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Ethics of Multiculturalism in Military Medicine


A Brief Discussion of Military Medical Ethics

According to Victor W. Sidel and Barry S. Levy, in a chapter written for the Borden Institute's Military Ethics textbook, the "physician-soldier" is a "moral impossibility." To their point of view, medicine and the military are at cross-purposes -- they have different goals. "Concern for the welfare of the patient" and "concern for the effective function of the fighting force" cannot be equal masters. One must take precedence.

However, the editors of the same textbook disagree, writing that it should be "physician first, officer second," and that there aren't usually conflicts between medical ethics and military necessity. (They aren't entirely clear about what to do when there are.)

The Borden Institute, part of the U.S. Army Medical Department Center and School, publishes textbooks on military medicine that cover everything from combat injuries to military preventive medicine. Two whole volumes cover military medical ethics, which says something about how difficult it is to define black and white.

Say we have a soldier with a life-threatening wound and one with gonorrhea. Both need penicillin. We have only one dose.

A physician would choose the patient in most critical medical need. An officer would choose the patient who could get back out on the field more quickly.

The latter is what happened with U.S. troops during the North African campaign in World War II [source: Annas]. It's an example of military triage, and that mode of thinking is, arguably, incompatible with a physician's.

In the United States' current military conflicts, the debate has intensified. Military physicians force-feed hunger strikers at Guantanamo, which the AMA and the World Medical Association (WMA) both consider to be unethical [source: Annas]. Requiring military doctors to OK prisoners for interrogation and punishment is also against international standards of human rights.

The counterpoint to this is that war calls for desperate measures, and that in some circumstances, when the rights of one person are held up against what the military considers "the good of the country," the individual will, and should, lose.

But ethics doesn't cover just dark topics like torture. What else falls under the mantle of a physician's ethical responsibilities?


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