Ethics in Humanitarian Aid Work: Learning From the Narratives of Humanitarian Health Workers

Ethical questions identified in a study of local and expatriate responders’ perspectives of vulnerability in the 2010 Haiti earthquake

“…The shortage of resources in the face of great needs and the necessity of responding quickly have been recognised as common sources of ethical challenge in humanitarian aid 1. Disaster relief efforts in a context of high levels of pre-existing vulnerability, in addition to vulnerability related to the disaster itself, present a more complex situation, however, than a mere case of identifying the best strategy for the distribution of goods.…”

“…Situations of disaster, war or disease outbreak that prompt international humanitarian responses are rife with ethical tensions 1. Prominent sources of ethical questions include triage decisions and the need to quickly determine how limited resources should be allocated in situations of overwhelming need 1–4.…”

“…Prominent sources of ethical questions include triage decisions and the need to quickly determine how limited resources should be allocated in situations of overwhelming need 1–4. The scope of humanitarian responses also involves choices to allocate resources at broader levels, including decisions about where to initiate projects, when and how to end them as well as determinations of which populations or projects will be prioritised, and which will not be addressed, or may even be harmed by the approach taken 1 5–8. An additional source of ethical complications relates to power differentials within communities and between providers and recipients of care 1 8–10.…”

“…The scope of humanitarian responses also involves choices to allocate resources at broader levels, including decisions about where to initiate projects, when and how to end them as well as determinations of which populations or projects will be prioritised, and which will not be addressed, or may even be harmed by the approach taken 1 5–8. An additional source of ethical complications relates to power differentials within communities and between providers and recipients of care 1 8–10. These challenges may lead to ethical distress for individuals involved in humanitarian responses, especially when individuals must make choices and all options require something of ethical significance be relinquished 11.…”

Combat Hospital’s deployment of ethics and entertainment

“…For our research, the EMMRG team is gathering narratives in order to develop pedagogic cases and a decision-making model to assist military medical personnel to better prepare for and respond to challenging situations as they arise, and support them with their decisions once made; such ethics decision models and associated cases are currently being validated for humanitarian health care professionals. 6 So if shows such as Combat Hospital are used in ethics training as a useful starting point, educators would do well to also explore decision tools and cases, and compare these evidence-based examples to the limited analysis presented onscreen; it is critical to cut through the entertainment to get to the real-world impact.…”