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Between Samaritans and StatesThe Political Ethics of Humanitarian INGOs$
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Jennifer Rubenstein

Print publication date: 2015

Print ISBN-13: 9780199684106

Published to Oxford Scholarship Online: March 2015

DOI: 10.1093/acprof:oso/9780199684106.001.0001

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The Cost-Effectiveness Conundrum

The Cost-Effectiveness Conundrum

(p.143) 6 The Cost-Effectiveness Conundrum
Between Samaritans and States

Jennifer C. Rubenstein

Oxford University Press

In making large-scale decisions about resource use, how much weight should INGOs put on considerations of cost-effectiveness? Chapter 6 examines three answers to this question: the principle of “aid based on need alone,” the “harm minimization” principle, and the “ethics of refusal.” It argues that all three of these approaches fall short. Among other things, they all fail to acknowledge the cost-effectiveness conundrum. They therefore do not direct INGOs to develop the kind of political judgment that is necessary to navigate this conundrum effectively. Drawing on the example of Médecins sans Frontière’s response to an Ebola epidemic in Northern Uganda, the chapter introduces an appropriate type of political judgment for this purpose, the “ethics of resistance.”

Keywords:   cost-effectiveness, harm minimization, need, distribution, allocation, Ebola, ethics of refusal, ethics of resistance, Médecins sans Frontières (MSF), Uganda

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