While neutrality and impartiality are ideals of humanitarian aid work, the reality is that in the modern era, these are increasingly difficult to maintain and uphold.
Jones (1998) discusses the relationship between psychiatrists and psychologists with their clients. She argues that it is not of benefit to the client to remain truly neutral and detached. She uses examples such as in Nazi Germany, where psychiatrists were able to alter their frame of reference to see themselves as treating the nation, detached from the individual patient. In this way, therapeutic treatment could condone mass extermination as part of the benefit of treating what was viewed to be the maladies of the national health and identity. She goes on to discuss how the Hippocratic Oath, and statements by the American Medical Association and the American Psychiatric Association declare that a physician or psychiatrist should have a responsibility to protect patients from harm and injustice, and advocate for clients through public action. By necessity, then, they cannot remain unattached or avoid politics. In fact, our worldview, culture, ethical codes, training, diagnosis, and treatment are bound by systems of values, which may have consequences. Bias is inevitable, and while to a degree a treating provider may suspend their own values in relation to a client, it is better to disclose and discuss with them such factors. Additionally, there should be a stronger emphasis on dealing with the cultural systems, community and environmental factors rather than on the “deficiencies” of the individual. She also imports the need of cultural context and understanding in how we diagnose and treat clients. When the larger factors are left out, it is not treating the cause of the problem or illness but rather just symptoms of it. Neutrality is an absence of responsibility, a way for the provider to keep their hands clean and removed from ethical dilemmas.
In my work as a counselor, I can certainly understand why providers might hesitate to deeply advocate for social change for the benefit of their clients. While I think it is an honorable and critically important endeavor, it requires complex considerations of ethical dilemmas, active work for policy changes, and addressing large systemic cultural systems and values which may seem too large to tackle. When a provider has a full caseload, this task is nearly impossible to devote the time, energy, and resources towards. With a less than full caseload, a provider may not have the income to sustain such activities on their own free time. This creates another dilemma of another societal problem within itself where the financial pay for counselors (although not so for psychiatrists) is too low to accommodate such efforts on a large scale, and/or the work/life balance is off-kilter within our society, and does not support counselors utilizing part of their time to such activities. Additionally, if one is working for an agency, the agency often frowns upon any political activity or social protests or advocacy work which is not specifically sanctioned and approved for their own benefit, and as such, the counselor could be at risk of termination.
Fiona Terry, in her TED talk (2011) discusses how humanitarian action faces multiple scenarios which present “damned if we do, damned if we don’t” situations. For example, it is not uncommon for humanitarian aid supplies to fall inadvertently into the hands of terrorists. However, the war on terror has made it illegal to support terrorist organizations regardless of intentionality. This may cause some aid organizations to limit where they deliver aid in fear of retribution for inadvertent support to terrorist groups. There is also a paradox in maintaining neutral, and treating soldiers from any side of a conflict, who then may return to the fight, thus prolonging the conflict. The standard moral stance of humanitarian organizations has been that it is better to treat and give aid, than to not, regardless of the outcome. Neutrality is meant to be a tool to provide aid to those who need it most and not be a moral judgement. However, many organizations are now focused on providing aid as dictated by their donors, which typically falls within certain parameters and furthers the agendas of Western political goals.
Nascimento (2015) goes deeper into these paradoxes, framing it within the history of humanitarianism which originally intended to hold to the ideals of neutrality and impartiality, but due to increasingly complex geopolitical situations and conflicts, this has shifted into what is termed ‘new humanitarianism.’ On the surface, ‘new humanitarianism’ sounds to be an ultimately better strategy, focusing on “much broader and longer-term objectives, such as development or peace” (Nascimento, 2015, p. 1). However, this is complicated for humanitarian organizations working on the ground as it means an intertwining with politics and militarization. One of these problems arises from the imposition of standards which are deemed culturally “good” by the donors to the organizations and their respective governments. This places cultural and political values onto countries who may not subscribe to such notions, and requires that they make certain changes and subscribe to certain conditions in order to receive humanitarian assistance. This can be seen as a political maneuver at the hands of the countries backing the aid, and create further animosity or backfire completely, causing the loss of aid to critically vulnerable populations who desperately need it. “New humanitarianism’ also started being questioned and challenged in its assumptions by academics and practitioners due to the fact that decisions that had humanitarian implications were increasingly being taken on the basis of political criteria and interests instead of on the victims’ needs” (Nascimento, 2015, p. 4). This also has implications on the fundamental properties of human rights, and the underlying missions of most humanitarian organizations to address these at the most basic level. Morris (1998) agrees with very similar points in his article.
With complex crises, complex and systemic responses from the international community are required to address multiple socio-political, socio-economic, environmental, and cultural factors which are, in the Western view, contributing to the emergency situation (Nascimento, 2015). However, this requires the use of multiple organizations and groups targeting different aspects of the situation, which often do not align with their goals and priorities, and may not communicate and plan effectively as a broad multi-organizational team. These failings have led to a breakdown of humanitarian aid in multiple countries. Worse than a failed humanitarian intervention, critics have proposed that “these actions emphasized the ineffectiveness and lack of professionalism characteristic of classical humanitarian organizations that fed and perpetuated conflicts and crises through their misuse of aid and poor resource distribution” (Nascimento, 2015, p. 3). There has also been an increase in the use of military deployment to provide aid themselves, or to protect and stabilize conditions for humanitarian workers, or while intervening through military force while humanitarian groups simultaneously provide aid, causing confusion in the local population in seeing humanitarianism and the use of acts of war as part of the same coin. “What has been experienced and promoted by this ‘new humanitarianism’, is essentially a misconception of the need for humanitarian aid by an international system that simultaneously denies its own roles in sustaining or addressing complex emergencies and threatens further the capacity of victims of conflict-related disasters to have access to humanitarian assistance and to the enjoyment of their human rights” (Nascimento, 2015, p. 9). Increased coordination between multiple organizations and actors, the removal of politics from conditions for humanitarian aid, and both short-term immediate assistance for basic needs and also long-term strategies to restore peace which utilize and collaborate with, rather than impose, cultural values of the country in conflict or crises, will be important considerations moving forward to provide much needed humanitarian aid.
References
Jones, L. (1998). The question of political neutrality when doing psychosocial work with survivors of political violence. International Review of Psychiatry, 10(3), 239-247.
Morris, N. (1998). Humanitarian aid and neutrality. Conference on the promotion and protections of human rights in acute crisis. London. Retrieved from https://www1.essex.ac.uk/rightsinacutecrisis/report/morris.htm#4
Nasciemnto, D. (2015). One step forward, two steps back? Humanitarian Challenges and Dilemmas in Crisis Settings. The Journal of Humanitarian Assistance. Retrieved from https://sites.tufts.edu/jha/archives/2126
TEDx Talks [username]. (2011). TEDxRC2 – Fiona Terry – The Paradox of Humanitarian Aid . YouTube. Retrieved from https://www.youtube.com/watch?v=J45cWdDEbm0&noredirect=1