Health care in danger: Launch of a common core on ethics

To watch the full conference, click here.

On 30 June 2015, the ICRC hosted a public livestreamed conference to mark the launch of The Ethical principles of health care in times of armed conflict and other emergencies. Qualified as "ground-breaking" by ICRC President Peter Maurer, the code of ethics, already signed by five major health care organizations representing 30 million professionals worldwide, aims at protecting both patients and health care personnel operating in conflict zones. The event took place under the umbrella of the HCiD project and the Research and debate cycle on principles guiding humanitarian action.

Keynote Speaker

• Peter Maurer, President of the ICRC

Moderator

• Pascale Meige, Deputy Director of Operations, ICRC

Panelists

• David Benton, Chief Executive Officer, International Council of Nurses
• Luc Besançon, General Secretary & Chief Executive Officer, International Pharmaceutical Federation
• Otmar Kloiber, Secretary General, World Medical Association
• Major General (ret.) Roger Van Hoof, Secretary-General, International Committee of Military Medicine

Summary of the conference

A feeling of urgency

Although health care professionals do not operate in a world void of norms intended to protect their persons and duties, the violence faced by medical staff, facilities and transports in recent years reveals the insufficiency of existing standards. Such violence, as underlined Peter Maurer, not only takes an immediate human toll, but implies a dramatic causal chain: obstructing access to health services, weakening the presence of skilled medical workers and hampering the reconstruction of health systems.

If you attack the activity of one nurse, you attack and frustrate the activity of all of us. (David Benton)

Operating in conflict also comes with acute ethical dilemmas for health care personnel who lack guidance for making and justifying their choices. The new code of ethics will thus serve to reassert the fundamental respect due in all circumstances to the medical mission, as well as the basic principles that should guide the provision of health care.

Overall these ethical principles have a key value: it is to provide confidence to the different health care professionals in the fact that they should not be a target. (Luc Besancon)

Empowering health care personnel to better protect patients

In conflict, patients and medical workers find themselves at the heart of complex political and military stakes that risk undermining their personal security and the provision of health care. The added value of the guidelines is that they strengthen the mandate of health care personnel to act in the best interest of the patient. On the one hand, medical workers benefit from a reference against which they can compare their own practice; this is a clear indication that care shall be provided with respect for dignity and without discrimination. On the other hand, medical workers will be empowered by the authoritative and normative character of the code of ethics. By way of example, when faced with a commander or a chief insisting that his soldiers be treated first or that his people are worth more than others, nurses and doctors will be entitled to refuse, on the ground that equal treatment is an international standard.

We need a clear environment of rules for those working, who themselves feel unsafe and have to know how to treat the patients coming in friend or foe. (Otmar Kloiber)

Generating respect

The panelists agreed that to achieve the broadest possible impact, this code of ethics had to be transmitted through a wide variety of channels. To facilitate the dissemination and implementation of the rules, five groups of people were identified. (1) The health personnel at the operational level, so that they be informed of their rights and duties and apply them in their day to day activities. (2) The heads of medical facilities, so that they help embed the ethical rules in the practice of their staff. (3) State authorities, to make them agree on the rules and involve them in their dissemination. (4) Non state actors, to convince them of the validity of the rules and of their values for all conflict actors (5) education professionals, to lay strong foundations of respect for the medical profession and services.

Now it is of upmost importance to give this document the widest possible distribution. (Roger Van Hoof)

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