Ethical challenges in humanitarian health in situations of extreme violence

Grant awarded: £393,579

Lead organisation: Johns Hopkins Bloomberg School of Public Health

Partnering organisations: Syrian American Medical Society & International Rescue Committee

Project length: 2016-2018

Study locations: Syria (Research conducted in Jordan and Turkey)

Principal Investigator: Leonard Rubenstein

  • Destroyed health facility in Aleppo @ Syrian American Medical Society


The primary purpose of this research is develop a framework, tool and recommendations to guide health care organizations in resolving the ethical challenges they face in environments where health care services are under persistent attack.

Researchers will seek a better understanding of the complex ethical challenges faced by humanitarian health organizations operating in Syria, and develop and test a framework and tools that can be used to resolve ethical questions that organizations face in situations of violence affecting their operations.

Expected outcomes:

Organizations providing services in settings where health care is under attack can employ the framework, tool and guidelines as a means of resolving difficult ethical quandaries they face. They will make more considered and principled decisions when facing challenging ethical decisions in circumstances of extreme violence. Improved decision-making can in turn lead to better efficiency, adaptability, priority setting, security, and equity in the programs they operated and greater adherence to ethical commitments. This outcome can stimulate greater trust by communities they serve.

Raising the visibility of the problem of chronic violence against health services increases the prospect that international organizations, donors and policy-makers will develop improved means of preventing or ameliorating such violence inflicted against health care services, so that ultimately the wrenching decisions humanitarian health organizations have to make can be avoided and health care services can operate in safety.


Elrha is a registered charity in England and Wales (1177110).

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