As a humanitarian medical organization, Médecins Sans Frontières (MSF) intervenes in places around the world affected by conflict and crisis. Although we are guided by humanitarian principles, our medical teams are often confronted with complicated dilemmas. In a chapter from a new book called Humanitarian Action and Ethics (Zed Books), current and former MSF field workers consider some of the ethical challenges that form an inevitable part of MSF's medical humanitarian action, and how the organization can better enable our staff and front-line field workers to address them.
As part of International Humanitarian Law (IHL), Additional Protocols I and II of 1977 to the Geneva Conventions and other treaties provide for the protection of patients, medical personnel and health infrastructures during armed conflicts. They recognize the primacy of medical ethics in times of war, notably the principle of non-discrimination. Attacks against hospitals or health care providers during armed conflicts signal a blatant disregard for such protections. A state of affairs where IHL is ignored, denied or revisited has far-reaching consequences for the medical profession.
Chiara Lepora and Robert Goodin invite us to join their insightful ‘conversation’ on complicity and compromise. Their book makes a dense, utterly precise and rewarding reading, as one proceeds stepwise through the logic of their philosophical arguments. For those unfamiliar with the relatively new discipline of ‘humanitarian ethics’, it might be disconcerting at first to see humanitarian actions brought to illustrate theories on complicity, with the Rwandan refugees crisis of 1994 and the tortured patient taken as two exemplary cases.
The West African Ebola epidemic has set in motion a collective endeavour to conduct accelerated clinical trials, testing unproven but potentially lifesaving interventions in the course of a major public health crisis. This unprecedented effort was supported by the recommendations of an ad hoc ethics panel convened in August 2014 by the WHO.