The ethics of humanitarian action

In this step we will explore what it means to apply ethical principles to action in humanitarian crises, but why are ethics so important?

Ethics in the field

Humanitarian workers face ethical challenges on a daily basis to maintain the principles of humanity, impartiality, independence, and neutrality. Humanitarians are compelled to ask themselves a profound ethical question: ‘are we doing more harm than good’?

At their core, humanitarian principles are the cornerstone of intervention, guiding organisations and individuals in their work to save lives and preserve human dignity. However, what may in theory seem a straightforward ethical matter is in practice complex to make happen in unpredictable environments. In conflict settings, banditry, diverting aid, and extortion are strategies used to transform humanitarian aid into an instrument of manipulation and power, depriving affected populations of humanitarian assistance. In addition, the rising number of attacks on humanitarian workers1, including those delivering health interventions, highlights the increasing risks to organisations and their staff in crises settings.

Who observes humanitarian principles?

As we have seen, the humanitarian principles were born from the experiences of the pioneers of modern humanitarian action, including the International Red Cross, and they have developed into the ethical framework guiding the philosophy and organisational culture of many humanitarian organisations. However, humanitarian principles are not necessarily shared by all parties in a crisis setting. Some local political and military actors may not consider humanitarian principles relevant, and may decide to take actions that are contrary to ethical principles and International Humanitarian Law (IHL). More recently, an increasingly diverse set of actors, particularly in the Middle East or even after the earthquake in Haiti2, have emerged in the humanitarian sphere who have different values, motivations, and agendas that may not embrace or be in direct opposition to humanitarian principles.

What are the challenges of putting humanitarian principles into practice?

Observing and employing humanitarian principles in practice can be unclear and complex, and navigating moral dilemmas in crisis settings requires humanitarians to manage the line between adhering to principles and practising responsibly.

Neutrality & independence

Humanitarians must deal with all parties in a conflict to enable access to affected people. In practice, this is likely to be armed forces including militia, police, and political leaders, and may include people known to have committed human rights violations. To develop and maintain key relationships it is essential to maintain neutrality and independence, as the perception of being partisan can lead to a loss of credibility and the ability to operate effectively and safely.

Health interventions often face pressure to treat favoured groups, rather than those most in need. This can take the form of delivering healthcare services to a particular location or prioritising certain groups during triage. It is essential for humanitarians to establish credibility with and gain the confidence of actors, to enable decisions of provision to be made on the basis of need rather than ethnicity, political views, or other reasons related to the conflict.

Complicity

The risk of complicity, or involvement with an unlawful act, poses a direct challenge to humanitarian principles by leading to negative consequences of aid provision. Following the Rwanda genocide (1994-5), refugee camps across the border in Goma, Democratic Republic of Congo, were targeted. Stolen aid, including vehicles, equipment and cash, were used to fuel the war economy and finance a new militia to invade Rwanda.

Staff security

As humanitarian workers are increasingly under attack, organisations face tough decisions on if and how to deliver aid. Healthcare workers have increasingly come under attack as hospitals have become targets, notably with recent incidents in Somalia3, Syria4 and Yemen5, among others. Ethical questions about who, what, and how health interventions should or can be delivered pivot on the acceptability and management of risk to staff. The perception of health workers as targets in conflict led to Médecins Sans Frontières pulling out of Somalia in 2013 after 22 years of delivering lifesaving healthcare3.

The humanitarian community has had and will continue to face uncomfortable realities about the actors it interacts with, particularly in conflict settings. Ensuring the support, safety and protection of both conflict-affected communities and humanitarian workers has and continues to pose ethical dilemmas. The challenge is to interpret and apply humanitarian principles as soundly as possible, in the face of insecurity and volatility in field operations.

Much of what has been discussed here relates to conflict settings, but what ethical considerations do you think face humanitarian staff in other contexts, such as natural disasters and disease outbreaks?

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This article is from the free online course:

Health in Humanitarian Crises

London School of Hygiene & Tropical Medicine