Abstract

Some of the best instances of bioethics are applications of ethical conceptual analysis to real-world cases that is done in a way that prompts both reflection on the part of the practitioners involved in the real-world case and reflection by the bioethicist on the way in which the field of bioethics understands the concept in question. Buth et al ’s paper in this issue is a fine example of just this. Their paper brings together three important concepts that straddle the worlds of politics and ethics and are to some extent under-theorised in applied settings. These three concepts – moral narcissism, moral complicity and dirty hands – raise particular problems for the activities of researchers, aid workers and others from richer countries working in poorer or conflict-torn parts of the world. Buth et al set out a general account of these concepts and their relationship. Their focus is substantially on complicity largely because Médecins Sans Frontières have been accused of it in each of the three cases they go on to discuss. These three cases involve MSF interventions in Myanmar, Libya and on the border between Syria and Jordan. Each are importantly different: from the involvement of MSF with the wrongdoers varies from not speaking out and continuing to operate in other parts of the country to being used as a coercive pawn providing aid. The situations are complex and, in the end, Buth et al see the analysis of them in terms of complicity as a useful first step but that is all. There are some important nuances embedded in the paper that are worth bringing out. First, moral narcissism as they define it, comes about at the point at which “an appropriate concern for one’s own moral integrity turns into moral self-indulgence” or a …