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Intimate Deliberation with Suffering Individuals

Alongside these forms of public and collective ethical deliberation around humanitarian grand strategy, humanitarian deliberation also needs to take account of much more intimate instances of joint deliberation in which a humanitarian worker discusses very personal options with an individual or family. This might involve a patient in a clinic, an older sibling caring for her baby brother in a therapeutic feeding centre, a prisoner in detention, a family seeking their lost relative, a family requesting a cash grant or a person recovering from sexual violence. These very personal discussions should be at the heart of humanitarian action and are the intimate frontline of humanitarian ethics. Empathic communication, reciprocal reversals and perspective-taking are integral in this intimate deliberation too, but the context of this deliberation is a more immediate relationship of care. This is different to the organizational and political deliberations of humanitarian strategy described above. Instead, it is the face-to-face encounter of personal responsibility emphasized by Levinas, Ricoeur, the religious traditions and medical ethics.

ICRC medical doctor Paul Bouvier has described how these intimate deliberations need to be truly "human encounters” in which a "relationship of humanitarian care is at the core of humanitarian action”.35 In his powerful paper on ICRC’s work with detainees, Bouvier emphasizes how intimate humanitarian work needs always to involve "moments of shared humanity” and "mutual recognition” in which the humanitarian worker and the affected person both present themselves openly, giving something of themselves and receiving something of each other. These individual or family discussions are the repeated instantiations of the principle of humanity in action. In them, all parties are seen as human and seek to be humane. Bouvier tells several stories of small things given and received between detainees and ICRC delegates, including a drop of perfume. Once a male prisoner asked an ICRC delegate if she could bring him some perfume. She borrowed some eau de toilette from a male colleague and brought it into the prison the next day with the approval of the authorities. Bouvier continues:

The detainee sprayed himself generously and joyfully with the perfume, on his face, his hair and his clothes. The man was radiant and said with gratefulness: "You know, today for the first time since I am here, I smell good. I feel I am a human.” Then he went to the courtyard to see his comrades, sharing his joy, and rubbing his clothes on theirs to share the perfume. When we saw them later in the day, they came to us joyful and proudly sharing the good smell.

Importantly, Bouvier also tells of detainees giving small presents of their own to delegates, and stories of detainees insulting and yelling at delegates as the only people on whom they could safely vent their pent- up anger. And he tells of delegates crying as they hear stories of suffering and torture face-to-face.

In its understanding of intimate deliberation, humanitarian ethics can usefully draw on Paul Ricoeur’s notion of solicitude and Simone Weil’s emphasis on attention that we examined in the earlier discussion of humanity. Both these ideas capture the professional focus and individual concern that must embody humanitarian action at its most intimate point of impact. This is the closeness and proximity that humanitarian ethics has always prized. Belgian philosopher Gaelle Fiasse has summarized the medical ethics of Paul Ricoeur in a way that is perfectly suited to guide the face-to-face deliberative encounters of humanitarian action in health projects, but also in all other humanitarian projects like food security, livelihoods, education, psycho-social, water and sanitation, shelter and advocacy gathering that involve individual relationships of humanitarian care.36 Fiasse shows how Ricoeur’s emphasis on narrative, imagining, translation and mutual fragility can create the right relationship between patient and carer, a deliberative relationship that can be applied at the heart of humanitarian action.

Listening is the first step in a careful deliberation with someone about the best options in their suffering.37 Ricoeur’s insight into narrative identity (the idea that we are our individual story and its "entanglements” with others) means that a good way to listen is to attend to a person’s narrative of what has happened in their lives, and what they want to happen. It is to pay attention to the story they have made of their lives and to understand the next chapter or the ending that they seek. Real listening is not just hearing but requires imagination. Simone Weil described the importance of listening as part of her doctrine of attention: "to listen to someone is to put oneself in his place while he is speaking”.38 As humanitarian workers know well, listening across large gaps in culture, class, gender, experience and pain is not easy. It requires imagination of the kind that Weil recommends and a certain translation too. For Ricoeur this translation means learning "to speak the language” of the other person. This fluency is really the ability to resonate with the lived experience of the other person and so understand where they are and what they need. Our translations are never perfect and are always undertaken "with some salvaging and some acceptance of loss”.39 However, this process of imaginative translation, which is often mediated to international humanitarian workers through actual linguistic interpreters, is essential if deliberation is to be real and meaningful.40

The importance of letting people speak must not be underestimated in humanitarian deliberation. Speaking out is an act of power and the act of listening shows respect for the speaker. Speaking can, therefore, be a particularly important experience for people who have lost much or are routinely ignored and maltreated in armed conflict and disaster. As one Egyptian widow told the Cambridge anthropologist Helen Watson:

"Words from the heart are more alive than your scribbling. When we speak, our words burn.”41 In the same way that people are right to talk of their lives, humanitarians need also to speak powerfully of the value of humanity in all their public and private deliberations with authorities and communities. Humanitarian deliberation with others must prioritize humane speech if humanitarian values are to respond to people’s needs and burn holes in brutal ideologies that seek to reject them.

This kind of solicitous dialogue happens best when we humanitarians recognize that we are all fragile and that, in some ways, we may be more fragile than the person before us. People are also resilient and able to work out the best options for each other in a given humanitarian situation. As Fiasse observes: "sometimes a suffering person can be more actualized in other dimensions of her being than the person treating her”.42 This is certainly a common experience for humanitarian workers who regularly stand in awe at the dignity, resilience, practical wisdom and goodness of people deeply affected by armed conflict, famine and disaster.

 
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