Military Medical Ethics Volume 1

Contents

Front Matter

Contributors
Foreword by The Surgeon General
Preface

Section I: Medical Ethics

1. The Moral Foundations of the Patient-Physician Relationship: The Essence of Medical Ethics
   Edmund D. Pelligrino
   The patient-physician relationship has evolved throughout the centuries, remaining the central basis for medical care during eras of paternalism, autonomy, and managed care.
2. Theories of Medical Ethics: The Philosophical Structure
   David C. Thomasma
   Medical ethics applies philosophical theories to clinical problems. There are competing theories, each with strengths and weaknesses, that can be used to analyze ethical issues.
3. Clinical Ethics: The Art of Medicine
   John Collins Harvey
   Clinical ethics is the practical application of ethical theory at the bedside. Ethics consultants and educators help clinicians grapple with ethical dilemmas in the patient-physician relationship. Seminal cases are discussed in an attachment to the chapter.
4. The Science Behind the Art: Empirical Research on Medical Ethics
   Daniel P. Sulmasy
   Research into the application of medical ethics uses rigorous methods of inquiry to examine the current status of thinking in the field. It describes, rather than applies, the use of ethical analysis in actual situations, including those unique to the military.

Section II: Military Ethics

5. The Profession of Arms and the Officer Corps
   Anthony E. Hartle
   The professional ethic for the American military has strong roots in history and provides a rich tradition and basis for right action in the pluralistic culture in society today.
6. Honor, Combat Ethics, and Military Culture
   Faris R. Kirkland
   Honor, one of the core values in military service, should be reciprocal between superiors and subordinates. Ethical leadership is an essential responsibility of those entrusted to command soldiers in combat.
7. The Military and Its Relationship to the Society It Serves
   Nicholas G. Fotion
   There are several models describing the relationship between the military and the society it serves that reflect the tension between a closed military culture and one more similar to, or even identical to, the civilian culture.
8. Just War Doctrine and the International Law of War
   William V. O`Brien and Anthony C. Arend
   Decisions to resort to war and how to conduct a war have been analyzed using moral theory. International laws of war and international conventions attempt to codify moral and legal restraints on these decisions.
9. The Soldier and Autonomy
   Sandra L. Visser
   The Military mission requires significant individual sacrifices from the soldier, including some of his autonomy. Appropriately balancing individual liberty with the needs of the military requires rigorous ethical analysis and justification.

Section III: The Synthesis of Medicine and the Military

10. Physician-Soldier: A Moral Profession
    William Madden and Brian S. Carter
    The profession of medicine may appear to have opposite goals from the profession of arms, in that one involves healing and the other killing. In reality, however, the professions and their goals are remarkably similar and morally can be combined.
11. Physician-Soldier: A Moral Dilemma?
    Victor W. Sidel and Barry Levy
    In contradistinction to the previous chapter, these authors contend that conflicts arising between the ethos of both professions make it morally impossible for physicians to serve in the military. Response to the chapter by Edmund G. Howe, MD, JD and Dominic R. Rascona, MD
12. Mixed Agency in Military Medicine: Ethical Roles in Conflict
    Edmund G. Howe
    Mixed agency involves the conflict between duties to the individual patient and those to the military. Ethical analysis can be applied to resolving this conflict and, by so doing, emotional distress to the physician can be minimized.

Back Matter

Abbreviations and Acronyms
Index

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