Patient Rights and Practitioner Duties

In military medicine, the goals of war transform patient rights and practitioner duties. Attention to conserving mission readiness and maintaining one’s fitness for duty limits soldiers’ rights to refuse standard medical care, initiate DNR (Do Not Resuscitate) orders, maintain privacy, and demand confidentiality. At the same time, however, military medical practitioners are expected to maintain impartiality and neutrality. In wartime, both are problematic. The imperative of military necessity may override impartiality while medical staff members tending compatriot warfighters are not neutral. Special, associative duties of care, moreover, may demand preferential treatment for compatriots at the expense of the medical needs of others. Citing dual loyalty, some observers call on military medical personnel to choose between their medical and military obligations. Dual loyalty, however, is a false dichotomy that obscures the moral tension between collective and individual interests coloring all aspects of political and military ethics.