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Caring for Compatriots: Military Necessity before Medical Need
Gross, Michael L.Gross
Gross, Michael L.Gross
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What is behind the assertion that medical ethics does not change in times of armed conflict? One answer may be the universality of the principles of medical ethics. Norms such as the duty to do no harm, to provide impartial care to the sick and injured, and to respect a patient’s dignity, autonomy, and privacy should not vary according to circumstances. Thus the ethics of psychiatric, neonatal, pediatric or geriatric medicine, for example, are all the same. The circumstances vary, as do the conditions of the patient, but the ethics of medical care remain constant. One is tempted, like the WMA, to draw the same conclusions about military medical ethics and to see service personnel as simply another kind of patient. During peacetime this is true. In many countries, service personnel and their families receive medical care from military medical organizations in the same way that nonmilitary civilians receive their care from the national health care system. And, in many cases, facilities overlap, particularly when government hospitals provide care to military and civilian patients alike. In these circumstances, the principles of medical ethics apply equally. Each patient, whether military or civilian, is treated in accordance with the principle of medical necessity that mandates that care be provided on the basis of a national plan that balances lifesaving care with quality-of-life care. To act otherwise would invite charges of bias and partiality. However, the situation changes dramatically during wartime, particulary on the battlefield where the principle of military necessity may conflict with and sometimes overwhelm the principle of medical necessity. In the sections below, I will first discuss the principle of military necessity and then explain how it affects patient care and patient rights during wartime.
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2015
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With permission of the license/copyright holder