American leaders have cooperated with regimes around the world that are, to varying degrees, repressive or corrupt. Such cooperation is said to serve the national interest. But these partnerships also contravene the nation’s commitments to democratic governance, civil liberties, and free markets. During the Cold War, policymakers were casual about sacrificing important values for less-than-compelling strategic rationales. Since the 9/11 attacks, similar ethical compromises have taken place, although policymakers now seem more selective than their Cold War–era counterparts. Americans want a foreign policy that pursues national interests while observing American values. How might that reconciliation of interest and morality be accomplished? In Perilous Partners, authors Ted Galen Carpenter and Malou Innocent provide a strategy for resolving the ethical dilemmas between interests and values faced by Washington. They propose maintaining an arm’s-length relationship with authoritarian regimes, emphasizing that the United States must not operate internationally in ways that routinely pollute American values. It is a strategy based on ethical pragmatism, which is the best way to reconcile America’s strategic interests and its fundamental values. Perilous Partners creates a strategy for conducting an effective U.S. foreign policy without betraying fundamental American values.

Pervasive violence against hospitals, patients, doctors, and other health workers has become a horrifically common feature of modern war. These relentless attacks destroy lives and the capacity of health systems to tend to those in need. Inaction to stop this violence undermines long-standing values and laws designed to ensure that sick and wounded people receive care. Leonard Rubenstein—a human rights lawyer who has investigated atrocities against health workers around the world—offers a gripping and powerful account of the dangers health workers face during conflict and the legal, political, and moral struggle to protect them. In a dozen case studies, he shares the stories of people who have been attacked while seeking to serve patients under dire circumstances including health workers hiding from soldiers in the forests of eastern Myanmar as they seek to serve oppressed ethnic communities, surgeons in Syria operating as their hospitals are bombed, and Afghan hospital staff attacked by the Taliban as well as government and foreign forces. Rubenstein reveals how political and military leaders evade their legal obligations to protect health care in war, punish doctors and nurses for adhering to their responsibilities to provide care to all in need, and fail to hold perpetrators to account. Bringing together extensive research, firsthand experience, and compelling personal stories, Perilous Medicine also offers a path forward, detailing the lessons the international community needs to learn to protect people already suffering in war and those on the front lines of health care in conflict-ridden places around the world.