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Teaching Military Medical Ethics: Another Look at Dual Loyalty and Triage

Published online by Cambridge University Press:  18 August 2010

MICHAEL L. GROSS
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Extract

Military medical ethics is garnering growing attention today among medical personal in the American and other armies. Short courses or workshops in “battlefield ethics” for military physicians, nurses, medics, social workers, and psychologists address the nature of patient rights in the military, care for detainees, enemy soldiers and local civilians, problems posed by limited resources, ethical questions arising in humanitarian missions, as well as end-of-life issues, ethics consultations, care for veterans, advance directives, and assisted suicide. Although many of these issues are the core subjects of any bioethics curriculum, military medical ethics presents unique challenges to bioethics educators.

Type
Special Section: Bioethics Education
Information
Cambridge Quarterly of Healthcare Ethics , Volume 19 , Issue 4 , October 2010 , pp. 458 - 464
Copyright
Copyright © Cambridge University Press 2010

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References

1. My thanks to Major Jacob F. Collen, M.D., for providing this case for discussion. Dr. Collen and his colleagues discuss battlefield medical ethics in Sessums, LL, Collen, JF, O’Malley, PG, Jackson, JL, Roy, MJ. Ethical practice under fire: Deployed physicians in the global war on terrorism. Military Medicine 2009;174(5):441–7CrossRefGoogle Scholar.

2. In an unpublished pilot survey by Daniel Dakar, 19 Israeli combat medics were asked how they would respond to an incident where among the wounded were several lightly to moderately wounded Israeli soldiers and a severely wounded Palestinian. Ten of the respondents stated they would treat the Israeli soldiers first. One responded he would treat the Palestinian first. The other eight stated they would first verify that their comrades were not faced with life-threatening injuries. Some then said they would stabilize their comrades and then treat the Palestinian, while others would stabilize the Palestinian first and then treat their fellow soldiers.

3. Army Field Manual, 2000, FM 4-02.10, Paragraph 1.1 (d).

4. Convention (I) for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field. Geneva, 12 August 1949, Article 12.

5. Convention (I) for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field. Geneva, 12 August 1949, Article 12. Commentary, paragraph 2 (A).

6. For a recent account, see Allhoff, F, ed. Physicians at War: The Dual-Loyalties Challenge. Dordrecht: Springer; 2008CrossRefGoogle Scholar.

7. See, for example, the American Medical Association, Code of Medical Ethics, Opinion 2.068—Physician Participation in Interrogation, available at http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics/opinion2068.shtml.

8. See Gross, ML. Medicalized weapons and modern war. Hastings Center Report 2010;40(1):34–43CrossRefGoogle ScholarPubMed.

9. See Gross, ML. Bioethics and Armed Conflict: Moral Dilemmas of Medicine and War. Cambridge, MA: MIT Press; 2006:137–74Google Scholar.

10. See note 9, Gross 2006:76–84.

11. The classic study is Stouffer, SA, Lumsdaine, AA, Lumsdaine, MH, Williams, RM Jr, Smith, MB, et al. . The American Soldier: Combat and its Aftermath. New York: Wiley, 1949Google Scholar.