Risks Associated with Different Understandings of “Medical Neutrality”

The chapter explores how multiple meanings of “medical neutrality” make it difficult for health care personnel to understand what is expected of them, and how they should behave to respect such neutrality. The article presents the issue using peacetime, emergencies, civil insurgence, and conflict scenarios to discuss what could be the expectations raised by the idea of “neutral behavior” in each case. It assumes two key considerations: one is that, even in conflict settings, neutrality also demands specific behaviors from the health care personnel (beyond the key message of “do not interfere negatively with provision of care”, that is clearly a responsibility of parties of conflict). The second is that this chapter does not treat provision of care as a practice that is dissociated of political, social, and economic aspects of the environment where it is being carried out. The risks identified are of individual, professional and systemic nature, and include, inter alia, risks of moral distress, violence, loss of protection under International Humanitarian Law. Final recommendations are around the need to provide explicit and contextualized definitions of what is understood as “neutrality” in each context, and to provide training and support to health care professionals, encouraging the debate beyond the humanitarian sector.