“Do No Harm” as a Code of Action

Do No Harm (DNH) is an ethical principle as well as a decision-making approach, which requires humanitarian agencies and their individual representatives to try to minimize the “harm” they may be doing while providing assistance. It is understood that this harm is most often unintentional. Derived originally from medical ethics, DNH is ultimately about decision making in complex environments. Complex environments are characterized by constant change, complexity, and unpredictability. These complex environments may include large-scale emergencies such as tsunamis, violent uprisings, or armed conflicts.

Beginning in the early 1990s, a number of donor agencies, United Nations organizations, and international and local nongovernmental organizations(NGOs) collaborated through the Local Capacities for Peace Project (LCPP) to learn more about how aid that is given in conflict settings interacts with the conflicts. Based on gathering and comparing the field experience of many different NGO programs in many different contexts, this study aimed to address the question “How can we provide assistance without exacerbating tensions or conflict?” The lessons learned from this work have had a widespread impact on a variety of fields and are now used by not only aid agencies but also a broad range of development organizations, peacebuilders, advocates, corporations, militaries, and other practitioners working in complex environments.

The DNH approach recognizes that intervention strategies and policy choices, such as humanitarian aid, state building, or peace-building efforts that aim to create change and improve the lives of the people, often become part of the context by shaping it and being shaped by it. However, experience shows that despite the best intentions, intervention programs can also unintentionally create, reinforce, exacerbate, and prolong conflicts. Every profession entails risks and potential for harm, even if it is effective in achieving its intended goals, promoting development, and saving lives. While some harm may be unintentional and accidental, in other cases, harm may be inevitable, and some harm may even be necessary to successfully intervene in a situation, as is the case in medical surgery. In other instances, decision makers may be faced with two different harmful intervention strategies for a greater good. Emergency situations are often characterized by fluid, unpredictable, and volatile complexities and may entail difficulty to address moral dilemmas. On the other hand, harm may be a result of systemic issues such as sociocultural, political, and economic structures, or even different value systems. For example, democratic elections held immediately after a conflict—without carefully assessing local political, demographic, and sociocultural dynamics—may breed further violence if certain groups feel threatened or marginalized by the election results. In these instances, decision makers may have to consider curbing competitive elections and establishing a power-sharing mechanism in order to avoid further bloodshed.

The DNH approach acknowledges that although intervention efforts aim to have a positive impact, they might have unintended negative outcomes. This is [Page 204]because it is very difficult to know and predict everything in complex environments. Still, potential benefits of an intervention do not remove the responsibility of the decision makers to do everything in their power to reduce the risks and probable harm and develop systematic ways to learn how to address them. Therefore, the DNH approach provides a framework to understand the interaction between decisions and context and offers a tool to develop strategies to minimize harm and increase benefits of these efforts.

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