The politics of life and death is explored from the perspective of Doctors Without Borders (Médecins sans frontières [MSF]), an activist nongovernmental organization explicitly founded to respond to health crises on a global scale. Following the work of Michel Foucault and Giorgio Agamben, I underline key intersections between MSF’s operations that express concern for human life in the midst of humanitarian disaster and the group’s self‐proclaimed ethic of engaged refusal. Adopting the analytic frame of biopolitics, I suggest that the actual practice of medical humanitarian organizations in crisis settings presents a fragmentary and uncertain form of such power, extended beyond stable sovereignty and deployed within a restricted temporal horizon.