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Correspondence
Submissions should be
made via our electronic
submission system at
http://ees.elsevier.com/
thelancet/
www.thelancet.com Vol 385 April 11, 2015 1391
20 years of the ICRC
Code of Conduct for
Disaster Relief: what do
we need to improve?
The Code of Conduct for Disaster
Relief of the International Committee
of the Red Cross (ICRC) was written
for use by the International Red
Cross, Red Crescent Movements, and
non-governmental organisations
(NGOs) working in disaster relief.
The code was published just
after the Rwanda genocide in
April, 1994.1
The code consists of
a purpose and four definitions;
it outlines ten general principles
of conduct, and includes three
annexes of recommendations to
governments of disaster-affected
countries, donor governments, and
intergovernmental organisations.
The main purpose was to guarantee
high standards of behaviour
in disaster response. In 2005,
Dorothea Hilhorst2
did a survey
comprising open-ended questions
to all 289 signatories of the code at
that time. The respondents (180 of
289 signatories) stressed the need
for clarification and elaboration
of issues related to neutrality,
independence, and respect for local
culture. Additionally, a change in the
wording of the code was proposed to
eradicate bias towards international
NGOs and increase relevance to
local NGOs.2,3
Since the code was
published, other documents have
addressed disaster ethics—such as
the Ethical Principles on Disaster Risk
Reduction and People’s Resilience,
issued by the Council of Europe.4
As a response to the many
questions generated by disasters, the
European Cooperation in Science and
Technology (COST) Action IS1201
Disaster Bioethics was started at the
end of 2012. One of the four working
groups set up under this COST
Action—Working Group 4 (WG4),
Ethics and Governance—specifically
aims to promote good policies
and high standards in disaster risk
reduction and management.
In 2014, on the eve of the 20th
anniversary of the code’s publication,
ten members of WG4 did a thorough
analysis of its full text. Their main
objective was to assess the relevance
of the code, and to suggest changes
that could help to update it for current
global disaster relief conditions.
The ten members came from
different professional backgrounds
(two lawyers, two ethicists or phil-
osophers, one physician, one scientist,
two social scientists, and two NGO
representatives). They were divided
into smaller groups on the basis of
their expertise, and each subgroup
analysed the full content of the
code. A set of open-ended questions
about the code and its relevance
for today’s disaster relief efforts
was systematically addressed by all
subgroups. Here we summarise their
findings.
The participants first assessed which
ethical principles could be found in
the text of the code. All participants
agreed that respect for human dignity
and the principle of accountability
were evident. Legal experts found
that issues of independence and
effectiveness were likewise addressed.
Social scientists noted that equity and
social justice issues were addressed,
and NGO representatives noted that
issues of community participation
and effectiveness were also covered.
Ethicists identified principles of
humanitarianism and impartiality,
and physicians noted that issues of
data and identity protection were
addressed adequately in the code.
However, participants agreed that
some definitions of central terms
included in the code were inadequate
and that some ethical issues were
missing and should be addressed in
a revised code. A summary of these
issues is presented in the panel, and
our recommendations are shown in
the appendix.
We are all members of COST Action IS1201 Disaster
Bioethics.We declare no competing interests.
*Ana Borovecki, Jónína Einarsdóttir,
DónalO’Mathúna,PaulinaPospieszna,
Orly Maya Stern, Natália OlivaTeles
abor@mef.hr
School of Medicine, Andrija Stampar School of
Public Health, University of Zagreb, Zagreb, Croatia
(AB); Faculty of Social and Human Sciences,
Department of Anthropology, University of Iceland,
Iceland (JE); School of Nursing and Human Sciences,
Dublin City University, Dublin, Ireland (DO’M);
Department of Political Science and Journalism,
Adam Mickiewicz University of Poznan, Poznan,
Poland (PP); London School of Economics and
Political Science, London, UK (OMS); and Medical
Genetics Centre Doutor Jacinto Magalhăes, Centro
Hospitalar do Porto, and Faculty of Medicine,
University of Porto, Portugal (NOT)
1 Walker P. Cracking the code: the genesis, use
and future of the Code of Conduct. Disasters
2005; 29: 323–36.
2 Hihorst D. Dead letter or living document?
Ten years of the Code of Conduct for disaster
relief. Disasters 2005; 29: 351–69.
3 Roberts S. The ICRC, neutrality and
Guatemala: a case for improving best
practices. 2012. www.du.edu/korbel/criic/
humanitarianbriefs/Stephanie_Roberts.docx
(accessed Jan 6, 2015).
4 Council of Europe. Ethical principles on disaster
risk reduction and people’s resilience. 2012.
http://www.preventionweb.net/english/
professional/publications/v.php?id=26384
(accessed Jan 6, 2015).
Panel: Amendments needed in the code
• Updated definition of disaster
• The code should strongly promote disaster risk reduction,
capacity building, participation of local communities, and
respect for local culture
• Gender issues need central prominence
• The code should mention the importance of humanitarian
needs assessment
• More emphasis is needed on vulnerable and marginalised
groups in different cultural settings
• Disaster relief in conflicts needs elaboration
• Prevention and reduction of risk need to be addressed
• Ethical issues for research in disaster settings and with
humanitarian aid need to be addressed
• The code promotes accountability to donors and recipients but
needs more guidance to deal with unethical practices such as
discrimination, favouritism, or corruption, and various
conflicts of interest
• Issues related to liability of aid providers and responders need
to be included
• The code was aimed at the International Red Cross, Red
Crescent Movements, and NGOs only, but it can be useful to
other groups working in disaster relief
• Importance of cooperation with local governments is
highlighted but local organisations should also be mentioned
For more on the COST Action
IS1201 Disaster Bioethics see
http://disasterbioethics.eu/
See Online for appendix

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20 years of the ICRC Code of Conduct for Disaster Relief: What do we need to improve?

  • 1. Correspondence Submissions should be made via our electronic submission system at http://ees.elsevier.com/ thelancet/ www.thelancet.com Vol 385 April 11, 2015 1391 20 years of the ICRC Code of Conduct for Disaster Relief: what do we need to improve? The Code of Conduct for Disaster Relief of the International Committee of the Red Cross (ICRC) was written for use by the International Red Cross, Red Crescent Movements, and non-governmental organisations (NGOs) working in disaster relief. The code was published just after the Rwanda genocide in April, 1994.1 The code consists of a purpose and four definitions; it outlines ten general principles of conduct, and includes three annexes of recommendations to governments of disaster-affected countries, donor governments, and intergovernmental organisations. The main purpose was to guarantee high standards of behaviour in disaster response. In 2005, Dorothea Hilhorst2 did a survey comprising open-ended questions to all 289 signatories of the code at that time. The respondents (180 of 289 signatories) stressed the need for clarification and elaboration of issues related to neutrality, independence, and respect for local culture. Additionally, a change in the wording of the code was proposed to eradicate bias towards international NGOs and increase relevance to local NGOs.2,3 Since the code was published, other documents have addressed disaster ethics—such as the Ethical Principles on Disaster Risk Reduction and People’s Resilience, issued by the Council of Europe.4 As a response to the many questions generated by disasters, the European Cooperation in Science and Technology (COST) Action IS1201 Disaster Bioethics was started at the end of 2012. One of the four working groups set up under this COST Action—Working Group 4 (WG4), Ethics and Governance—specifically aims to promote good policies and high standards in disaster risk reduction and management. In 2014, on the eve of the 20th anniversary of the code’s publication, ten members of WG4 did a thorough analysis of its full text. Their main objective was to assess the relevance of the code, and to suggest changes that could help to update it for current global disaster relief conditions. The ten members came from different professional backgrounds (two lawyers, two ethicists or phil- osophers, one physician, one scientist, two social scientists, and two NGO representatives). They were divided into smaller groups on the basis of their expertise, and each subgroup analysed the full content of the code. A set of open-ended questions about the code and its relevance for today’s disaster relief efforts was systematically addressed by all subgroups. Here we summarise their findings. The participants first assessed which ethical principles could be found in the text of the code. All participants agreed that respect for human dignity and the principle of accountability were evident. Legal experts found that issues of independence and effectiveness were likewise addressed. Social scientists noted that equity and social justice issues were addressed, and NGO representatives noted that issues of community participation and effectiveness were also covered. Ethicists identified principles of humanitarianism and impartiality, and physicians noted that issues of data and identity protection were addressed adequately in the code. However, participants agreed that some definitions of central terms included in the code were inadequate and that some ethical issues were missing and should be addressed in a revised code. A summary of these issues is presented in the panel, and our recommendations are shown in the appendix. We are all members of COST Action IS1201 Disaster Bioethics.We declare no competing interests. *Ana Borovecki, Jónína Einarsdóttir, DónalO’Mathúna,PaulinaPospieszna, Orly Maya Stern, Natália OlivaTeles abor@mef.hr School of Medicine, Andrija Stampar School of Public Health, University of Zagreb, Zagreb, Croatia (AB); Faculty of Social and Human Sciences, Department of Anthropology, University of Iceland, Iceland (JE); School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland (DO’M); Department of Political Science and Journalism, Adam Mickiewicz University of Poznan, Poznan, Poland (PP); London School of Economics and Political Science, London, UK (OMS); and Medical Genetics Centre Doutor Jacinto Magalhăes, Centro Hospitalar do Porto, and Faculty of Medicine, University of Porto, Portugal (NOT) 1 Walker P. Cracking the code: the genesis, use and future of the Code of Conduct. Disasters 2005; 29: 323–36. 2 Hihorst D. Dead letter or living document? Ten years of the Code of Conduct for disaster relief. Disasters 2005; 29: 351–69. 3 Roberts S. The ICRC, neutrality and Guatemala: a case for improving best practices. 2012. www.du.edu/korbel/criic/ humanitarianbriefs/Stephanie_Roberts.docx (accessed Jan 6, 2015). 4 Council of Europe. Ethical principles on disaster risk reduction and people’s resilience. 2012. http://www.preventionweb.net/english/ professional/publications/v.php?id=26384 (accessed Jan 6, 2015). Panel: Amendments needed in the code • Updated definition of disaster • The code should strongly promote disaster risk reduction, capacity building, participation of local communities, and respect for local culture • Gender issues need central prominence • The code should mention the importance of humanitarian needs assessment • More emphasis is needed on vulnerable and marginalised groups in different cultural settings • Disaster relief in conflicts needs elaboration • Prevention and reduction of risk need to be addressed • Ethical issues for research in disaster settings and with humanitarian aid need to be addressed • The code promotes accountability to donors and recipients but needs more guidance to deal with unethical practices such as discrimination, favouritism, or corruption, and various conflicts of interest • Issues related to liability of aid providers and responders need to be included • The code was aimed at the International Red Cross, Red Crescent Movements, and NGOs only, but it can be useful to other groups working in disaster relief • Importance of cooperation with local governments is highlighted but local organisations should also be mentioned For more on the COST Action IS1201 Disaster Bioethics see http://disasterbioethics.eu/ See Online for appendix