First, Do No Harm

I must have given hundreds of talks and speeches of various types over the last twenty years on the issue of refugees and people seeking asylum – and written plenty of pieces on the topic (not least on this blog).  Last weekend I was speaking to a group of inspiring young medical students at Griffith University on the Gold Coast who were seeking to get a better understanding of health, social and political factors affecting people seeking asylum.  I’d spoken before at similar events put together by the same organisation – Towards International Medical Equality. But it was only while talking to them that the central relevance of the fundamental medical maxim – First, Do No Harm – crystallised in my mind.

There are other phrases that encapsulate a similar idea – some less elegantly than others – but in policy areas where it is not always clear what course of action is the best, that fundamental initial principle should at the very least be a guide as to what not to do – First, Do No Harm.

At the moment, the considered policy of the Australian government – mirrored to a very large extent by the main opposition party – is to knowingly inflict serious, prolonged harm on innocent people.  The situation in the Australian government organised and funded detention camps on both Nauru and Manus Island is nothing short of a humanitarian catastrophe.  Perhaps the worst aspect of this is that it has always been almost inevitable that this was going to occur.  We knew the enormity f the human harm that would occur as a result of this approach, and yet it was pursued despite, or more likely because, of this knowledge.

There is obviously no quick or easy solution to the global reality of large and growing numbers of refugees, or even to how best to deal with the relatively small number of these people who seek to make their way directly to Australia.

But even complex issues often have aspects of them which are very simple.  And surely one of the clearest and basic principles in determining how best to deal with a situation involving human suffering is not to deliberately add to that suffering.
This coming federal election campaign provides a very clear opportunity to indicate to the two largest parties that policy ‘solutions’ which rely fundamentally on inflicting serious harm on vulnerable, innocent people are not acceptable or supportable.  There are and will always be other ways to address an issue.

The brutality must stop. It can be stopped now. It must be stopped – now.

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  1. Andrew, you and I are in the fortunate position of being able to observe this problem from the safety of our respective positions and we are not required to make a terrible decision; do we reopen the trafficking business (again), or do we close the borders and regulate the flow of refugees into Oz. The first option saw about 1,200 drown out of about the approximately 50,000 who made the attempt, when Rudd came into power. The second option has led the unsatisfactory current scenario, but perhaps you have overlooked the fact that the current mess is primarily the legacy of Labor having to reverse its earlier “compassionate” opening of the borders.
    Letting those now in detention into Australia will definitely restart the whole process again. The fact that you and your fellow travellers will shout “victory” from the rooftops will ensure that the world knows that Australia’s borders are porous once again. Will you accept responsibility for the safety of the leaky boats that are sent our way?
    I do not understand how your proposal could, in the medium term, do “no harm”, should we cycle through the open-close-open-close … the borders for several decades. Isn’t it less harmful to leave the borders closed and regulate the flow for the long term? Yes, we inflict suffering upon those detained now, but eventually they will be cleared out of detention, the centres will close and the situation with regards to our nation will be at least controllable, and arguably the most humane course of action we can take.
    Perhaps you would prefer to see us bring all comers into Australia by chartered aircraft, so avoiding the leaky boats and making traffickers uncompetitive. Even the moral superpowers in Europe couldn’t keep that strategy in place for very long. And they are not even sure of what constitutes a nation state anymore.
    The problem you might have with Australia is that it’s occupied by Australians. And we all vote.

  2. Thanks for your feedback Rick. I can’t see anywhere in your comment an argument as to why we have to proactively and deliberately inflict extra harm on people as part of this.

    Under the current policy of both Labor and Liberal it is by no means the case that these people will “eventually be cleared out of detention” – and even if/when that does happen, we will have inflicted serious and permanent harm on many of them, just as we did the last time this strategy was adopted.

    I don’t really understand what you mean your comment that “the problem I might have with Australians is that it’s occupied by Australians.” But in any case, I am very much aware that Australians all vote – which is why I am urging us all to vote in support of people and parties who oppose policies which rely on inflicting cruelty on innocent people.

  3. Andrew it appears to me that Manus Island or something like it is the the only realistic course of action. To bring the detainees on shore starts the trafficking again, and the detainees are trying to hang on long enough until Labor gets into power, and then buckles to the left factions and breaks its pre-election promise to maintain off shore processing. I don’t deny that Manus seems to be very unsatisfactory. But the trafficking has a worse outcome, it does more harm, so waiting out the detainees until they accept they will never get into Australia looks like the least awful option.

    I note in particular that the detainees have said they will not accept any country other than Australia. This indicates that they believe they can force us to take them in, and you are, while well intentioned, encouraging them to take that approach. It is your right to encourage them in this way, as it is my right to argue against your simplistic position.

    I dispute your interpretation of government policy as proactive harm, which has the overtone of torture. I wonder if your moral position might be a little unrealistically pure, in that you are not confronting the extremely poor alternative courses of action that are available. Indulging in some short term moral purity (as practiced by Rudd) led to the significant loss of life and re-filling of the detention centres. What do you propose we actually do? Will the consequences of your preferred course of action cause more suffering than the current mess? In the medium and long term, it probably will.

    I think your moral positioning on this issue may also be overlooking the innate foundations of morality. I am taken by the work of Jonathan Haight (who is not politically conservative), who describes several moral foundations, of which compassion is only one. It is a little simplistic in my view to regard others as less moral (by pursuing what you say is “proactive harm”) than yourself. Perhaps you are failing to recognise the morality being exercised by your opponents, even though the application of their moral principles involves inner conflict, doubt, and harm to others. They are trying, I hope, to minimise harm, and that unfortunately causes some others to suffer.

    The point about Australia being occupied relates to the fact that as an innately tribal animal, humans will cling to their national identity. Excessive uncontrolled inflows of people is culturally and and politically unsustainable. What is excessive is a fluid concept, but politically, voters will keep pulling governments back to the contemporary centre on this issue. As demonstrated by the Labor Party in their last term of government, and by the northern European moral superpowers this year. You will never be happy with this political reality, and your choice of language; “policies which rely upon inflicting cruelty”, for example; is taking a morally superior stance. As the current “least worst option” policy is the most politically palatable one, my point is that you are holding yourself up as superior, morally, to most voters. I think you are wrong. You are not recognising the moral foundations that other people use in making difficult decisions.

  4. There is nothing in my comment that isn’t a fact,
    Losing control of their country is what set off the war in Iraq, because when the election was held after America tried to set up a Democracy, the Shiites gained control of Iraq by having more numbers in the Parliament.

    The rest is history.
    I don’t see why you should need to moderate something that is obviously a fact
    Any history book will demonstrate that this is a recurring fact in history.

    How many times do you need to see people wanting separatist states, carving out pieces of country to govern,themselves. I didn’t make it up and it is not a fantasy but a fact.

  5. When labour reopened the borders in the last few months before they were
    closed again there were 28,000 people a month coming here on boats.
    Multiple multiply that by 12months that’s over 300,000 people coming every year. Let enough people in, mainly from Muslim countries, give them the vote
    And eventually we will lose control of this country at the ballet box.

    There is no difference in the outcome of being overrun by people coming without guns, and the loss of country, from being overrunning by armies with guns.
    In the end you risk losing control of your country.

  6. When labour reopened the borders in the last few months before they were
    closed again there were 28,000 people a month coming here on boats.
    Multiple multiply that by 12months that’s over 300,000 people coming every year. Let enough people in, mainly from Muslim countries, give them the vote
    And eventually we will lose control of this country at the ballet box.

    There is no difference in the outcome of being overrun by people coming without guns, and the loss of country, from being overrunning by armies with guns.
    In the end you risk losing control of your country.

  7. Thanks for this post Andrew. I fully agree with you.
    Inflicting serious harm (mental torture ) to those asylum seekers who attempt to get here by boat in order to deter others is effective, inhumane and incidentally extraordinarily costly.

    Both major parties now pretend that there is no other solution than to destroy a few lives to save other asylum seekers from drowning. This is poor rhetoric, a fig leaf to cover a shameful attempt to attract the votes attached to sectarian/racist hatred at a time when so few votes separate election winners and losers. Doing so it encourages more racist/religious/sectarian hatred.

    I am disgusted. I want to be able again to be proud of being an Australian citizen.
    My vote will not go to either major political parties, but to a party who reject cruelty, make rejection of this inhumane policy central to their campaign, who argue the question from fact, and present realistic, humane alternatives. The Greens policies shown at fit my requirements.

  8. Hello Andrew,

    I am a bit late responding however I have only just read your blog on this matter. I wonder if you would address two matters.
    The first is could you please name five, no even two will do, countries in the world of nations that allow anyone in without first having to meet strict immigration criteria?
    The second matter is this. All of the detainees on Manus or Nauru are either Sri Lankan or from Afghanistan, Iran and the Middle Eastern ‘hotspots’. However all arrived by boat from Indonesia, Sri Lanka or possibly other near Asian countries – eg. Malaysia. Other than the Sri Lankans all passed through various intermediary countries before embarking by boat for Australia. They were not in any danger – or were they – in the countries they traversed before boarding the boat. The Sri Lankans could have made a far easier choice and sailed to nearby India if they had genuine refugee issues. Therefore it should follow that their unfortunate choice to come to Australia was not to escape danger, but for economic or social reasons. That is little different than me deciding I would be better off in the US so the US authorities should just let me in. The fact is the US will not let me in. As it happens neither will Sri Lanka, Iran, Afghanistan or any of the Middle eastern ‘hotspot’ countries let me in just because I want to enter their country. There is no denying the hardship these people have endured but the fact is were they were not safe from persecution and danger the day they got out of their country of origin? On what basis can anyone justify them spurning the safety they had when they left their country of origin, jumping the refugee process already administered by the UN by virtue of their ability to pay smugglers and allow them unlimited entry to Australia.

  9. Hello Andrew,

    I posted a comment with questions in response to this article but there was no response. Was the question too hard or is the blog inactive?

Comments are closed.