scholarly journals Medical Ethics for the Military Profession

2021 ◽  
Vol 19 (36) ◽  
pp. 851-866
Author(s):  
Martin Bricknell ◽  
Marina Miron
Keyword(s):  
Medical Ethics ◽  
Ethical Issues ◽  
Military Force ◽  
Military Leaders ◽  
Dual Loyalty ◽  
Core Concepts ◽  
Military Profession ◽  
Legal Frameworks ◽  
Military Medical Ethics ◽  
The Military

This paper summarizes medical ethics in the military profession to raise military leaders’ awareness of Military Medical Ethics (MME) and the ethical issues that may impact their medical services and personnel. First, it summarizes core concepts, including the four principles of medical ethics (autonomy, beneficence, non-maleficence, and justice), the two legal frameworks for the use of military force in war, jus ad bellum and jus in bello, and the concept of dual loyalty. It then examines MME issues during conflict, in garrison healthcare, and during the COVID-19 epidemic. Finally, it concludes by arguing that MME is an important domain of military ethics that should be taught to military leaders to complement the detailed education of MME for military medical professionals.

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.

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

2010 ◽  
Vol 19 (4) ◽  
pp. 458-464 ◽  
Author(s):  
MICHAEL L. GROSS
Keyword(s):  
Medical Ethics ◽  
Assisted Suicide ◽  
Dual Loyalty ◽  
Core Subjects ◽  
Life Issues ◽  
End Of Life Issues ◽  
Military Medical Ethics ◽  
Short Courses ◽  
The Military ◽  
Military Physicians

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.

Are Military and Medical Ethics Necessarily Incompatible? A Canadian Case Study

2016 ◽  
Vol 44 (4) ◽  
pp. 639-651 ◽  
Author(s):  
Christiane Rochon ◽  
Bryn Williams-Jones
Keyword(s):  
Medical Ethics ◽  
Code Of Ethics ◽  
Armed Forces ◽  
Codes Of Ethics ◽  
Core Values ◽  
Dual Loyalty ◽  
Canadian Armed Forces ◽  
Military Institution ◽  
The Military ◽  
Military Physicians

Military physicians are often perceived to be in a position of ‘dual loyalty’ because they have responsibilities towards their patients but also towards their employer, the military institution. Further, they have to ascribe to and are bound by two distinct codes of ethics (i.e., medical and military), each with its own set of values and duties, that could at first glance be considered to be very different or even incompatible. How, then, can military physicians reconcile these two codes of ethics and their distinct professional/institutional values, and assume their responsibilities towards both their patients and the military institution? To clarify this situation, and to show how such a reconciliation might be possible, we compared the history and content of two national professional codes of ethics: the Defence Ethics of the Canadian Armed Forces and the Code of Ethics of the Canadian Medical Association. Interestingly, even if the medical code is more focused on duties and responsibility while the military code is more focused on core values and is supported by a comprehensive ethical training program, they also have many elements in common. Further, both are based on the same core values of loyalty and integrity, and they are broad in scope but are relatively flexible in application. While there are still important sources of tension between and limits within these two codes of ethics, there are fewer differences than may appear at first glance because the core values and principles of military and medical ethics are not so different.

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.

U.S. Medical Students' Knowledge about the Military Draft, the Geneva Conventions, and Military Medical Ethics

2007 ◽  
Vol 37 (4) ◽  
pp. 643-650 ◽  
Author(s):  
J. Wesley Boyd ◽  
David U. Himmelstein ◽  
Karen Lasser ◽  
Danny McCormick ◽  
David H. Bor ◽  
...  
Keyword(s):  
Medical Students ◽  
Medical Ethics ◽  
Medical Personnel ◽  
Medical Schools ◽  
Geneva Conventions ◽  
Military Medical Ethics ◽  
Military Draft ◽  
The Military ◽  
E Mail

The objective of this study was to ascertain how much U.S. medical students are taught about and know about military medical ethics, the Geneva Conventions, and the laws governing conscription of medical personnel. The authors developed an Internet-based questionnaire on these matters, and e-mail invitations to participate were sent to approximately 5,000 medical students at eight U.S. medical schools. Thirty-five percent of e-mail recipients participated in the survey. Of those, 94 percent had received less than one hour of instruction about military medical ethics and only 3.5 percent were aware of legislation already passed making a “doctor's draft” possible; 37 percent knew the conditions under which the Geneva Conventions apply; 33.8 percent did not know that the Geneva Conventions state that physicians should “treat the sickest first, regardless of nationality;” 37 percent did not know that the Geneva Conventions prohibit ever threatening or demeaning prisoners or depriving them of food or water; and 33.9 percent could not state when they would be required to disobey an unethical order.

scholarly journals Thematic Analysis of Military Medical Ethics Publications From 2000 to 2020—A Bibliometric Approach

2021 ◽  
Author(s):  
Zachary Bailey ◽  
Peter Mahoney ◽  
Marina Miron ◽  
Martin Bricknell
Keyword(s):  
Mental Health ◽  
Medical Ethics ◽  
Health Personnel ◽  
Relative Proportion ◽  
Analysis Tool ◽  
Military Operations ◽  
Mental Health Patient ◽  
Military Health ◽  
Dual Loyalty ◽  
Military Medical Ethics

ABSTRACT Introduction There has been external criticism of the compliance of military health personnel with internationally agreed principles in military medical ethics (MME). In response, a number of authors have called for clarity on the principles and topics within the domain of MME. This complements an increased acknowledgment of the need for education in MME for military health personnel. Our paper utilizes bibliometric techniques to identify key themes in MME to inform the development of a curriculum for this subject. Materials and Methods We designed a search strategy to find publications over the period January 1, 2000-December 31, 2020 in the domain of MME from the three databases, PubMed, Web of Science, and Scopus, using the search string (ethic* OR bioethics* OR moral*) AND military AND (medic* OR health*). We obtained a total of 1,115 publications after duplication removal. After exclusion based on topic, year, and study design, we analyzed a total of 633 publications using Scopus’s embedded analysis tool and the software VOSViewer. We generated a co-occurrence word map from the abstracts of each of the publications. We deduced themes of MME based on the clusters shown in the word map, and we categorized each publication into one of these themes to analyze the change of themes over time. Results We observed a 10-fold increase in annual publications on MME between 2000 and 2020. The majority of papers were written by U.S. (72%) and UK (13%) authors, although a total of 15 countries were represented. After using VOSViewer to identify co-occurring keywords in titles and abstracts from these publications, nine themes were identified: biomedical research, care to detained populations, disaster/triage, mental health, patient-focused foundations, technology, dual loyalty, education/training, and frameworks. The relative proportion of each of these themes changed over the study period, with mental health being dominant by the end. Conclusions This study has identified key themes that might inform the development of a curriculum for teaching MME. It is noticeable that the majority of themes cover MME from the perspective of professional practice on military operations; noting, the research and technology themes also pertain to the generation of knowledge for military operations. There were a limited number of publications covering practice in the non-deployed or garrison settings, and these were codified under the themes of “framework” and “dual loyalty”. The results are skewed toward English-speaking countries and exclude non-academic publications. Further work will search for other open-source information and non-English publications. To our knowledge, this exploratory bibliometric analysis on MME in the academic literature is the first of its kind. This article has demonstrated the use of bibliometric techniques to evaluate the evolution of knowledge in MME, including the identification of key themes. These will be used to support further work to develop a curriculum for the teaching of MME to military medical audiences.

Fault Lines of the American Military Profession

2017 ◽  
Vol 44 (3) ◽  
pp. 521-543 ◽  
Author(s):  
Thomas Crosbie ◽  
Meredith Kleykamp
Keyword(s):  
Large Scale ◽  
Future Research ◽  
Military Leaders ◽  
American Military ◽  
The Past ◽  
Fault Lines ◽  
Military Profession ◽  
Social Scientific ◽  
Armed Services ◽  
The Military

Over the past decade, the American armed services have witnessed a near-constant stream of so-called ethical lapses. Spanning rank, specialty, and service, these “lapses” have given rise to a flood of criticism by journalists and piercing calls for reform from politicians. In response, American military leaders have pointed to the paired concepts of profession and professionalism as the solution. In this article, we use classical conceptualizations of the military profession to resituate the problem of ethical lapses as instead one of the three fault lines of the contemporary American military profession, unfolding alongside crises in military expertise and identity. The three fault lines reveal at once the large scale of the challenges facing the American armed services and our very limited social scientific understanding of those problems. We end by emphasizing the need for future research to establish an updated empirical baseline for theories of the military profession in America.

Healthcare on the Battlefield

2013 ◽  
Vol 4 (2) ◽  
pp. 197-219 ◽  
Author(s):  
Brigit Toebes
Keyword(s):  
Medical Ethics ◽  
Armed Forces ◽  
Medical Personnel ◽  
Armed Conflicts ◽  
Humanitarian Law ◽  
Human Right ◽  
Dual Loyalty ◽  
Medical Neutrality ◽  
Face Complex ◽  
The Military

During armed conflicts healthcare workers or medical personnel often work under extremely difficult and dangerous circumstances. In such situations doctors and nurses, hospitals and medical units are at a serious risk of being attacked. Medical personnel also face complex ethical dilemmas when it comes to the treatment of patients from all sides of a conflict. This concerns military medical personnel in particular: as members of the armed forces, they face dilemmas of ‘dual loyalty’ where they may have to choose between the interests of their employer (the military) and the interests of their patients. This contribution looks at these issues from the perspectives of medical ethics, international humanitarian law (ihl), and human rights law (hrl). The article argues that the standards of medical ethics continue to apply during armed conflicts, and that during such situations medical ethics, ihl and hrl are mutually reinforcing. The principle of ‘medical neutrality’ and the human ‘right to health’ are positioned as key norms in this field. The article presents a normative framework for the delivery of health care on the battlefield in the form of a set of commitments for actors involved in the conflict, including the belligerent parties and (military) medical personnel.

scholarly journals Dual loyalty in military medical ethics: a moral dilemma or a test of integrity?

2018 ◽  
Vol 165 (4) ◽  
pp. 282-283
Author(s):  
Peter Olsthoorn
Keyword(s):  
Medical Ethics ◽  
Patient Care ◽  
Professional Ethics ◽  
Moral Dilemma ◽  
Armed Forces ◽  
Medical Personnel ◽  
Dual Loyalty ◽  
A Value ◽  
Military Medical Ethics

When militaries mention loyalty as a value they mean loyalty to colleagues and the organisation. Loyalty to principle, the type of loyalty that has a wider scope, plays hardly a role in the ethics of most armed forces. Where military codes, oaths and values are about the organisation and colleagues, medical ethics is about providing patient care impartially. Being subject to two diverging professional ethics can leave military medical personnel torn between the wish to act loyally towards colleagues, and the demands of a more outward looking ethic. This tension constitutes a test of integrity, not a moral dilemma.

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