Ethics in humanitarian services: report on the earthquake in Nepal.

The Nepal earthquake was one of the biggest natural calamities of the year 2015. This paper attempts to explore the ethical issues involved in the humanitarian services rendered during the crisis and thereafter. The four principles of biomedical ethics - autonomy, beneficence, non-maleficence, and justice - are discussed in relation to the relief activities immediately following the disaster and the subsequent long-term activities, such as rehabilitation, wherever applicable. The discussion touches upon public health components such as vulnerable populations, environmental ethics and justice for the future. Incorporating ethical principles into the response to disasters is of vital importance to ensure that healthcare complies with professional norms and ethical standards, and is in tune with the medical needs of the local culture. Beneficence is prioritised, while non-maleficence and autonomy tend to be ignored. Justice, particularly distributive justice, deserves due attention in the context of limited resources, not only during the emergency phase but also during the phases of rehabilitation and planning for the future.