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You are part of a team of expatriate nurses and doctors working with an international non-governmental organization.  The team includes two surgeons. You are working in a post-disaster setting and have a mandate to treat patients with injuries and trauma that resulted from the disaster.  In the first weeks following the disaster, the surgical team performed a high number of procedures every day.  In recent days there has been a decrease in surgical cases and there is OR time available.  The surgeons receive a request from local doctors that they perform hernia repairs for several local villagers who have been living with hernias for many years.  Hernia repair is well within the capacities of the team and their facilities.  Hernias are a significant issue for local farmers and have a serious impact on the individual’s ability to perform manual labour.  However, your team has a strict mandate from the non-governmental organization and a closely scripted memorandum of agreement with the Ministry of Health.

  • Under what conditions should the team treat patients beyond the mandate?
  • Should they perform these procedures?


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