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Books and reviews: "Health and humanitarian concerns: Principles and ethics"

30-06-1995 Article, International Review of the Red Cross, No. 306, by Jacques Meurant

* Henryk Leszek Zielinski, Health and humanitarian concerns - Principles and ethics , Martinus Nijhoff Publishers, Dordrecht, 1994, 117 pp.  

The Fundamental Principles of the Red Cross and Red Crescent have inspired and guided the activities of the International Red Cross and Red Crescent Movement since their adoption in 1965 by the 20th International Conference of the Red Cross, and they can be said to constitute the Movement's ideological charter.

However, over the decades, experience has shown that the application of these Fundamental Principles within the Movement can clash with other ideologies, traditions and interests, or run up against violations of international humanitarian law or of human rights.

Professional and voluntary health workers sometimes find themselves confronted with difficult situations in which their assignments do not conform to the principles that they must respect. Doctors, nurses or social workers from National Societies, called on by their governments or government agencies to assist in or to take over the running of health programmes, then face a serious dilemma for which they are ill prepared.

So, what should they do and how should they go about it? To say only that health professionals should act within the framework of the Fundamental Principles is not enough. They must also understand these Principles and how to use them. Until now, no single text had been written that offered guidance on the relationship between the conduct of health professionals, the major humanitarian issues, the Fundament al Principles and codes of professional ethics.

The guidelines laid down by Henryk L. Zielinski in his book aim to remedy this shortcoming. The author presents us firstly with information compiled from basic documents and reference works on humanitarian issues as they relate to the tasks of the Movement in the area of health. He then draws on interviews with workers experienced in health issues within the Movement, and finally analyses various questionnaires sent out to the National Societies.

After reminding us of the respective mandates of the Movement's components in the area of health, both during armed conflict and in peacetime, the author presents each one of the Fundamental Principles and explains, with examples, what they mean for health workers.

The importance of professional codes of ethics is also emphasized. Both the Declaration of Geneva, adopted in 1948 by the World Medical Association (WMA) and amended in 1968 and 1983, and the International Code of Medical Ethics, adopted in 1949 by the WMA and amended in 1968 and 1984, are based on the Hippocratic oath devised by the Greek physician who gave it his name (460370 BC).

The most interesting part of the book is a series of exercises aimed at helping health professionals make sound decisions which respect humanitarian values. Here the author looks at what happens when a country's authorities refuse permission for medical teams to help communities affected by a famine; how a medical team might react when asked by a government to force feed-hunger strikers; and whether health workers should intervene in the private life of a family where children are being abused.

Other examples are based on cases of torture, the sale of organs, AIDS, etc. In each case Dr Zielinski poses apt questions and gives the basis of a reply referring back to the relevant documents mentioned earlier.

This useful book is supplemented with numerous annexes, which health workers might find interesting, of official texts relating to the Movement, the United Nations and various medical organizations.