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This paper assesses from an international law perspective the increasing use of “Do No Harm” as a principle to guide a broad array of international activities, such as state-building, human rights and climate change. Originally a medical principle derived from the Hippocratic Oath, Do No Harm’s increased use has coincided with greater attention to the responsibility of international actors who, when setting out to do ‘good,’ have tried to ensure that activities do not cause harm or make things worse off. Do No Harm is nowhere found in binding sources, treaties or otherwise, but is invoked in connection with a range of international legal norms in a varied and inconsistent manner. The basic assumption that this paper seeks to test then is that Do No Harm is not living up to its self-stated role, serving rather to defer a series of policy or political choices concerning the nature or apportionment of various actors’ responsibility. To that end, the paper describes some general features of Do No Harm’s uses, followed by a more in-depth discussion of uses in humanitarian assistance, international human rights and international environmental law. That discussion reveals that Do No Harm does flag gaps in the regulation of international conduct, but does not resolve inherent trade-offs that arise when seeking to avoid harm. Those trade-offs are especially pronounced where Do No Harm’s different uses overlap and risk engendering either a false sense of coherence between competing priorities, or an overly technocratic approach to risk mitigation and performing prior assessments of possible impacts of activities. The larger analysis is ultimately a call for greater conceptual clarity, when faced with the convenience offered by Do No Harm’s incontrovertible veneer.

A Pebble in the Shoe: Assessing the Uses of Do No Harm in International Assistance