Life in Crisis: The Ethical Journey of Doctors without Borders

Life in Crisis: The Ethical Journey of Doctors without Borders

Life in Crisis: The Ethical Journey of Doctors without Borders

Life in Crisis: The Ethical Journey of Doctors without Borders


Life in Crisis tells the story of Médecins Sans Frontières (Doctors Without Borders or MSF) and its effort to "save lives" on a global scale. Begun in 1971 as a French alternative to the Red Cross, the MSF has grown into an international institution with a reputation for outspoken protest as well as technical efficiency. It has also expanded beyond emergency response, providing for a wider range of endeavors, including AIDS care. Yet its seemingly simple ethical goal proves deeply complex in practice. MSF continually faces the problem of defining its own limits. Its minimalist form of care recalls the promise of state welfare, but without political resolution or a sense of well-being beyond health and survival. Lacking utopian certainty, the group struggles when the moral clarity of crisis fades. Nevertheless, it continues to take action and innovate. Its organizational history illustrates both the logic and the tensions of casting humanitarian medicine into a leading role in international affairs.


Help us save a life today.

Msf fundraising brochure, 2008

The prospect of “saving lives” now serves as a common point of moral reference. Variations on the theme figure prominently in fundraising appeals, suggesting that donations to aid organizations can transmute into rescue. Politicians and corporations, with varying degrees of sincerity, seek to validate their actions through an accounting of potential protection or harm. As a moral precept the preservation of human life offers the allure of simplicity: whatever else holds in the complexity of human affairs, surely helping others live should be a good thing.

Beyond rhetorical appeals to virtue, what would it mean to build a framework for action around an ethic of life, understood medically and cast on a global scale? the following pages pursue this question through the story of a particular organization, one founded with precisely such an aim in mind. the group’s name— Médecins Sans Frontières, or Doctors Without Borders—reflects both its fundamental orientation to health and its distinctly universal ambition. To the extent that its acronym, msf, has become a staple reference in international aid, the group has realized its geographic aspiration. Its general goals and modes of engagement are far from unique; many other nongovernmental organizations practice humanitarian medicine. Nonetheless, MSF’s historical trajectory and restless, critical ethos render it a particularly telling case. Over four decades the group has sought to save lives and push limits, reflecting upon and sometimes reconsidering its actions without abandoning its fundamental commitment to combat suffering. in settings where action itself stands for virtue (in the sense that “doing something” displays good character), MSF’s engagement offers the abiding appeal of immediacy. When lives appear to be at stake, urgent medical care acquires an aura of moral purity. What more essential response, after all, could there be? Nonethe-

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