Dual loyalties exist in many medical fields, from occupational health to public health. Military health professionals, as all health professionals, are ethically responsible for their patients' well-being. In some situations, however, military health professionals can face unique ethical tensions between responsibilities to individual patients and responsibilities to military operations. This book summarizes the one-day workshop, Military Medical Ethics: Issues Regarding Dual Loyalties, which brought together academic, military, human rights, and health professionals to discuss these ethical challenges. The workshop examined two case studies: decisions regarding returning a servicemember to duty after a closed head injury, and decisions on actions by health professionals regarding a hunger strike by detainees. The workshop also addressed the need for improvements in medical ethics training and outlined steps for organizations to take in supporting better ethical awareness and use of ethical standards.

"The goal of military medicine is to conserve the fighting force necessary to prosecute just wars. Just wars are defensive or humanitarian. A defensive war protects one's people or nation. A humanitarian war rescues a foreign, persecuted people or nation from grave human rights abuse. To provide medical care during armed conflict, military medical ethics supplements civilian medical ethics with two principles: military-medical necessity and broad beneficence. Military-medical necessity designates the medical means required to pursue national self-defense or humanitarian intervention. While clinical-medical necessity directs care to satisfy urgent medical needs, military-medical necessity utilizes medical care to satisfy the just aims of war. Military medicine may therefore attend the lightly wounded before the critically wounded or use medical care to win hearts and minds. The underlying principle is broad, not narrow, beneficence. The latter addresses private interests, while broad beneficence responds to the collective welfare of the political community"--

As asymmetric ‘wars among the people’ replace state-on-state wars in modern armed conflict, the growing role of military medicine and medical technology in contemporary war fighting has brought an urgent need to critically reassess the theory and practice of military medical ethics. Military Medical Ethics for the 21st Century is the first full length, broad-based treatment of this important subject. Written by an international team of practitioners and academics, this book provides interdisciplinary insights into the major issues facing military-medical decision makers and critically examines the tensions and dilemmas inherent in the military and medical professions. In this book the authors explore the practice of battlefield bioethics, medical neutrality and treatment of the wounded, enhancement technologies for war fighters, the potential risks of dual-use biotechnologies, patient rights for active duty personnel, military medical research and military medical ethics education in the 21st Century.

2 volumes, sold as a set. Textbooks of Military Medicine. Section editors Edmund D. Pelegrino, Anthony E. Hartle, and Edmund G. Howe, et al. Addresses medical ethics within a military context.

Is medical ethics in times of armed conflict identical to medical ethics in times of peace, as the World Medical Association declares? In Bioethics and Armed Conflict, the first comprehensive study of medical ethics in conventional, unconventional, and low-intensity war, Michael Gross examines the dilemmas that arise when bioethical principles clash with military necessity—when physicians try to save lives during an endeavor dedicated to taking them—and describes both the conflicts and congruencies of military and medical ethics. Gross describes how the principles of contemporary just war, unlike those of medical ethics, often go beyond the welfare of the individual to consider the collective interests of combatants and noncombatants and the general interests of the state. Military necessity plays havoc with such patients' rights as the right to life, the right to medical care, informed consent, confidentiality, and the right to die. The principles of triage in battle conditions dictate not need-based treatment but the distribution of resources that will return the greatest number of soldiers to active duty. And unconventional warfare, including current "wars" on terrorism, challenges the traditional concept of medical neutrality as physicians who have sworn to "do no harm" are called upon to lend their expertise to "interrogational" torture or to the development of biological or chemical weapons. Difficult dilemmas inevitably arise during armed conflict, and medicine, Gross concludes, is not above the fray. Medical ethics in time of war cannot be identical to medical ethics in peacetime.