presents a professional challenge due to the inherent tension between immediate patient needs in a resource-limited humanitarian setting and the established ethical and professional standards for informed consent. The urgency of a surgical intervention, especially in a Pacific Rim region potentially affected by natural disasters or with limited healthcare infrastructure, can create pressure to proceed without the ideal level of patient understanding. Careful judgment is required to balance the imperative to save lives with the fundamental right of individuals to make autonomous decisions about their medical care. The best professional practice involves obtaining informed consent that is as comprehensive as possible given the circumstances, even in a humanitarian response. This means clearly explaining the nature of the proposed surgery, its potential benefits, significant risks, and available alternatives, including the option of no treatment. Crucially, it requires assessing the patient’s capacity to understand this information and make a decision. If the patient is unable to provide consent due to their condition or other factors, the process must involve seeking consent from a legally authorized representative, if one is available and identifiable. This approach upholds patient autonomy and respects their dignity, aligning with core ethical principles of beneficence, non-maleficence, and respect for persons, which are foundational in global health and humanitarian medical practice. Proceeding with surgery without a clear understanding of the procedure, risks, and benefits by the patient or their authorized representative is ethically unacceptable. This failure to ensure informed consent violates the principle of patient autonomy and can lead to significant ethical breaches. Similarly, assuming consent based on perceived urgency or cultural norms without attempting to verify understanding and capacity is a dangerous shortcut that undermines patient rights. Relying solely on the presence of a family member without assessing their authority or the patient’s wishes, if discernible, also represents a failure in due diligence. Professionals in this situation should employ a decision-making framework that prioritizes patient rights while acknowledging operational realities. This involves: 1) Rapidly assessing the patient’s condition and the urgency of intervention. 2) Making a swift but thorough attempt to communicate essential information about the procedure, risks, and benefits in a culturally sensitive and understandable manner, using interpreters if necessary. 3) Evaluating the patient’s capacity to consent. 4) If capacity is lacking or unclear, diligently seeking out and verifying the authority of a legal representative. 5) Documenting all efforts made to obtain informed consent, including any challenges encountered and decisions made. 6) If immediate life-saving intervention is absolutely necessary and consent cannot be obtained from any source, this should be a last resort, clearly documented, and followed by a comprehensive discussion with the patient or representative as soon as feasible.

The evaluation methodology shows a commitment to rigorous assessment and continuous improvement in the Frontline Pacific Rim Global Surgery and Humanitarian Response Proficiency Verification. This scenario presents a professional challenge due to the inherent tension between maintaining assessment integrity and accommodating individual circumstances that might impact a candidate’s performance. Careful judgment is required to balance these competing interests in a way that upholds the program’s standards and fairness. The best approach involves a transparent and consistent application of the established blueprint weighting, scoring, and retake policies, while also demonstrating empathy and a willingness to explore reasonable accommodations within the policy framework. This means acknowledging the candidate’s situation, clearly explaining the existing policies regarding retakes and their implications, and offering to discuss potential pathways for support or re-evaluation that align with the program’s guidelines. This approach is correct because it prioritizes fairness, consistency, and adherence to the established evaluation framework, which are fundamental ethical principles in professional assessments. It respects the integrity of the verification process by not creating ad-hoc exceptions that could undermine its credibility. Furthermore, it offers a supportive, yet structured, response to the candidate’s concerns. An approach that immediately offers a special retake opportunity outside of the established policy, without thorough consideration of the implications for other candidates or the program’s overall standards, is professionally unacceptable. This could be perceived as favoritism and would undermine the fairness and consistency of the scoring and retake policies. It fails to uphold the principle of equal treatment for all candidates. Another professionally unacceptable approach would be to rigidly dismiss the candidate’s concerns and simply state that the policy is absolute, without any attempt to understand the situation or offer any form of support or clarification. This demonstrates a lack of empathy and can be perceived as unsupportive, potentially damaging the reputation of the program and discouraging future participation. It neglects the ethical consideration of treating individuals with respect and dignity. Finally, an approach that suggests altering the scoring or weighting of the assessment to accommodate the candidate’s situation would be inappropriate. This directly compromises the integrity of the blueprint and the validity of the assessment itself. It would mean that the verification no longer accurately reflects the intended proficiency levels, rendering the entire process unreliable. Professionals should employ a decision-making framework that begins with understanding the established policies and their rationale. They should then actively listen to and acknowledge the candidate’s situation, seeking to understand the underlying issues. The next step is to assess whether the situation warrants any consideration within the existing policy framework, such as exploring available support mechanisms or clearly explaining the retake process and its consequences. If a deviation from policy is contemplated, it must be done with extreme caution, ensuring it is justifiable, documented, and does not compromise the integrity or fairness of the assessment for others. Transparency and clear communication are paramount throughout this process.

This scenario presents a professional challenge due to the inherent risks associated with using energy devices in a resource-limited, high-pressure humanitarian surgical setting. The critical need for patient safety, coupled with potential equipment limitations and varying levels of team experience, necessitates a rigorous and systematic approach to operative principles and energy device safety. Careful judgment is required to balance the urgency of surgical intervention with the imperative to minimize harm. The correct approach involves a comprehensive pre-operative assessment of all available energy devices, including thorough functional checks and confirmation of appropriate accessories. This includes verifying that the device’s settings are appropriate for the intended surgical task and that the entire surgical team is aware of the device’s capabilities and limitations. Furthermore, it mandates clear communication protocols regarding the activation and deactivation of the energy device, ensuring that only the surgeon or a designated assistant controls its use. This aligns with fundamental principles of patient safety and operative best practice, emphasizing proactive risk mitigation and clear communication, which are paramount in any surgical environment, especially in humanitarian contexts where resources may be strained. Adherence to established protocols for energy device use, even in challenging circumstances, is a cornerstone of professional responsibility and ethical surgical practice. An incorrect approach would be to proceed with the surgery without adequately testing the energy device, assuming it is functional based on prior use or visual inspection. This fails to acknowledge the potential for malfunction or degradation of equipment, particularly in austere environments, and directly contravenes the principle of ensuring all tools are safe and effective before patient contact. Such an oversight significantly increases the risk of unintended tissue damage, burns to the patient or staff, or device failure during a critical moment, leading to adverse patient outcomes. Another incorrect approach would be to delegate the responsibility for energy device operation to an individual without confirming their understanding of its specific settings and safety features, or without establishing clear communication channels for its activation. This abdication of direct oversight and communication bypasses essential safety checks and can lead to accidental activation or inappropriate use, jeopardizing patient safety. It neglects the principle of shared responsibility and clear command within the surgical team. A further incorrect approach would be to prioritize speed of operation over meticulous adherence to energy device safety protocols, such as failing to ensure proper insulation of active electrodes or neglecting to confirm the absence of flammable materials near the operative site. This demonstrates a disregard for established safety guidelines and introduces preventable risks of fire, burns, or electrical injury to the patient and surgical team. It prioritizes expediency over the fundamental ethical obligation to do no harm. Professionals should employ a decision-making framework that begins with a thorough pre-operative assessment of all equipment, including energy devices. This should be followed by a clear, shared understanding of the surgical plan and the role of each instrument. Communication should be open and continuous throughout the procedure, with specific attention paid to the safe and effective use of energy devices. When in doubt about equipment functionality or safety, the professional obligation is to pause, troubleshoot, or seek alternative solutions rather than proceeding with potentially compromised safety measures.

This scenario presents a profound ethical dilemma common in humanitarian surgical missions, where resource scarcity clashes with the imperative to provide optimal care. The professional challenge lies in balancing the immediate needs of critically ill patients with the long-term implications of resource allocation and the potential for harm from suboptimal treatment. Careful judgment is required to navigate these complex ethical waters, ensuring that decisions are not only medically sound but also ethically defensible and aligned with humanitarian principles. The best approach involves a systematic, evidence-based triage process that prioritizes patients with the highest likelihood of survival and benefit from available resources, while also acknowledging the limitations and communicating them transparently. This aligns with the ethical principles of beneficence (acting in the patient’s best interest) and justice (fair distribution of scarce resources). In a global health context, adherence to established humanitarian guidelines, such as those promoted by organizations like Médecins Sans Frontières (MSF) or the World Health Organization (WHO) in disaster settings, emphasizes maximizing benefit for the greatest number of people under extreme constraints. This approach necessitates a clear, objective assessment of each patient’s condition, prognosis, and the potential impact of intervention, ensuring that decisions are not influenced by personal bias or external pressures. An approach that focuses solely on the most complex cases, regardless of their likelihood of survival with limited resources, is ethically problematic. This can lead to the depletion of critical resources on patients who may not ultimately benefit, thereby compromising the care available for others who might have a better prognosis. It fails to uphold the principle of justice by not distributing scarce resources equitably to maximize overall positive outcomes. Another ethically unsound approach is to prioritize patients based on perceived social status or nationality. This is a direct violation of humanitarian principles and the ethical duty to treat all individuals with equal dignity and respect, irrespective of their background. Such a bias undermines the core values of humanitarian aid and can lead to discriminatory practices. Finally, an approach that avoids making difficult triage decisions altogether, leading to a paralysis of action or a haphazard distribution of care, is also professionally unacceptable. This inaction can result in preventable deaths and suffering, as resources are not effectively utilized. It represents a failure to exercise professional responsibility in a crisis situation. Professionals in these situations should employ a structured decision-making framework that includes: 1) rapid assessment of patient acuity and prognosis; 2) understanding the specific limitations of available resources; 3) applying pre-defined, objective triage criteria; 4) transparent communication with patients, families, and the medical team; and 5) continuous reassessment as the situation evolves. This systematic process ensures that decisions are as objective, equitable, and beneficial as possible under challenging circumstances.

Scenario Analysis: This scenario presents a significant ethical and professional challenge due to the inherent power imbalance between a senior surgeon and a junior trainee, coupled with the potential for patient harm and the need to uphold professional standards. The junior surgeon is faced with a situation where their mentor’s actions may be compromising patient safety and deviating from established best practices in a critical subspecialty procedure. The pressure to conform, fear of reprisal, and the desire to maintain a positive professional relationship all complicate the decision-making process. Upholding the principles of patient advocacy and professional integrity is paramount. Correct Approach Analysis: The best professional approach involves discreetly and respectfully raising concerns with the senior surgeon directly, focusing on objective observations and potential patient risks. This approach prioritizes open communication and allows the senior surgeon an opportunity to self-correct or clarify their intentions. It aligns with ethical principles of beneficence (acting in the patient’s best interest) and non-maleficence (avoiding harm) by addressing potential complications before they manifest. It also respects the hierarchical structure of surgical training while asserting the junior surgeon’s responsibility to patient safety. This is often supported by institutional policies on professional conduct and patient safety reporting, which encourage direct communication as a first step in addressing concerns. Incorrect Approaches Analysis: One incorrect approach is to immediately escalate the issue to hospital administration or a formal ethics committee without first attempting to discuss the concerns with the senior surgeon. This bypasses a crucial step in professional discourse and can be perceived as a lack of collegiality, potentially damaging the working relationship and hindering future communication. While escalation may be necessary if direct communication fails or if the risk is immediate and severe, it should not be the initial response in this context. Another incorrect approach is to remain silent and do nothing, hoping the situation resolves itself or that the senior surgeon’s methods are, in fact, acceptable. This abdication of responsibility directly violates the ethical duty to advocate for the patient and to intervene when patient safety is potentially compromised. It also fails to uphold professional standards and could lead to significant patient harm, with the junior surgeon bearing moral and potentially legal responsibility for their inaction. A further incorrect approach is to openly challenge or criticize the senior surgeon’s technique in front of the surgical team or other staff. This is unprofessional, disrespectful, and can create a hostile learning environment. It undermines the authority of the senior surgeon and can lead to defensiveness, making it less likely that the concerns will be heard or addressed constructively. Such public confrontation is detrimental to team cohesion and patient care. Professional Reasoning: Professionals facing such dilemmas should employ a structured decision-making process. First, objectively assess the situation and identify specific concerns related to patient safety and established procedural guidelines. Second, consider the most appropriate and least confrontational method for addressing these concerns, prioritizing direct, respectful communication with the individual involved. Third, if direct communication is ineffective or inappropriate, consider seeking advice from a trusted senior colleague or mentor. Finally, if patient safety remains at risk, follow established institutional protocols for reporting concerns, which may involve escalating the issue through appropriate channels. The guiding principle throughout this process is the paramount importance of patient well-being and professional integrity.

The scenario presents a common challenge in humanitarian response: balancing the urgent need for skilled personnel with the ethical imperative of ensuring adequate preparation and resource allocation. The professional challenge lies in the potential for well-intentioned but inadequately prepared individuals to deploy, potentially compromising patient care, team effectiveness, and the overall mission’s success, while also potentially diverting limited resources from more critical needs. Careful judgment is required to navigate the tension between immediate deployment and thorough preparation. The best professional approach involves prioritizing comprehensive candidate preparation and realistic timeline recommendations. This means ensuring that all potential participants have access to and complete relevant pre-deployment training, including cultural competency, specific surgical techniques applicable to the Pacific Rim context, and an understanding of the logistical and ethical challenges of humanitarian missions. It also entails establishing clear, achievable timelines for this preparation, allowing sufficient time for skill development, administrative processes, and mental readiness. This approach is correct because it aligns with the ethical principles of beneficence (acting in the best interest of the beneficiaries by ensuring competent care) and non-maleficence (avoiding harm by deploying only adequately prepared individuals). Furthermore, it reflects best practices in project management and humanitarian aid, which emphasize thorough planning and resource optimization to maximize impact and minimize risk. Adherence to established guidelines for humanitarian deployments, which often mandate specific training and vetting processes, is also implicitly supported. An incorrect approach would be to prioritize rapid deployment over thorough preparation, assuming that on-the-job learning is sufficient. This fails to acknowledge the complexity and potential risks associated with surgical interventions in resource-limited settings. Ethically, it violates the principle of non-maleficence by potentially exposing patients to substandard care due to a lack of preparedness. It also risks team cohesion and effectiveness, as unprepared individuals may struggle to adapt, leading to increased burden on experienced team members and potential mission failure. Another incorrect approach would be to focus solely on the technical surgical skills of candidates, neglecting crucial aspects like cultural sensitivity, communication, and understanding of local health systems. While surgical proficiency is vital, humanitarian response requires a holistic understanding of the environment and the people being served. Failing to address these non-technical but equally critical competencies can lead to misunderstandings, mistrust, and ultimately, ineffective aid delivery, violating ethical principles of respect for persons and cultural humility. A further incorrect approach would be to provide generic, one-size-fits-all preparation resources without considering the specific needs and challenges of the Pacific Rim region and the particular surgical focus of the mission. This approach is insufficient because it fails to equip candidates with the specialized knowledge and skills required for the unique context, such as prevalent local diseases, available infrastructure, and specific cultural considerations relevant to patient care and community engagement. It represents a failure to adequately prepare individuals for the specific demands of the mission, potentially leading to suboptimal outcomes and ethical compromises. Professionals should employ a decision-making framework that begins with a clear understanding of the mission’s objectives and the specific needs of the target population. This should be followed by an assessment of the required competencies, encompassing both technical and non-technical skills. Resources and timelines should then be developed to ensure that all participants meet these competency standards through tailored preparation. Regular evaluation of the preparation process and feedback mechanisms are essential to adapt and improve, ensuring that the deployed team is both skilled and ethically prepared to serve.

Scenario Analysis: This scenario presents a professional challenge because it requires an individual to navigate the complex interplay between personal professional development goals and the overarching mission of a humanitarian response. The core tension lies in ensuring that participation in the Frontline Pacific Rim Global Surgery and Humanitarian Response Proficiency Verification serves its intended purpose and that eligibility criteria are met without compromising the integrity of the program or the effectiveness of the humanitarian effort. Careful judgment is required to balance individual aspirations with the collective needs of the mission and the beneficiaries. Correct Approach Analysis: The best professional practice involves proactively seeking clear, official guidance from the Frontline Pacific Rim Global Surgery and Humanitarian Response program administrators regarding the specific purpose and eligibility requirements for the Proficiency Verification. This approach ensures that the individual’s understanding aligns with the program’s objectives, which are designed to assess and enhance skills directly relevant to frontline global surgery and humanitarian response in the Pacific Rim. Adhering to these defined purposes and eligibility criteria is paramount for ensuring that the verification process is meaningful, that participants are appropriately qualified, and that the program contributes effectively to its humanitarian goals. This aligns with ethical principles of transparency, accountability, and responsible resource allocation within humanitarian operations. Incorrect Approaches Analysis: Pursuing the Proficiency Verification solely based on a general understanding of its potential to enhance a resume, without confirming specific program objectives or eligibility, risks misaligning personal goals with the program’s intent. This could lead to participation by individuals whose skills or motivations are not directly relevant to the program’s focus on frontline Pacific Rim operations, potentially diverting resources and attention from those most suited. Another incorrect approach is assuming eligibility based on prior general humanitarian experience without verifying if that experience meets the specific criteria for this particular Pacific Rim program. This could result in unqualified individuals participating, undermining the program’s credibility and effectiveness. Finally, prioritizing personal career advancement over the stated purpose and eligibility of the verification program is ethically problematic, as it suggests a self-serving motive that could detract from the core humanitarian mission. Professional Reasoning: Professionals facing such situations should adopt a systematic decision-making process. First, they must identify the stated purpose and objectives of any program or initiative. Second, they should actively seek out and understand the specific eligibility criteria and guidelines provided by the organizing body. Third, they must critically assess how their personal goals and qualifications align with these stated purposes and criteria. If there is any ambiguity or discrepancy, the professional should proactively seek clarification from the program administrators. This ensures that actions are aligned with ethical obligations, regulatory frameworks, and the intended impact of the initiative.

Scenario Analysis: This scenario is professionally challenging because it involves balancing the immediate need for surgical intervention with the potential for unforeseen complications arising from inadequate pre-operative assessment and planning, particularly in a resource-limited humanitarian context. The ethical imperative to provide care must be weighed against the principle of non-maleficence, ensuring that the intervention does not cause more harm than good due to preventable risks. Careful judgment is required to navigate the complexities of limited information, potential cultural sensitivities, and the imperative to act responsibly. Correct Approach Analysis: The best professional practice involves a structured operative plan that explicitly identifies and mitigates potential risks, even when faced with time constraints and limited resources. This approach prioritizes patient safety by proactively addressing foreseeable complications. It aligns with the ethical principles of beneficence (acting in the patient’s best interest) and non-maleficence (avoiding harm). Specifically, it requires a thorough, albeit potentially expedited, pre-operative assessment, consultation with available colleagues, and the development of contingency plans for common or significant risks associated with the proposed procedure in the given context. This structured approach ensures that the surgical team is prepared for potential adverse events, thereby enhancing the likelihood of a positive outcome and minimizing iatrogenic harm. Incorrect Approaches Analysis: One incorrect approach involves proceeding with surgery based on a general understanding of the procedure without a detailed, individualized risk assessment and mitigation plan. This fails to acknowledge the specific patient’s condition and the unique challenges of the humanitarian setting, potentially leading to unexpected complications that could have been anticipated and managed. It violates the principle of non-maleficence by not taking all reasonable steps to prevent harm. Another unacceptable approach is to delay surgery indefinitely due to a lack of perfect information or ideal conditions, thereby potentially exacerbating the patient’s condition and increasing suffering. While thorough planning is crucial, an overly cautious approach that paralyzes action can also be detrimental, failing the principle of beneficence when timely intervention is indicated. The ethical challenge lies in finding the appropriate balance. A further flawed approach is to delegate the entire operative planning to junior team members without adequate senior oversight or input, especially when dealing with complex cases or unfamiliar environments. This can lead to critical oversights in risk assessment and mitigation, as it bypasses the experience and judgment of more seasoned practitioners, potentially compromising patient safety and violating the duty of care. Professional Reasoning: Professionals should employ a systematic decision-making process that begins with a rapid but comprehensive assessment of the patient’s condition and the surgical problem. This should be followed by a collaborative discussion with the surgical team to identify potential risks, considering the specific context (e.g., available equipment, post-operative care capabilities, patient’s overall health). A structured operative plan should then be formulated, including clear steps for the procedure, anticipated challenges, and pre-defined strategies for managing common or severe complications. This plan should be communicated to the entire team. If significant uncertainties remain that cannot be adequately mitigated, the decision to proceed should be carefully re-evaluated, potentially involving further consultation or considering alternative management strategies. The overarching principle is to maximize benefit while minimizing harm through diligent and proactive planning.

Scenario Analysis: This scenario presents a significant ethical and professional challenge due to the inherent conflict between immediate patient need and the established protocols for resource allocation and informed consent, particularly in a resource-limited humanitarian setting. The surgeon must balance the urgency of a life-threatening condition with the ethical imperative to ensure the patient understands and consents to a procedure that deviates from standard practice due to the absence of necessary equipment. This requires a nuanced understanding of applied surgical anatomy and physiology to assess the feasibility of an alternative approach, while simultaneously navigating complex ethical considerations regarding patient autonomy and beneficence. Correct Approach Analysis: The best professional approach involves a thorough assessment of the patient’s anatomy and physiological status to determine if a modified procedure is surgically feasible and safe, even with limited resources. This includes clearly communicating the risks, benefits, and alternatives (including the risks of no intervention) to the patient or their surrogate in a language and manner they understand. Obtaining informed consent, even under duress, is paramount. This approach prioritizes patient autonomy and beneficence by ensuring the patient is an active participant in the decision-making process, even when faced with difficult circumstances. It aligns with humanitarian principles of providing the best possible care while respecting individual rights. Incorrect Approaches Analysis: Proceeding with a modified procedure without attempting to obtain informed consent, even if deemed medically necessary, violates the fundamental ethical principle of patient autonomy. This approach disregards the patient’s right to self-determination and can lead to significant legal and ethical repercussions, as well as erode trust in the medical team. Opting for no intervention solely because the ideal equipment is unavailable, despite a potentially viable alternative that could save the patient’s life, fails to uphold the principle of beneficence. While caution is necessary, abandoning all attempts at treatment when a reasonable, albeit modified, option exists can be considered a dereliction of duty, especially in a humanitarian context where resources are scarce and needs are high. Performing the modified procedure and informing the patient only after the fact, or in a way that minimizes their understanding of the deviation from standard care, is ethically unacceptable. This constitutes a breach of transparency and undermines the informed consent process, potentially leading to patient dissatisfaction and distrust, and failing to respect their right to know what is being done to their body. Professional Reasoning: Professionals in such situations should employ a decision-making framework that prioritizes patient well-being and ethical conduct. This involves: 1) Rapidly assessing the clinical situation and the patient’s anatomical and physiological status. 2) Identifying potential alternative interventions that, while not ideal, could achieve a beneficial outcome. 3) Thoroughly evaluating the risks and benefits of these alternatives in the context of available resources. 4) Engaging in clear, empathetic, and culturally sensitive communication with the patient or their surrogate to explain the situation, the proposed modified procedure, and all available options, including the option of no intervention. 5) Obtaining informed consent based on this comprehensive understanding. 6) Documenting the entire process meticulously.

This scenario presents a significant professional challenge due to the inherent tension between maintaining operational efficiency and ensuring patient safety through rigorous quality assurance. The pressure to deploy resources rapidly in humanitarian settings can sometimes lead to overlooking critical review processes, which are fundamental to learning and preventing future harm. Careful judgment is required to balance the immediate needs of a crisis with the long-term imperative of improving surgical outcomes and patient care. The best professional approach involves a systematic and transparent morbidity and mortality (M&M) review process that actively incorporates human factors analysis. This approach is correct because it directly addresses the core principles of quality assurance in healthcare. By reviewing cases where adverse outcomes occurred, the team can identify systemic issues, individual learning opportunities, and the influence of environmental or systemic factors (human factors) on performance. This aligns with ethical obligations to provide competent care and continuously improve practices. Regulatory frameworks in global health often emphasize the importance of learning from errors and near misses to enhance patient safety and accountability. A proactive human factors analysis within M&M reviews is crucial for understanding how the complex interplay of individual, team, and environmental factors contributes to adverse events, moving beyond simple blame to systemic solutions. An incorrect approach would be to dismiss the elevated mortality rate as an unavoidable consequence of the challenging operating environment without conducting a thorough review. This fails to meet the ethical obligation to investigate adverse events and identify potential areas for improvement. It also neglects the potential for human factors to play a significant role, even in resource-limited settings, and misses opportunities to implement evidence-based strategies to mitigate risks. Another incorrect approach is to focus solely on individual surgeon performance during the review, attributing all adverse outcomes to skill deficits. This is ethically problematic as it can lead to unfair blame and discourages open reporting of errors. It also ignores the broader systemic and human factors that contribute to surgical outcomes, such as inadequate equipment, poor communication, or overwhelming workload, which are often more impactful in humanitarian contexts. A further incorrect approach would be to conduct superficial M&M reviews that lack a structured methodology or fail to document findings and action plans. This renders the review process ineffective, as it does not lead to tangible improvements in care. It also undermines the principles of accountability and continuous quality improvement, which are essential for building trust and ensuring the long-term sustainability of humanitarian surgical programs. Professionals should employ a decision-making framework that prioritizes patient safety and continuous learning. This involves establishing clear protocols for M&M reviews, ensuring dedicated time and resources for these reviews, and fostering a culture of psychological safety where team members feel comfortable reporting errors and discussing challenges openly. The framework should integrate human factors principles to understand the context of care delivery and identify systemic solutions rather than focusing on individual blame. Regular training on M&M review processes and human factors analysis is also vital.