It is thus critical to examine the ethical implications of closing projects and consider how closure can be accomplished in ways that are consistent with humanitarians’ ethical commitments including minimizing harm, being accountable, upholding impartiality and neutrality, and demonstrating respect.

Context:

 

Non-governmental organizations routinely make and enact decisions to close humanitarian health projects. Doing so is unavoidable, and a necessary component of humanitarian action. However, ethical questions may arise related to why a project is selected to be closed and how closure is implemented. Different models of closing projects have been utilized, including phasing down (gradually decreasing the project in size, sometimes leaving a small presence in place in case the project needs to be reactivated in the future), phasing over (gradually shifting it to local actors), handing over (transfer of the project to local actors), and ‘cut and run’ (sudden termination of a project). While many project closures unfold smoothly, in other cases they are contested and give rise to ethically challenging situations for humanitarian organizations, their partners, and local communities. Considerations include clarifying what is owed to communities with whom an organization has been working, the intrinsic as well as instrumental value of humanitarian projects, and the structured nature of health vulnerabilities during war, disaster or public health emergency. It is thus critical to examine the ethical implications of closing projects and consider how closure can be accomplished in ways that are consistent with humanitarians’ ethical commitments including minimizing harm, being accountable, upholding impartiality and neutrality, and demonstrating respect. Though ethicists have examined the ethics of humanitarian priority-setting – including around the initiation of humanitarian projects – to our knowledge, none have undertaken a focused examination of the ethics of closing humanitarian projects.

Project:

Our interdisciplinary research team (with expertise in global bioethics, political philosophy, humanitarian action, nursing, rehabilitation and qualitative research methods) will work collaboratively with knowledge users from Médecins du Monde-Canadato answer the following r

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esearch question: What values and approaches support ‘ethical closure strategies’ when humanitarian organizations elect to close a project?We will use an integrated study design that combines qualitative individual and group interviews with normative ethical analysis in order to develop aguidance framework. This approach will enable us to work ‘up’ from experiences of individuals with first-hand experience of the phenomenon of interest (whether as humanitarian workers, policy-makers, or representatives of communities where humanitarian projects have been closed), and to work ‘down’ from normative theories. The combination of these approaches will promote the development of a practical and relevant guidance framework that is grounded in experience, and that is also informed and inspired by theory and careful normative analysis. Our hope is that through this project we will spark further discussion and debate around this important topic within and across humanitarian organizations, and that the study outputs will support organizations as they make and implement decisions to close humanitarian projects.

Visit humanitarianhealthethics.net for updates on the project

The team:

Matthew Hunt, Ryoa Chung, Lisa Eckenwiler and John Pringle

Partner:

Médecins du Monde-Canada

medecindumonde

Funding:

RRSPQ Public Health Ethics Axis, 2018-19

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