scholarly journals Mandating the COVID-19 Vaccine for U.S. Service Members: An Exploration of Ethical Arguments

2021 ◽  
Author(s):  
Jeanne A Krick ◽  
Tyler R Reese
Keyword(s):  
Drug Administration ◽  
Department Of Defense ◽  
Service Member ◽  
Service Members ◽  
Individual Autonomy ◽  
Mandatory Vaccination ◽  
The Military ◽  
Full Approval ◽  
Individual Service ◽  
The U.S

ABSTRACT As the COVID-19 pandemic continues across the globe, the advent of novel vaccines has created a possible path to prepandemic life for many. Still, many individuals, including those in the U.S. military, remain hesitant about getting vaccinated. The U.S. Food and Drug Administration recently granted full approval to the Pfizer-BioNTech mRNA vaccine (Comirnaty). Consistent with messaging from President Biden, the Department of Defense leadership has instructed the military to prepare for mandatory vaccination. While many have praised this declaration, others have raised concerns regarding the suppression of individual service member autonomy. This commentary explains the different ethical principles relevant to individual autonomy and how they are understood in a military context and then explores the ethical arguments both for and against mandating vaccination for all U.S. service members.

Acceptance matters: Disengagement and attrition among LGBT personnel in the U.S. military

2021 ◽  
pp. e20210017
Author(s):  
Kathleen A. McNamara ◽  
Gribble Rachael ◽  
Marie-Louise Sharp ◽  
Eva Alday ◽  
Giselle Corletto ◽  
...  
Keyword(s):  
Department Of Defense ◽  
Active Duty ◽  
Service Members ◽  
Career Intentions ◽  
Military Career ◽  
The Past ◽  
Perceived Acceptance ◽  
Bisexual And Transgender ◽  
The Military ◽  
The U.S

LAY SUMMARY The U.S. military has undergone several changes in policies toward lesbian, gay, bisexual, and transgender (LGBT) service members over the past decade. Some LGBT service members report continued victimization and fear of disclosing their LGBT identity, which can affect retention of LGBT personnel serving in the military. However, there is little research on this population. This study uses data from a survey funded by the U.S. Department of Defense (2017–2018) and completed by 544 active-duty service members (296 non-LGBT and 248 LGBT) to better understand the career intentions of LGBT service members. Of transgender service members, 33% plan to leave the military upon completion of their commitment, compared with 20% of cisgender LGB and 13% of non-LGBT service members. LGBT service members were twice as likely as non-LGBT service members to be undecided as to their military career path. Lower perceived acceptance of LGBT service members in the workplace was associated with a higher risk of leaving among LGBT service members. Lower perceived unit cohesion was associated with attrition risk for all members, regardless of LGBT status. These findings suggest that the U.S. military can do more to improve its climate of LGBT acceptance to prevent attrition.

Military Families and Communication

2016 ◽  
Author(s):  
Steven R. Wilson ◽  
Leanne K. Knobloch
Keyword(s):  
World War Ii ◽  
Family Communication ◽  
Social Networking Sites ◽  
Military Families ◽  
Extended Family ◽  
Family Members ◽  
Service Member ◽  
Service Members ◽  
Communication Processes ◽  
The U.S

Since the terrorist attacks on U.S. soil on September 11, 2001, communication scholars have turned their attention to understanding family communication processes across the deployment cycle. Military families are composed of service members as well as their spouses/partners, children, and extended family members. In 2012, U. S. Department of Defense statistics indicate that 53% of U.S. military personnel are married and 44% have children. Although scholars from fields such as family studies, psychology, and sociology have been studying military families since World War II, family communication scholars are relative newcomers to this topic. There are several reasons why communication scholars have spent the past decade investigating how service members, spouses, and children interact with each other as well as their larger social networks. One reason is the length and scope of the post 9/11 conflicts, such that millions of families in the U.S. and abroad have been impacted by these wars. A second is that the conflicts in Afghanistan and Iraq represent the first time the U.S. has fought two wars simultaneously with an all-volunteer force. This has meant that the burden of service has fallen on a small percentage of the U.S. public, which sometimes has left military families feeling isolated from their civilian counterparts. Third, communication technologies have evolved in comparison to prior conflicts, such that service members often have had the opportunity to interact regularly with family via multiple channels (e.g., phone, video, email, and social networking sites as well as letters/packages) during recent deployments. A fourth reason is that deployments create a context in which families are faced with choices and potential dilemmas about communicating. From the time that deployment orders are received, throughout months of separation, and after the service member returns home, military families must decide what to talk about (or avoid talking about) openly. During deployment, family members must find ways of maintaining their relationships while coping with new stressors. After the service member returns home, families often must manage relational uncertainty while renegotiating routines. In cases where service members have difficulty readjusting to civilian life, family members must find ways of navigating dilemmas that can arise when they attempt to voice their concerns. Most military families display remarkable resilience in responding to these communicative transitions and tensions. By conducting research framed by a number of theories, family communication scholars have worked towards better understanding the experiences of military families and producing knowledge useful for those serving with military families. Although comparative work on military families in other countries is starting to emerge, most research on communication processes has focused on U.S. military families. Research grounded in the relational turbulence model, communication privacy management theory, multiple goals theories, relational dialectics, and intergroup communication theories has helped clarify how military families communicatively navigate the process of having a service member deployed.

Assisted Reproductive Technology and the Reproductive Endocrinology and Infertility Specialist in the U.S. Military

2018 ◽  
Vol 36 (06) ◽  
pp. 323-326
Author(s):  
Justin Pilgrim ◽  
Mae Healy ◽  
Belinda Yauger ◽  
Saioa Torrealday ◽  
John Csokmay ◽  
...  
Keyword(s):  
Assisted Reproductive Technology ◽  
Department Of Defense ◽  
Active Duty ◽  
Reproductive Technology ◽  
Service Members ◽  
Reproductive Endocrinology ◽  
Cultural Backgrounds ◽  
Active Duty Military ◽  
Military Members ◽  
The U.S

AbstractThe U.S. military mirrors the U.S. population given the diverse ethnic and cultural backgrounds of the service members. Active-duty military members, veterans, and Department of Defense beneficiaries can be negatively impacted by infertility.

Strengthening the Biological Weapons Convention: Comments on the Contributions of Marie Isabelle Chevier and Lynn Marvin Hansen

1990 ◽  
Vol 9 (1) ◽  
pp. 122-126 ◽  
Author(s):  
Erhard Geissler
Keyword(s):  
Department Of Defense ◽  
Biological Weapon ◽  
Terrorist Group ◽  
Biological Weapons ◽  
Biological Warfare ◽  
History Of ◽  
The Military ◽  
Biological Weapons Convention ◽  
The U.S

In agreement with the overwhelming number of experts, I certainly share the view of Chevier and Hansen that the Biological Weapons Convention needs to be strengthened. Of course it is still a matter of discussion whether the military utility of biological and toxin weapons (hereafter, respectively, BW and TW) changed after the introduction of biotechnology. It is impossible, however, to ignore the 1986 statement of the U.S. Department of Defense (1988), that:… perhaps the most significant event in the history of biological weapons development has been the advent of biotechnology. It enables the development of new microorganisms and products with new, unorthodox characteristics… Conceptually, then, a nation or terrorist group can design a biological weapon to meet a variety of contingencies or needs… The break through and the subsequent achievements make biological warfare much more feasible and effective for countries which either are not bound by the convention or which choose to violate it.

When OK is Not OK: Public Concern About White Nationalism in the U.S. Military

2020 ◽  
pp. 0095327X2091839
Author(s):  
Robert Ralston ◽  
Matthew Motta ◽  
Jennifer Spindel
Keyword(s):  
Military Service ◽  
Service Members ◽  
Representative Survey ◽  
Public Concern ◽  
Military Service Members ◽  
Within Subjects ◽  
White Nationalism ◽  
The Military ◽  
The U.S

Are Americans aware and concerned about White nationalism in the U.S. Military? Our large and demographically representative survey suggests that while most Americans suspect at least some presence of White nationalism in the military, many do not view it as a serious problem; particularly self-identified conservatives and respondents who hold highly favorable views toward military service members. However, in a between-/within-subjects experiment embedded in our survey, we show that providing information about the issue of White nationalism in the U.S. Military increases the public’s overall concern about White nationalism in the U.S. Military.

scholarly journals Mandatory HPV Vaccination; Opportunity to Save Lives, Improve Readiness and Cut Costs

2021 ◽  
Author(s):  
Collin A Sitler ◽  
Larissa F Weir ◽  
Erin A Keyser ◽  
Yovanni Casablanca ◽  
Erica Hope
Keyword(s):  
Human Papillomavirus ◽  
Hpv Vaccination ◽  
Active Duty ◽  
Service Members ◽  
Transmitted Infection ◽  
Vaccination Programs ◽  
Vaccination Rates ◽  
The Usa ◽  
Mandatory Vaccination ◽  
The U.S

ABSTRACT Human papillomavirus (HPV) is the most common sexually transmitted infection (STI) in the U.S. military and accounts for more healthcare visits than the next two most common STIs combined. Human papillomavirus is preventable with a safe, effective, prophylactic vaccine that has been available since 2006, yet vaccination rates remain low. The vaccine is approved for females and males aged 9-45 years for prevention of HPV-related dysplasia and cancers. Although it is recommended by the Centers for Disease Control and Prevention (CDC)’s Advisory Committee on Immunization Practices (ACIP), it is not part of the U.S. military’s mandatory vaccine list. Human papillomavirus does not just affect female service members—male service members have a higher reported seropositive rate than their civilian counterparts and can develop oropharyngeal, anal, or penile cancers as sequelae of HPV. Oropharyngeal cancer, more common in males, is the fastest growing and most prevalent HPV-related cancer in the USA. Several countries, such as Australia and Sweden, have successfully implemented mandatory vaccine programs and have seen rates of HPV-related diseases, including cancer, decline significantly. Some models project that cervical cancer, which is the fifth-most common cancer in active duty women, will be eliminated in the next 20 years as a result of mandatory vaccination programs. Between higher seropositive rates and lack of widespread vaccination, HPV dysplasia and cancer result in lost work time, decreased force readiness, negative monetary implications, and even separation from service. With more than half of the 1.3 million service members in the catch-up vaccination age range of less than 26 years of age, we are poised to have a profound impact through mandatory active duty service member vaccination. Although multiple strategies for improving vaccination rates have been proposed, mandatory vaccination would be in line with current joint service policy that requires all ACIP-recommended vaccines. It is time to update the joint service guidelines and add HPV vaccine to the list of mandatory vaccines.

scholarly journals A Burden and Prevalence Analysis of Chronic Pain by Distinct Case Definitions among Active Duty U.S. Military Service Members, 2018

2020 ◽  
Vol 5;23 (9;5) ◽  
pp. E429-E439
Author(s):  
Hunter Jackson Smith
Keyword(s):  
Chronic Pain ◽  
Military Service ◽  
Case Definition ◽  
Service Members ◽  
Case Definitions ◽  
Chronic Pain Patients ◽  
Prevalence Estimates ◽  
The Military ◽  
Pain Patients ◽  
The U.S

Background: Chronic pain is a growing problem in the military, and the methods by which we have to perform epidemiologic surveillance are insufficient. It represents both a public health and military readiness concern, as those who suffer from it experience adverse impacts on work productivity, physiological health, and quality of life. Objectives: This study was designed to assess the prevalence of chronic pain among active component military service members utilizing 2 distinct, published case definitions. It sought to describe the demographics and military characteristics of those receiving chronic pain diagnoses. The study also aimed to provide improved granularity regarding military chronic pain patients’ pain severity and its impacts on their job performance. Study Design: Cross-sectional analysis for 2018. Setting: This analysis utilized data available from the Defense Medical Surveillance System, a database containing longitudinal data on service members. Methods: Patients: The surveillance population consisted of all active component service members from the U.S. Army, Navy, Air Force, and Marines of all grades serving at any point during the surveillance period of January 1, 2018 through December 31, 2018. Measurement: Diagnoses were ascertained from the administrative records of all medical encounters of individuals who received care through the Military Health System or civilian referrals. Data from patients’ Periodic Health Assessment (PHA) encounters were also utilized to derive more granular data regarding their experiences of pain. Results: Case Definition 1, more specific for identifying chronic pain, identified a more severe subset of chronic pain patients when compared against Case Definition 2, a more comprehensive method for identifying potential chronic pain patients. Case Definition 1 found a higher prevalence of impactful pain (CD1: 36.7% vs. CD2: 23.5%), and Case Definition 1 patients are more likely to be on limited duty and require treatment related to their pain. Several demographic groups were also found to be at increased risk of chronic pain diagnosis, including women, black non-Hispanic, Army, older age, and enlisted. Limitations: First, in utilizing administrative data, this allows for the possibility of misclassification bias. Second, some deployment data still used ICD-9 coding even in 2018, resulting in a minor underestimation by approximately 30 patients and approximately 60 encounters. Third, the prevalence estimates for the demographics were not adjusted for potential confounders. Conclusions: Chronic pain has been difficult to define via administrative and screening data, and as such its burden and prevalence estimates can vary considerably depending on which case definition is used. This is of particular importance in the U.S. military, as these estimates can significantly impact our calculations for force readiness and the protection of our national security. To our knowledge, this study is the first of its kind to examine chronic pain across the entirety of the U.S. armed forces and to utilize granular, annually collected PHA data in this way. The results of this exploratory analysis could be used as a template to better characterize the burden of chronic pain from a populationbased perspective and monitor the effectiveness of pain management strategies. Key words: Chronic pain, military, case definition, surveillance, epidemiology

scholarly journals Prevalence of Comorbidities in Active and Reserve Service Members Pre and Post Traumatic Brain Injury, 2017-2019

2021 ◽  
Author(s):  
Tajrina Hai ◽  
Yll Agimi ◽  
Katharine Stout
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Emotional Disorders ◽  
Service Members ◽  
Data Repository ◽  
Clinical Practices ◽  
Military Health ◽  
Post Traumatic ◽  
The Military ◽  
The U.S

ABSTRACT Objective To understand the prevalence of comorbidities associated with traumatic brain injury (TBI) patients among active and reserve service members in the U.S. Military. Methods Active and reserve SMs diagnosed with an incident TBI from January 2017 to October 2019 were selected. Nineteen comorbidities associated with TBI as identified in the literature and by clinical subject matter experts were described in this article. Each patient’s medical encounters were evaluated from 6 months before to 2 years following the initial TBI diagnoses date in the Military Data Repository, if data were available. Time-to-event analyses were conducted to assess the cumulative prevalence over time of each comorbidity to the incident TBI diagnosis. Results We identified 47,299 TBI patients, of which most were mild (88.8%), followed by moderate (10.5%), severe (0.5%), and of penetrating (0.2%) TBI severity. Two years from the initial TBI diagnoses, the top five comorbidities within our cohort were cognitive disorders (51.9%), sleep disorders (45.0%), post-traumatic stress disorder (PTSD; 36.0%), emotional disorders (22.7%), and anxiety disorders (22.6%) across severity groups. Cognitive, sleep, PTSD, and emotional disorders were the top comorbidities seen within each TBI severity group. Comorbidities increased pre-TBI to post-TBI; the more severe the TBI, the greater the prevalence of associated comorbidities. Conclusion A large proportion of our TBI patients are afflicted with comorbidities, particularly post-TBI, indicating many have a complex profile. The military health system should continue tracking comorbidities associated with TBI within the U.S. Military and devise clinical practices that acknowledge the complexity of the TBI patient.

LGBT Military Service Policies in the United States

2020 ◽  
Author(s):  
Andrew Goodhart ◽  
Jami K. Taylor
Keyword(s):  
United States ◽  
Military Service ◽  
The United States ◽  
Psychological Disorder ◽  
Service Members ◽  
Transgender People ◽  
And Bisexual ◽  
Lgbt People ◽  
The Military ◽  
The U.S

For most of its history, the U.S. military has maintained a policy of exclusion toward lesbian, gay, bisexual, and transgender (LGBT) people serving in uniform. The justifications for these exclusions have included the view that being homosexual or transgender is a psychological disorder, that it undermines military morale and effectiveness, and a fear that LGBT people would be vulnerable to foreign espionage. Explicit policies banning consensual homosexual sex—and excluding from service those who engage in it—date to the period between World Wars I and II, but de facto efforts at exclusion have existed since the early days of the republic. Regulations governing homosexuals in the military came under pressure in the 1970s and 1980s as societal views toward lesbian, gay, and bisexual (LGB) people changed, and those LGB service members discharged under the policy increasingly challenged their treatment in court. (Public pressure to change regulations governing transgender people in the military arose mostly in the 2000s, though litigation efforts date to the 1970s.) In addition to general shifts in public and legal opinion, the debate over LGB people serving in the U.S. military was affected by the experience of foreign militaries that allow LGB people to serve. United States law began to loosen formal restrictions on LBG people serving in uniform with the passage of “Don’t Ask, Don’t Tell” (DADT) in 1994, but it still required LGB people to serve in secret. Changing public perceptions of LGB people and problems implementing the ban galvanized support for eliminating such restrictions. In 2010, President Obama signed legislation repealing DADT and removing all restrictions on LGB people serving in the military. However, transgender people do not enjoy the same rights. The Trump administration has revised Obama-era rules on transgender service members to enable greater exclusion. The issue is being contested in the courts and appears ripe for further political and legal dispute.

Psychological Aspects of Infertility Post-Injury

2016 ◽  
Author(s):  
Laura S. Covington
Keyword(s):  
Public Policy ◽  
Fertility Preservation ◽  
Insurance Coverage ◽  
Service Member ◽  
Service Members ◽  
Ethical Considerations ◽  
Post Injury ◽  
General Overview ◽  
Psychosocial Implications ◽  
The Military

This chapter explores how service members with injuries that damage sexual and reproductive functioning may experience the psychosocial implications of impaired fertility. It addresses a general overview of infertility and then describes the experience within the military context. Infertility can be an invisible, secondary wound that is not felt until one considers procreation and that may last for many years. Further, infertility is an injury that affects not only the service member but also his or her partner. Many ethical considerations and barriers, including limited insurance coverage and accessibility for treatment, make it difficult to access technologies for reproduction. Fertility preservation and sperm harvesting should be considered as options by service members before deployment. While advances in technologies can help injured service members to procreate, the challenges and emotional fallout are significant and need to be addressed in treatment, counseling, and public policy.

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