Military Medical Ethics in Contemporary Armed Conflict

2021 ◽  
Author(s):  
Michael L. Gross
Keyword(s):  
Medical Ethics ◽  
Armed Conflict ◽  
Just War ◽  
Military Medicine ◽  
Moral Dilemmas ◽  
Medical Attention ◽  
Ethical Challenges ◽  
Moral Foundation ◽  
Manage Health Care ◽  
Military Medical Ethics

Beleaguered countries struggling against aggression or powerful nations defending others from brutal regimes mobilize medicine to wage just war. As states funnel medical resources to maintain unit readiness and conserve military capabilities, numerous ethical challenges foreign to peacetime medicine ensue. Force conservation drives combat hospitals to prioritize warfighter care over all others. Civilians find themselves bereft of medical attention; prison officials force feed hunger-striking detainees; policymakers manage health care to win the hearts and minds of local nationals; and scientists develop neuro-technologies or nanosurgery to create super soldiers. When the fighting ends, intractable moral dilemmas rebound. Postwar justice demands enormous investments of time, resources, and personnel. But losing interest and no longer zealous, war-weary nations forget their duties to rebuild ravaged countries abroad and rehabilitate their war-torn veterans at home. Addressing these incendiary issues, Military Medical Ethics in Contemporary Armed Conflict integrates the ethics of medicine and the ethics of war. Medical ethics in times of war is not identical to medical ethics in times of peace but a unique discipline. Without war, there is no military medicine, and without just war, there is no military medical ethics. Military Medical Ethics in Contemporary Armed Conflict revises, defends, and rebuts wartime medical practices, just as it lays the moral foundation for casualty care in future conflicts.

Conclusion

2021 ◽  
pp. 275-282
Author(s):  
Michael L. Gross
Keyword(s):  
Medical Ethics ◽  
Armed Conflict ◽  
Just War ◽  
Military Medicine ◽  
Novel Weapons ◽  
Nation States ◽  
The Future ◽  
Ethics Of War ◽  
Military Medical Ethics

Rounding out Military Medical Ethics in Contemporary Armed Conflict, the conclusion first highlights the signposts that lead the reader to understand how the ethics of war is inseparable from the ethics of military medicine. Military medicine must serve just war. Historically, just wars are defensive or humanitarian. But things may change. So next, we look to the future. Past wars do not necessarily predict coming conflicts. Future wars will see novel weapons and new adversaries drawing from nation-states, nonstates, criminals, and unknown assailants. Nevertheless, the experience of recent wars, particularly those in Iraq and Afghanistan, offers important lessons to guide military medicine as war evolves into ways we can anticipate and in ways we cannot.

Introduction

2021 ◽  
pp. 1-10
Author(s):  
Michael L. Gross
Keyword(s):  
Medical Ethics ◽  
Armed Conflict ◽  
Military Medicine ◽  
Abu Ghraib ◽  
Medical Experimentation ◽  
Guantanamo Bay ◽  
Force Feeding ◽  
Military Medical Ethics

“Can military medicine be ethical?” is one question that may puzzle readers whose knowledge of medical ethics since 9/11 is colored by the prisons of Abu Ghraib and Guantanamo Bay. To address these and other challenges, Military Medical Ethics in Contemporary Armed Conflict explores controversial topics that include preferential care for compatriot warfighters, force feeding detainees, weaponizing medicine to wage war, medical experimentation, and neural enhancement for warfighters. Less controversial but no less compelling concerns direct our attention to postwar justice: the duty to rebuild war-torn nations and the obligation to care for war-torn veterans.

scholarly journals Dilemmas in Military Medical Ethics: A Call for Conceptual Clarity

2016 ◽  
Vol 4 ◽  
Author(s):  
Christiane Rochon
Keyword(s):  
Medical Ethics ◽  
Ethical Issues ◽  
Military Medicine ◽  
Codes Of Ethics ◽  
Armed Conflicts ◽  
Conceptual Clarity ◽  
Ethical Conflicts ◽  
Military Medical Ethics ◽  
The Military ◽  
Military Physicians

Despite the increase in and evolving nature of armed conflicts, the ethical issues faced by military physicians working in such contexts are still rarely examined in the bioethics literature. Military physicians are members of the military, even if they are non-combatants; and their role is one of healer but also sometimes humanitarian. Some scholars wonder about the moral compatibility of being both a physician and soldier. The ethical conflicts raised in the literature regarding military physicians can be organized into three main perspectives: 1) moral problems in military medicine are particular because of the difficulty of meeting the requirements of traditional bioethical principles; 2) medical codes of ethics and international laws are not well adapted to or are too restrictive for a military context; and 3) physicians are social actors who should either be pacifists, defenders of human rights, politically neutral or promoters of peace. A review of the diverse dilemmas faced by military physicians shows that these differ substantially by level (micro, meso, macro), context and the actors involved, and that they go beyond issues of patient interests. Like medicine in general, military medicine is complex and touches on potentially contested views of the roles and obligations of the physician. Greater conceptual clarity is thus needed in discussions about military medical ethics.

Military Medical Ethics and Just War

2021 ◽  
pp. 13-34
Author(s):  
Michael L. Gross
Keyword(s):  
Medical Ethics ◽  
Medical Care ◽  
Military Medicine ◽  
Political Community ◽  
Medical Necessity ◽  
Medical Needs ◽  
Private Interests ◽  
Human Rights Abuse ◽  
Underlying Principle ◽  
Military Medical Ethics

The goal of military medicine is to conserve the fighting force necessary to prosecute just wars. Just wars are defensive or humanitarian. A defensive war protects one’s people or nation. A humanitarian war rescues a foreign, persecuted people or nation from grave human rights abuse. To provide medical care during armed conflict, military medical ethics supplements civilian medical ethics with two principles: military-medical necessity and broad beneficence. Military-medical necessity designates the medical means required to pursue national self-defense or humanitarian intervention. While clinical-medical necessity directs care to satisfy urgent medical needs, military-medical necessity utilizes medical care to satisfy the just aims of war. Military medicine may, therefore, attend the lightly wounded before the critically wounded or use medical care to win hearts and minds. The underlying principle is broad, not narrow, beneficence. The latter addresses private interests, while broad beneficence responds to the collective welfare of the political community.

Moral Reasoning in Military Medical Ethics

2021 ◽  
pp. 56-70
Author(s):  
Michael L. Gross
Keyword(s):  
Medical Ethics ◽  
Public Discourse ◽  
Applied Ethics ◽  
Medical Personnel ◽  
Moral Dilemmas ◽  
Political Community ◽  
Reasonable Pluralism ◽  
Military Medical Ethics ◽  
Deliberative Forum ◽  
The Military

Applied ethics must resolve moral dilemmas, because, at the end of the day, medical personnel and military commanders must act. Reaching a defensible ethical decision requires moral agents to define the military and medical mission clearly and answer the following questions. Is the proposed operation or policy an effective and necessary means to attain the mission’s goals? Are the costs proportionate, keeping in mind that costs include military, medical, and moral costs? Finally, is the deliberative forum appropriate? Military medical ethics entails private (doctor-patient) and public discourse. Public discourse or deliberation engages the political community and its institutions. It requires widespread participation, well-reasoned arguments, reasonable pluralism, and, ultimately, responsive public policy.

The Ethics of Unwinnable War

2017 ◽  
Author(s):  
Dominic Tierney
Keyword(s):  
High Probability ◽  
Just War ◽  
Just War Theory ◽  
Moral Dilemmas ◽  
Probability Of Success ◽  
Military Campaigns ◽  
Military Campaign

According to just war theory, military campaigns should only be fought as a last resort, with the goal of correcting a grave evil, and where there is a high probability of success. But what happens when a military campaign unravels and becomes unwinnable? How can a leader reconcile just war theory with the need to extricate the country from a quagmire? In recent decades, US presidents have repeatedly faced such moral dilemmas, as campaigns in Korea, Vietnam, Afghanistan, and Iraq all became unwinnable. When victory is no longer achievable, leaders should dial down the goals of the war, resist the pressure to embrace barbarism, negotiate with the adversary, and seek the best possible peace from the range of plausible alternatives.

scholarly journals Paediatric Residents and Fellows Ethics (PERFEct) survey: perceptions of European trainees regarding ethical dilemmas

2021 ◽  
Author(s):  
M. C. den Boer ◽  
A. Zanin ◽  
J. M. Latour ◽  
J. Brierley
Keyword(s):  
Medical Education ◽  
Medical Ethics ◽  
Ethics Education ◽  
Ethical Dilemmas ◽  
Moral Dilemmas ◽  
Ethics Training ◽  
Healthcare Team ◽  
Medical Ethics Education ◽  
European Paediatric ◽  
Future Practice

AbstractWith an increasingly complex healthcare environment, ethics is becoming a more critical part of medical education. We aimed to explore European paediatric trainees’ experiences of facing ethical dilemmas and their medical ethics education whilst assessing their perceptions of ethical dilemmas in current and future practice. The Young Sections of the European Academy of Paediatrics and European Society of Paediatric and Neonatal Intensive Care developed an explorative online survey covering demographics, ethical dilemmas faced and ethics training. The survey was made available in nine languages from November 2019 to January 2020 via newsletters and social media. Participants (n = 253) from 22 countries, predominantly female (82%) and residents (70%), with a median age of 29-years, completed the survey. The majority (58%) faced ethical dilemmas monthly or more frequently. Most ethics training was received by ethics lectures in medical school (81%) and on the job (60%). A disagreement between the healthcare team and patient/family was the most frequently faced moral dilemma (45%); the second was withholding/withdrawing life-prolonging measures (33%). The latter was considered the most challenging dilemma to resolve (50%). Respondents reported that ethical issues are not sufficiently addressed during their training and wished for more case-based teaching. Many have been personally affected by moral dilemmas, especially regarding withholding/withdrawing life-prolonging measures, and often felt inadequately supported.Conclusion: Paediatric trainees face many moral issues in daily practice and consider that training about managing current and future ethical dilemmas should be improved, such as by the provision of a core European paediatric ethics curriculum. What is Known:• Paediatric services are becoming more complex with an increase in ethical dilemmas asking for rigorous training in ethics.• Ethics training is often lacking or covered poorly in both pre- and postgraduate medical education curricula.• Existing ethics training for European paediatric trainees is haphazard and lacks standardisation. What is New:• The PaEdiatric Residents and Fellows Ethics (PERFEct) survey provides insight into the European paediatric trainees’ views regarding ethical dilemmas in their current and future practice.• European paediatric trainees report a lack of ethics training during paediatric residency and fellowship.• This study provides content suggestions for standardised medical ethics training for paediatric trainees in Europe.

scholarly journals Just War, Pacifism, Just Peace, and Peacebuilding

2019 ◽  
Vol 80 (1) ◽  
pp. 169-185
Author(s):  
Lisa Sowle Cahill
Keyword(s):  
Armed Conflict ◽  
Just War ◽  
Roman Catholic ◽  
Global South ◽  
War And Peace ◽  
Cross Border ◽  
Ethics Of War ◽  
Just Peace

While Roman Catholic ethics of war and peace develops more restrictive criteria of just war and reprioritizes nonviolence, an important strand of Protestant theology defends war as a God-given instrument of government’s multiple ends. A newer ethics of just peace and peacebuilding emerges from Christian initiatives to transform armed conflict at intra-state and cross-border levels. This essay assesses these approaches and pacifism, concluding with a perspective from the Global South.

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