Hunt MR (2008) Ethics beyond borders: how health professionals experience ethics in humanitarian assistance and development work. Our review found multiple instances where ethical obligations and humanitarian principles intersect (Tables 3 and 4). Int Rev Red Cross 94:13811408. https://doi.org/10.1111/1758-5899.12315. Public health ethics frameworks 2009; Rubenstein 2015), there has yet to be a comprehensive review focusing on ethics and humanitarian project closure. 2011). Copy the code below and paste it into your web site. Challenges to ethical obligations and humanitarian principles in conflict settings: a systematic review. Areas of ethical tension will almost certainly include the allocation of scarce resources, discontinuing care or closing to new admissions (both for covid-19 cases and those with other morbidities), "complicity" in coercive measures, care for staff amidst (PPE) supply shortages, and prioritisation vis--vis pre-existing crisis needs. Can Fam Physician 42:14151419, Burkle FM Jr et al (2017) The solidarity and health neutrality of physicians in war & peace. Prehosp Disaster Med 16:5358. 2017; Haver 2016; Weiss 2016); and tensions arising between organizational, individual, and local beliefs and norms (Civaner et al. The edited collection's 29 authors are a community of . https://doi.org/10.20529/IJME.2009.023, Michael M, Zwi AB (2002) Oceans of need in the desert: ethical issues identified while researching humanitarian agency response in Afghanistan. 28 View 3 excerpts, cites background and methods https://doi.org/10.1017/cbo9780511511233.006, Tribe R, Weerasinghe D, Parameswaran S (2014) Increasing mental health capacity in a post-conflict country through effective professional volunteer partnerships: a series of case studies with government agencies, local NGOs and the diaspora community. Actors responding to humanitarian crisis employ numerous principles to guide their actions and decisions. https://doi.org/10.1016/S0140-6736(09)61926-7. Humanitarian research is an important source of evidence and can yield valuable knowledge to improve crisis response, a clear ethical good. We must constantly ask ourselves about the nature and context of the interaction and how we negotiate with an individual with a view to maintaining some kind of recognition of what makes them unique. This is a qualitative study drawing on Grounded Theory analysis of 20 interviews with health care professionals who have provided humanitarian assistance. Similarly, we excluded military ethics as not germane to humanitarian practice. "Being a humanitarian means helping people who are suffering and saving lives any time any place in the world. Humanitarian Health Ethics Research Group. 2011). To be included in qualitative analysis, a publication needed to (1) include reference, implicitly or explicitly, to ethics and/or humanitarian principle(s); (2) relate to non-military relief work in active conflict or conflict-affected settings; (3) relate to organizational mission and/or delivery of services; and (4) relate to events occurring in the twentieth century or later. In the humanitarian principles category, the principle of solidarity was added as a node, as it was noted to be an emerging humanitarian principle. Humanitarians are required to be impartial,independent, professionally competent andfocused only on preventing and alleviatinghuman suffering. The authors choose not to provide this information. Satisfied with the reliability of coding, the two study team members proceeded to independently code the remaining articles. He was previously a senior research fellow at the Oxford Institute for Ethics, Law and Armed Conflict, which is based at Oxfords Blavatnik School of Government. Alongside her direct humanitarian work, Dr. Lepora has published in leading philosophy journals to engage with foundational questions about the ethics of humanitarian aid and complicity. Similarly, the ethical obligation to provide honest and transparent communication could be in tension with the principle of independence, for example, if distributing communication relies upon state-owned media. Slim H (1995) The continuing metamorphosis of the humanitarian practitioner: some new colours for an endangered chameleon. The moral experience of Canadian healthcare professionals during humanitarian relief work is explored to address the moral experiences of healthcare professionals in staff recruitment, as they implement training prior to departure, and in supporting Healthcare professionals in the field. a powerful message delivered with brio. While humanitarian wo "Ethics by itself is a heavy topic and takes an emotional toll and energy. Humanitarian action is designed to complement and support States in fulfilling those responsibilities; it should neither undermine nor supplement state responsibility. Passages that were difficult to interpret were discussed and coding was reconciled through discussion among the entire study team. They participate in primary health care, immunization campaigns, clinic- and hospital-based care, rehabilitation and feeding programs. This book has been written to answer these questions and to enable humanitarian workers to develop a practical understanding of the principles that govern their profession. The study draws on data from 70 humanitarian organizations and makes use of multiple regression models to deduce the relationship. Egeland J, Harmer A, Stoddard A (2011) To stay and deliver: good practice for humanitarians in complex security environments. 2017), gaps in situational awareness that allow dishonest actors to present distorted views of needs (Fegley 2009; Gardemann 2002; Haver 2016; Hunt et al. The collapse of in-country health systems (Al-Moujahed et al. Featuring contributions from humanitarian practitioners, health professionals, and social and political scientists, this book explores the question of ethics in modern humanitarian work,. https://doi.org/10.1056/NEJM198910193211629. It's not easy to write about." Reason and Emotion Humanitarian health care organizations and health workers working in contexts of armed or violent conflict experience challenges in fulfilling ethical obligations and humanitarian principles. Am J Trop Med Hyg 92:678680. Many obstacles stand in the face of international response to crises. Prehosp Disaster Med 9:45, Ben Shahar I (1993) Disaster preparation and the functioning of a hospital social work department during the Gulf War. The inability to recruit and retain skilled individuals can require organizations to fill essential staffing gaps with unqualified or untrained individuals (Fouad et al. The module will allow students to reflect upon the history and meaning of Humanitarianism and Humanitarian Engineering. 1989; Madhiwalla and Roy 2009). . Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. This module is the first module for all students, it is an introduction to humanitarian engineering looking from ethical, cultural, and practical perspectives. Broussard, G., Rubenstein, L.S., Robinson, C. et al. Third, the two study team members used the revised codebook to re-code the same ten articles, and results were compared. Ethical practice, in short, is a byproduct of strong communication practices, dynamic feedback mechanisms, and community-centered project design, and if we do it well, we can open new pathways to effective, community-led innovation. Practicing honesty and transparency in communications was an important theme in our review. Below, we present key summary findings. Ethics of Humanitarian Field Work Featuring Dr. Chiara Lepora Date Tue May 2nd 2017, 12:00 - 1:30pm Event Sponsor McCoy Family Center for Ethics in Society, WSD Handa Center for Human Rights & Int'l Justice Location Encina Hall, 616 Serra St., CISAC Central Conference Room (2nd Floor) Please RSVP here. PLoS Curr 6. https://doi.org/10.1371/currents.dis.96bec99f13800a8059bb5b5a82028bbf, Cobey JC, Flanagin A, Foege WH (1993) Effective humanitarian aid. In disaster management, compliance with the principles are essential elements of humanitarian . Regarding humanitarian principles, for instance, some organizations have maintained independence by refusing to accept funds conditional upon particular program changes or by investing and developing their own asset management strategies to avoid reliance upon, or sharing assets with, partisan groups. Violent attacks against humanitarian health organizations and workers have many negative consequences. Advancements in operational security (Egeland et al. this edited volume from ayesha ahmad and james smith offers an expansive tour across the difficult landscape of ethical conundrums in humanitarian action, traversing issues related to "moral distress," triage and treatment of mental health and ebola patients, cross-border health provision, humanitarian failures, and humanitarianism's place in the First, the search included only English language publications. For example, the ethical obligation to support a locally-led response could be in tension with the humanitarian principle of independence when local community members are aligned with one side of the conflict or another. I flag five here. In a qualitative study, the stories of ethical challenges and moral experience of humanitarian health care professionals who travelled to settings around the globe illustrated how health care decision-making in disaster contexts is often beset by complicating factors such as resource scarcity, security conflicts and disparate cultural expectations. J Public Health Med 17:335342, Al-Moujahed A, Alahdab F, Abolaban H, Beletsky L (2017) Polio in Syria: problem still not solved. 2017). From natural disaster areas to conflict zones, humanitarian workers today find themselves operating in diverse and difficult environments. Many aspects could be highlighted. Political PrinciplesNeutrality and Independence 4. Moral Responsibility in Humanitarian Ethics Its contents are solely the responsibility of the authors and do not necessarily represent the official views of Elrha or the r2hc. Ethical challenges and humanitarian principles were commonly co-coded. In addition, it lays the foundation for future efforts aimed at tailoring existing frameworks for ethical decision-making and evaluating different methods of navigating these complex challenges. VAT no: 206327686, New Wing The Charter also prohibits forceful interference against. https://doi.org/10.1111/j.1467-7717.2010.01149.x, Domres B, Koch M, Manger A, Becker HD (2012) Ethics and triage. https://doi.org/10.1080/09540269874835, Joshi PT, Dalton ME, O'Donnell DA (2008) Ethical issues in local, national, and international disaster psychiatry. Hugo Slim. Humanitarian Deliberation Springer Nature. 4. Principles and ethics. There is a growing appreciation of the organizational responsibility to protect its workers and acknowledgement of the diminished ability to provide quality care due to security concerns when organizations operate within conflict settings (Asgary 2015; Banatvala and Zwi 2000; Fouad et al. The Structure of Moral Choices . References used for codebook development. Second, the preliminary codebook was used by two study team members to review ten randomly selected full-text articles. Support staff to identify, understand, and debate ethical issues using common tools. 2009; Omaar and de Waal 1994; Slim 1997a, b). https://doi.org/10.1136/jramc-2013-000214, Black R (2003) Ethical codes in humanitarian emergencies: from practice to research? The ethical framework of the International Association of Professionals in Humanitarian Assistance and Protection (PHAP) begins with recognition of the value of all human life. During crisis situations in which normal systems are not functioning, there is a need for humanitarian action to protect and uphold human life and dignity. 'Humanitarian workers confront desperately difficult ethical choices every day as they struggle to provide aid in war and disasters. Impartiality stipulates that humanitarian actors must not discriminate or give preference to any nationality, race, religious belief, class, affiliation, or political opinion. Maintaining neutrality can also be difficult for organizations whose workers have experienced violence, threats, or compulsion, or have borne witness to violence or advocated on behalf of victims of atrocities (Blair 1996; Burkle Jr. et al. Appendix 2. 2011; Gastineau Campos and Farmer 2003; Haver 2016; Mak 2014; Slim 1995; Sunga et al. The paper seeks to recognise the difficult moral choices relief agencies are facing today and gives some practical guidelines to relief agency staff when confronting the ethics of a given situation, and introduces some basic moral principles surrounding the key ethical notions of action consequences and moral responsibility. Beyond this, careful consideration is needed whether a study is responsive to local needs, and likely to generate knowledge relevant to the priorities of local communities or others that will experience disaster, war or epidemic in the future. The analysis of ethical questions associated with crisis response can advance discussions about how relief efforts can best be designed and implemented to minimise ethical distress and improve assistance to local populations. In the course of this work, clinicians are frequently exposed to complex ethical issues. Short-term humanitarian medical volunteerism has grown significantly among both clinicians and trainees over the past several years. Manage cookies/Do not sell my data we use in the preference centre. Med Confl Surviv 28:113123. As the humanitarian enterprise faces some of its toughest challenges in trying to help people suffering from an unprecedented number of simultaneous conflicts and disasters around the world, Hugo Slim's new book Humanitarian Ethics: A These studies explore issues of relevance to humanitarian . An invaluable tool that should be in every humanitarians grab bag. Antonio Donini, editor of The Golden Fleece: Manipulation and Independence in Humanitarian Action, An informative text worth the attention of academics and professionals, and also those considering volunteering in places where governments and large NGOs have been found wanting. Socialist Review. Organizations may fear that providing aid could unintentionally sustain conflicts (Banatvala and Zwi 2000; Black 2003; Clarinval and Biller-Andorno 2014; Duffield et al. Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Ethical obligations can be mutually supportive, however. Lancet 390:25162526. Do humanitarian agencies inadvertently encourage ethnic cleansing by always being ready to mop-up the consequences of scorched earth warfare? Humanitarian health organizations and health workers frequently work in conflict settings where they are subject to direct attack and where active armed conflict disrupts basic institutions and provision of services. Journal of International Humanitarian Action We explore these potential concerns and their risk factors in three categories . In some instances, this intersection was found to represent apparent tension between fulfilling humanitarian principles and ethical obligations. https://doi.org/10.3310/hta15430, Chaudhri S, Cordes K, Miller N (2019) Humanitarian health programming and monitoring in inaccessible conflict settings: a literature review. Calls for action and outrage are examples of distinct moral values which can justify humanitarian imagery. https://doi.org/10.1017/S1049023X14000934, Rieffer-Flanagan BA (2009) Is neutral humanitarianism dead? While pursuing this goal, careful attention to both the ethics OF and ethics IN these research activities is a key responsibility for researchers, partnering organizations, RECs and funders. 2017). Without endorsing these as the best or only correct strategies, these are listed in Additional file 1: Appendix 4. 2011; Gastineau Campos and Farmer 2003). Getting the science right is an ethical responsibility. https://doi.org/10.1016/S0140-6736(17)30741-9, Fraser V, Hunt MR, de Laat S, Schwartz L (2015) The development of a humanitarian health ethics analysis tool. Social work grew out of humanitarian and democratic ideals, and its values are based on respect for . Int J Humanitarian Action 4, 15 (2019). PLoS One 12:e0174162. How does NaTakallam create social impact? Identifying and mapping these relationships could help organizations manage ethical issues arising during operations. Publications that described only clinical ethics issues (e.g., truth telling or informed consent) that were not strictly related to a conflict setting were excluded; this ensured a consistent focus on those issues salient to, and arising in, conflict settings. . . 2011) and a growing acceptance of increased danger in humanitarian endeavors (Duffield et al. https://bioethics.jhu.edu/research-and-outreach/projects/ethics-guidance-lessons-from-ebola/, Labb J, Daudin P (2016) Applying the humanitarian principles: reflecting on the experience of the International Committee of the Red Cross. The first concept block included 13 search terms: conflict, war, wars, warfare, revolution, revolutions, Arab spring, uprising, uprisings, cruelty, cruelties, or high-risk environments. The second block consisted of seven search terms: relief, relief work, aid, humanitarian, humanity, NGO, or NGOs. The third block included nine search terms: ethics, ethical, morality, professionalism, professional duties, neutrality, principles, independence, and accountability. The full search strategy can be found in Additional file 1: Appendix 1. 1989; Slim 1997b). The Ethical Origins of Humanitarian Action, PART TWO THE MODERN ELABORATION OF HUMANITARIAN PRINCIPLES. Developing more dynamic models of support and feedback will be useful, as well as training initiatives tailored for humanitarian researchers. Societal breakdowns, the loss of normal order, and punitive actions against humanitarian organizations severely limit their ability to fulfill their duty of humanity (Al-Moujahed et al. Full searches as executed in each of the three databases (Ovid/EMBASE, Scopus, and PubMed) on May 17, 2017 (at 1:00, 1:08, and 1:15 PM EST, respectively). The implications of this intersection are twofold. https://doi.org/10.1017/s1816383113000489, Fegley R (2009) Local needs and agency conflict: a case study of Kajo Keji County, Sudan. Hum Rights Q 31:888915. Article at www.fernandoalmansa.com 11. This research was funded by Elrhas Research for Health in Humanitarian Crises (R2HC) programme, funded equally by the Wellcome Trust and DFID, with Elrha overseeing the programmes execution and management. https://doi.org/10.4269/ajtmh.14-0364, Banatvala N, Zwi AB (2000) Conflict and health. It is a wonderful development that there is now a global system of humanitarian action that can reach people suff ering from armed confl ict and disaster in any part of the world. Revisiting the meaning of some humanitarian principles in new contexts. These can include the personal prerogatives of humanitarian workers themselves (Ben Shahar 1993; Civaner et al. To better understand the types of challenges experienced in these contexts, we conducted a systematic literature review. Efforts to avoid violence, such as concentrating operations in safe or comparatively secure areas, preclude access or attention to the most vulnerable and in need (Haver 2016). These considerations are particularly salient in humanitarian research where vulnerabilities are amplified and resources are scarce. Military and political interventions operating under the guise of humanitarian aid can lead combatants or beneficiaries to doubt the neutrality of humanitarian organizations (Asgary 2015; Clarinval and Biller-Andorno 2014; Cobey et al. In total, 66 articles met inclusion criteria and were included in the analysis (see Fig. As the sector professionalises and bureaucratises, it will help aid workers, managers and leaders to understand why principles matter more than ever and how they can be used to make better choices. Dev Pract 7:342352, Slim H (2015) Humanitarian ethics: a guide to the morality of aid in war and disaster. Second, based on our initial literature review, the humanitarian and ethics literatures infrequently connect to each other; one goal of our review was to elucidate those connections in the peer-reviewed literature. The identified relationships between ethical challenges and humanitarian principles suggests that frameworks and guidance for ethical decision-making, if adapted for conflict settings, could support organizational capacity to fulfill ethical and humanitarian commitments. Getting aid to vulnerable populations in armed conflicts and disasters is only the first step in responsible humanitarian action. When threats to impartiality result in aid given to combatants (e.g., when threats of violence force health care workers to provide aid to combatants to prevent worse harm to others), organizations and workers may believe they are complicit in prolonging conflict (Fink 2007) and/or have violated their duty to be impartial (Geiger et al. Organizations can inadvertently or unwittingly become affiliated with other political objectives, for example, if they capitalize upon access gained by other, partisan groups, or use security services (e.g., formal military support) (Black 2003; Clarinval and Biller-Andorno 2014; Egeland et al. 2014). 2017; Fouad et al. Reference list review yielded an additional seven publications. ), Georgetown University, Center for International and Regional Studies, School of Foreign Service in Qatar. The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. PLoS Curr 9. https://doi.org/10.1371/currents.dis.1a1e352febd595087cbeb83753d93a4c, Campbell R et al (2011) Evaluating meta-ethnography: systematic analysis and synthesis of qualitative research. 2017). Humanitarian health care organizations face similarly challenging ethical issues, such as whether to rebuild destroyed facilities in more remote locations (which may negatively affect access), whether to focus special attention and resources in reaching vulnerable groups (when doing so might be detrimental to serving the most people possible), how much risk they can allow for their workers, and how to remain independent in the face of demands by combatants and donors. However, the ethical issues at stake may not always be clear to organizational stakeholders. Table 3 displays the frequency of co-coding these two categories; Table 4 illustrates this intersection with five examples. Humanitarian and development aid in the times of economic crisis; times of great need and reduced resources. In reporting numbers, N refers to the total number of articles with the code applied, and n refers to the number of individual coding instances (i.e., a single article could include multiple coding instances). Arabic For Specific Purpose (ASP)- Humanitarian. This systematic review yielded three principal findings related to ethical and humanitarian challenges experienced by humanitarian health organizations in conflict settings. One really feels he himself has struggled with many of the dilemmas he describes and is eager to share his experience. The Jordan Times, Important and eminently readable . Violent attacks not only violate international law (Rubenstein and Bittle 2010); they also create ethical challenges (Slim 2015). 2017; Clarinval and Biller-Andorno 2014; Fouad et al. A full summary table of qualitative findings with representative quotations can be found in Additional file 1: Appendix 4. Current dilemmas facing multi-mandate relief operations in political emergencies. By categorizing the types of ethical challenges experienced by humanitarian care organizations, this review can help organizations anticipate issues that might arise in conflict settings. Int Rev Psychiatry 26:558565. Little analysis has been made of ethical challenges encountered by health care professionals (HCPs) participating in humanitarian aid work. Careful attention is needed toward both the ethics OF research in humanitarian settings, that is the justification for launching a particular study and whether it is designed in an ethically robust manner, and ethics IN research, including attention to ethical considerations arising in the course of carrying out a study. 1993; Gastineau Campos and Farmer 2003; Haver 2016; MacCormack 2007; Weiss 2016) and internal constraints related to the need to sustain existing programs and staff (Michael and Zwi 2002) could affect organizations abilities to adjust resource management nimbly in response to ever-changing circumstances (Clarinval and Biller-Andorno 2014; Hurst et al. Fourth, we did not assess the quality of included publications. 2017; Geiger et al. 2017; Farr 2013; Geiger et al. Appropriate acquisition and management of assets (i.e., informational, financial, and human assets) was an ethical obligation that emerged in the analysis. In this lesson, we will discuss the importance of ethics in humanitarian work and learn the terminologies needed to study and work in this domain. 2017; Rieffer-Flanagan 2009; Slim 1995). Our review identified that the primary challenges to neutrality were perceptions that humanitarian assistance was innately political (Fouad et al. Even when organizations attempt, at a minimum to meet their duties of beneficence by avoiding causing harm, they could face challenges in doing so. Cambridge University Press, pp 447474. Distilling relevant experiences and insights from both public health ethics and clinical ethics and adjusting them to the context of humanitarian aid may allow the young field of ethics of humanitarian action to advance in an efficient way, while benefitting from achievements in neighboring fields. 2017; de Waal 2010; Michael and Zwi 2002); difficulty in identifying and trusting local leaders (Black 2003; Cobey et al. Within these categories, nodes were created to accommodate specific obligations and principles; within these nodes, subnodes were created to capture specific challenges to fulfilling the obligations and principles. There is also a recognized need to ensure that health workers are adequately informed about these risks. 2019). Such an approach maintains both real and perceived independence. The Humanitarian Ethics and Principles in Practice module is run as two 60 minute sessions. A humanitarian's goal is to save lives, relieve suffering, and maintain human dignity. This paper reviews current approaches found in the engineering education literature to assess ethics instruction outcomes. Three databases were searched: PubMed, Ovid/EMBASE, and Scopus. humanitarianadviso.. Humanitarian Data Exchange (HDX) (2019) SHCC attacks on health care. Fulfilling the obligation to provide high-quality care requires explicit evaluation of outcomes, without which the quality cannot be assured (Al-Moujahed et al. Many obstacles stand in the face of international response to crises. Challenges to this obligation, founded on the ethical principle of beneficence, include disparities in the availability of facilities and supplies in conflict settings as compared to that of many workers home contexts (Baskett 1994; Bernthal et al. 2009; Jaspars and O'Callaghan 2010; Tribe et al. https://doi.org/10.1017/s1816383114000228, Omaar R, de Waal A (1994) Humanitarianism unbound? . Yet, there is a serious debate between different. If it could be delayed until the acuity of the crisis diminishes, it ought to be. Humanitarian principles are a set of principles that governs the way humanitarian response is carried out. 2011;5(1):91-9. WM made substantial contributions to the interpretation of the data and revised the manuscript critically for important intellectual content. For instance, seen through the intersection of ethics and humanitarian principles, the obligation to involve local communities in humanitarian response relates to fundamental ethical obligations of justice that involve fairness in decision-making, may help facilitate respect for local community norms, and could improve an organizations ability to deliver aid to communities in need, thereby meeting humanitarian obligations of humanity. ABSTRACT. Disagreements about inclusion between the two initial reviewers were adjudicated by one or more additional study team member(s). Lesson 1 Conflict and natural disasters, Lesson 4 Social Injustice (1) Racial Discrimination, Lesson 5 Social Injustice (2) Gender-based Discrimination, Lesson 6 Development and Ethics of Humanitarian Work. Challenges to the principle of independence were also prevalent. In: Cahill KM (ed) The pulse of humanitarian assistance. no: 978557 Given these realities, the justificatory bar for research is high: If a study could be conducted in a non-crisis situation and still answer its research question, it should be. Intimate ethicsAs medics, social workers, water engineers, protection officers or livelihood . For example, organizations commitments to independence could come into question due to political or financial ties with state agencies, non-state groups, or donors that might restrict an organizations activities, even if these ties were merely perceived. This is a qualitative study drawing on Grounded Theory analysis of 20 interviews with health care professionals who have provided humanitarian assistance. There are a host of ways that researchers take up and discharge this responsibility. Croat Med J 43:148155, Gastineau Campos N, Farmer P (2003) Partners: discernment and humanitarian efforts in settings of violence. The authors are grateful to Rachel Fabi, PhD, for earlier contributions to the study. Soc Work Health Care 18:147159. 2019]), in conducting research on sexual violence in emergency situations, and other areas (see Additional file 1: Appendix 2). This paper examines how health workers experience ethics in the course of humanitarian assistance and development work. LR made substantial contributions to the conception and design of the study; the analysis and interpretation of the data; and revised the manuscript critically for important intellectual content. Part 1: The ethics of doing good and working internationally Before going to another country (or even to another part of the same country) to help people, you should carefully consider the value and skills you have to offer as well as the impact you could have - and will be aware that you could do harm as well as doing good. Disasters 19:110126, Slim H (1997a) Doing the right thing: relief agencies, moral dilemmas and responsibility in political emergencies and war. Humanitarian practice and ethics are solidly founded on four "humanitarian principles": humanity, neutrality, impartiality, and independence. Stewardship PrinciplesSustainability and Accountability 6. During full-text review, we applied the following inclusion criteria. The precise ways in which ethical obligations are in tension or are mutually supportive are context dependent. Some organizations have responded to the obligation to protect workers, for example, by creating secure operational sites with minimal and/or strictly controlled access to the outside world (a strategy known as bunkerization). Humanitarian Action (Cornell University Press, Ithaca, NY, and London, 2002). Among these, four have come to represent the core principles of humanitarian action: humanity, impartiality, neutrality and independence. MD made substantial contributions to the conception and design of the study; the analysis and interpretation of the data; and the drafting of the manuscript. One aspect involves voluntary emergency aid overlapping with human rights advocacy, actions taken by governments, development assistance, and . 12. Glob Policy 7:135145. Financially, for example, external constraints related to the need to maintain relationships with existing and future donors (Cobey et al. Introduce ethical audits as part of standard practice. SG made substantial contributions to the acquisition of the data and revising the work critically for important intellectual content. Extremely dangerous security situations can result in providing aid preferentially to those in safer areas when, ideally, aid should be provided equitably to all and provided based on need (Clarinval and Biller-Andorno 2014; Egeland et al. Ultimately, States have the primary responsibility to protect and assist persons in their territories who are affected by disasters, armed conflicts or violence. Somerset House The article focuses on the moral skills required by today's humanitarian practitioners if they are to work out a new model of humanitarian identity and positioning which supersedes the traditional but devalued notion of neutrality. You can read our privacy policy here. statement and In addition, whether existing frameworks for ethical decision-making in humanitarian action (Clarinval and Biller-Andorno 2014; Fraser et al. Confl Health 5:6. https://doi.org/10.1186/1752-1505-5-6, Mak K (2014) Principles of neutrality and impartiality of humanitarian action in the aftermath of the 2011 Libyan conflict. 2011; Haver 2016), or if combatants insert themselves between humanitarian actors and aid beneficiaries (Fegley 2009). https://doi.org/10.1186/s41018-019-0063-x, DOI: https://doi.org/10.1186/s41018-019-0063-x. 2017; Joshi et al. Table 1 presents findings related to ethical obligations. Humanitarian Advisory Group is committed to drawing on our extensive field experience to offer an independent practitioner-led perspective on humanitarian and human rights issues. Health professionals have wrestled with their ethical guiding principles for millennia, and in some cases there is no longer an oath, but a booklet or manual to guide the practitioner. The Ethical Humanitarian Worker, Annex 1 The Principles of the Red Cross and Red Crescent Movement Corruption, abuse of authority, and financial profit might be one of the biggest issues in humanitarian work. 2017)an action that could present a challenge to the provision of high-quality care. Int Rev Red Cross 97:183210. Disasters 22:96108, Fink S (2007) Protection of civilians in armed conflict: a decade of promises. When we interviewed disaster researchers and members of Research Ethics Committees (RECs) who had reviewed disaster research protocols, we were struck by the following tension: interviewees identified community engagement as especially important, even essential, in disaster settings, yet they also consistently described it as very difficult to achieve. 2017; Civaner et al. Correspondence to masterful . 2017; Clarinval and Biller-Andorno 2014; Fouad et al. The purpose of this study is to establish the relationship between ethics and procurement performance of humanitarian organizations in Kenya. Privacy This can also result in restricting programs to more secure areas regardless of the needs of people living in insecure areas (Haver 2016). Sometimes ethics is separated out from the methodological rigor of research. PubMedGoogle Scholar. Although ethical obligations of humanitarian health organizations and health workers may overlap, the focus of the codebook was the organizational level. Humanitarian organizations operating in resource scarce settings can also be perceived as lacking neutrality because of how they allocate resources and maintain secure access to those in need. In the literature, solidarity has been defined in different ways to include concepts of political advocacy, human rights, shared suffering, and consultation with those affected (Hunt et al. The organizational ethical obligation most frequently coded was providing the highest attainable quality of care and services. Regarding impartiality, pressure on organizations to show favoritism to one group over another was the most frequent subnode. Alderslade R (1995) Human rights and medical practice, including reference to the joint Oslo statements of September 1993 and March 1994. The duty to care can be a legal obligation that employers must meet regarding their employees. BMJ 321:101105. The third most frequently coded obligation related to protecting and caring for workers (i.e., the duty to care in the humanitarian literature). Cite this article. A particular challenge related to this obligation was concern over risk transfers, or situations where organizations might seek to mitigate their own risks or risks to their workers by transferring them to others (e.g., by assigning certain tasks to local individuals). Second, the intersection between ethics and humanitarianism in conflict settings creates the potential for using ethical decision-making to support and improve humanitarian action. https://doi.org/10.1017/S1049023X1500480X, Gardemann J (2002) Primary health care in complex humanitarian emergencies: Rwanda and Kosovo experiences and their implications for public health training. This module provides an overview of what humanitarian ethics and principles are, why they are important and what they mean in practical terms for the Ukraine humanitarian response. This article explores the accounts of Canadian-trained health professionals working in humanitarian and development organizations who considered not treating a patient or group of patients because of resource limitations, and how medications and equipment are represented. Google Scholar, Asgary R (2015) Direct killing of patients in humanitarian situations and armed conflicts: the profession of medicine is losing its meaning. The search relied upon three key concept blocks: conflict settings, humanitarian or relief organizations, and non-clinical or non-military ethics. 2017; Gardemann 2002; Haver 2016), it is nearly impossible to treat all potential beneficiaries equitably or reach those most in need. 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