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Ethics | Collections | MSF Science Portal
Ethics

Ethics

MSF has published dozens of peer-reviewed articles that touch on humanitarianism and ethics. The articles range from rigorous peer-reviewed research on the health of humanitarian workers, to commentaries about the ethics of conducting research in conflict settings, to various approaches on how patients should be treated.

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Safe abortion care at MSF

Safe abortion care at MSF

Unsafe abortion is a major cause of maternal death, and the only one that is completely preventable. Yet over 30 million unsafe abortions occur each year, leading to at least 29,000 deaths and millions of serious complications—nearly all in low- and middle-income countries. MSF teams see these tragic consequences first-hand, treating thousands of patients every year with severe, potentially life-threatening effects from unsafe abortion.


To mark International Safe Abortion Awareness Day (28 September 2024), this Collection presents highlights of MSF’s work on safe abortion care (SAC) as a way to reduce maternal death and injury. By re-assessing and reshaping how our projects deliver SAC in fragile and conflict-affected settings, we have been able to significantly expand services in those contexts and across MSF projects globally. In parallel, we also conducted in-depth studies of abortion complications and their contributing factors in fragile settings, where a dearth of evidence limits understanding of women's needs in accessing comprehensive care. These findings are helping to identify gaps in service delivery and inform operational decision-making.

Medical and humanitarian harms of restrictive European migration policies

Medical and humanitarian harms of restrictive European migrat...
New tools and approaches to drug-resistant TB

New tools and approaches to drug-resistant TB
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Conflict, persecution, poverty, food insecurity and natural disasters—increasingly fueled by climate change—continue to drive migration globally. Yet many wealthy countries are doubling down on hostile policies to prevent people from seeking safety within their borders, thereby subjecting them to a wide range of harms. In a newly-published report MSF focuses on European Union and member state policies that intensify exposure to violence, exploitation, risk of drowning at sea, disease, and lack of access to basic health care and shelter, both within European Union borders and beyond. The Collection linked below presents this report alongside selected publications illustrating the broader context, based on quantitative studies and accounts from MSF patients and medical teams over nearly a decade of operational experience along the European migration route. From violent, squalid detention centers in Libya— where people intercepted by the EU-supported Libyan coast guard are forcibly returned —to perilous Mediterranean crossings in flimsy rubber boats and often abysmal reception centers and camps within the EU, it documents how these policies and practices further harm highly vulnerable people seeking safety and protection.
The World Health Organization estimates that 410,000 people developed a drug-resistant tuberculosis infection (DR-TB) in 2022, only 40% of whom were diagnosed and started on treatment—and only 63% then cured. Given all these points of failure, innovation in preventing, diagnosing and treating DR-TB cannot come fast enough. To mark World TB Day (24 March 2024) the content collection linked below highlights recent work by MSF and collaborators to help change this grim picture. The TB-PRACTECAL and endTB studies delivered robust evidence for shorter, safer, more effective drug regimens that are already saving lives worldwide. Other studies explore new approaches to preventive treatment and simpler, quicker, accurate detection of TB and drug resistance—especially among difficult-to-diagnose populations such as children and people living with HIV. But to impact DR-TB globally these innovations must become widely accessible. This requires changes on many fronts, as described in an accompanying Collection (Expanding Access to Lifesaving New TB Tools).
Journal Article
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Commentary

Mixing methods: How listening to researchers, healthcare workers, and community members can improve the design of studies testing medical innovations for Neglected Tropical Diseases

Erber AC, Ablordey A, Addissie A, Ahortor EK, Burtscher D,  et al.
2025-09-30 • PLOS Neglected Tropical Diseases
2025-09-30 • PLOS Neglected Tropical Diseases
Journal Article
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Review

Dignity-based practice in global health research: a framework of expectations

Bayingana A, Bhakuni H, van de Kamp J, Lariat J, Rathod L,  et al.
2025-09-13 • Lancet Global Health
2025-09-13 • Lancet Global Health
Conference Material
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Video

Application of the Médecins Sans Frontières clinical trial transparency policy: cost analysis of TB-PRACTECAL, a multicentre phase 2–3 trial in drug-resistant tuberculosis

Gotham D
2024-05-16 • MSF Scientific Day International 2024
2024-05-16 • MSF Scientific Day International 2024
Journal Article
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Review

Imperfect relief: Challenges to the impartiality and identity of humanitarian action

DuBois M, Healy S
2024-03-25 • International Review of the Red Cross
2024-03-25 • International Review of the Red Cross
One of the four core humanitarian principles, impartiality's substantive ethical and deeply operational nature directs aid agencies to seek and deliver aid on the basis of non-discrimina...
Journal Article
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Protocol

Responsible exit of humanitarian aid agencies at the end of programmes: a scoping review protocol

Bahati D, Sy H, Kalhor A, Marchal B
2023-08-23 • BMJ Open
2023-08-23 • BMJ Open
INTRODUCTION
In humanitarian settings, aid agencies are constantly challenged by difficult decisions such as when and how to terminate aid without harming the aid recipients, local i...
Journal Article
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Research

Health trajectories of international humanitarian aid workers: growth mixture modelling findings from a prospective cohort study

de Jong K, Martinmäki SE, te Brake H, Komproe IH, Kleber RJ,  et al.
2023-05-17 • BJPsych Open
2023-05-17 • BJPsych Open
BACKGROUND
Most staff stay healthy during humanitarian work, although some worsen. Mean scores on health indicators may be masking individual participants struggling with health...
Journal Article
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Commentary

Striving towards true equity in global health: A checklist for bilateral research partnerships

Hodson DZ, Etoundi YM, Parikh S, Boum Y
2023-01-18 • PLOS Global Public Health
2023-01-18 • PLOS Global Public Health
Interest in “global health” among schools of medicine, public health, and other health disciplines in high-income countries (HIC) continues to rise. Persistent power imbalances, racism, ...
Journal Article
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Research

Ethical guidance or epistemological injustice? The quality and usefulness of ethical guidance for humanitarian workers and agencies

Sheather J, Apunyo R, DuBois M, Khondaker R, Noman A,  et al.
2022-03-16 • BMJ Global Health
2022-03-16 • BMJ Global Health
This paper explores the quality and usefulness of ethical guidance for humanitarian aid workers and their agencies. We focus specifically on public health emergencies, such as COVID-19. ...
Journal Article
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Research

Preparing humanitarians to address ethical problems

McGowan CR, Baxter LM, DuBois M, Sheather J, Khondaker R,  et al.
2020-11-04 • Conflict and Health
2020-11-04 • Conflict and Health
Infectious disease outbreaks represent potentially catastrophic threats to those affected by humanitarian crises. High transmissibility, crowded living conditions, widespread co-morbidit...
Journal Article
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Review

The ethical imperative to relieve suffering for people with tuberculosis by ensuring access to palliative care

Harding R, Snyman L, Ostgathe C, Odell S, Gwyther L
2020-05-01 • International Journal of Tuberculosis and Lung Disease
2020-05-01 • International Journal of Tuberculosis and Lung Disease
Patients diagnosed with tuberculosis (TB) continue to
experience clinical uncertainty and high mortality and to
bear a high burden of symptoms and other concerns.
Addition...
Journal Article
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Commentary

A Médecins Sans Frontières ethics framework for humanitarian innovation

Sheather J, Jobanputra K, Schopper D, Pringle J, Venis S,  et al.
2016-09-06 • PLOS Medicine
2016-09-06 • PLOS Medicine
SUMMARY POINTS

• Humanitarian organisations often have to innovate to deliver health care and aid to populations in complex and volatile contexts.

• Innovation projec...
Journal Article
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Commentary

The Ebola clinical trials: a precedent for research ethics in disasters

Calain P
2016-08-29 • Journal of Medical Ethics
2016-08-29 • Journal of Medical Ethics
The West African Ebola epidemic has set in motion a collective endeavour to conduct accelerated clinical trials, testing unproven but potentially lifesaving interventions in the course o...
Journal Article
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Commentary

Ethics and images of suffering bodies in humanitarian medicine

Calain P
2012-07-27 • Social Science and Medicine
2012-07-27 • Social Science and Medicine
Media representations of suffering bodies from medical humanitarian organisations raise ethical questions, which deserve critical attention for at least three reasons. Firstly, there is ...
Journal Article
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Commentary

Ethics of conducting research in conflict settings

Ford NP, Mills EJ, Zachariah R, Upshur R
2009-07-10 • Conflict and Health
2009-07-10 • Conflict and Health
Humanitarian agencies are increasingly engaged in research in conflict and post-conflict settings. This is justified by the need to improve the quality of assistance provided in these se...