Military Medical Ethics Volume 2

Contents

Front Matter

Contributors
Foreword by The Surgeon General
Preface

Section IV: Medical Ethics in the Military

13. Medical Ethics on the Battlefield: The Crucible of Military Medical Ethics
    Thomas E. Beam, MD
    The battlefield is perhaps the most difficult of all environments in which to practice medicine. Pressures from the threat of enemy attack as well as unique issues, such as returning soldier/patients to duty, triage or even euthanasia on the battlefield, and physician participation in interrogation of prisoners of war, require agonizing choices.
14. Nazi Medical Ethics: Ordinary Doctors?
    Robert N. Proctor, PhD
    Medicine under the Nazi regime flourished and physicians participated, not as pawns but as pioneers, in the horrors of genocide and unethical experimentation. The reasons for this are varied and have many factors, but do not lessen the terror of physicians killing and torturing patients.
15. Nazi Hypothermia Research: Should the Data Be Used?
    Robert S. Pozos, PhD
    One of the better known examples of unethical research under the Nazi regime is that of the hypothermia experiments on prisoners. A recurring question remains as to whether or not the data represent good science and if so, whether or not to use these data.
16. Japanese Biomedical Experimentation During the World War II Era
    Sheldon H. Harris, PhD
    The Japanese experiments in China during World War II are perhaps less well known that those of the Nazi physicians, but equal them in scope and in harm to their victims. However, there was no Japanese equivalent to the Nuremberg physician`s trial. This raises obvious questions with very interesting implications.
17. The Cold War and Beyond: Covert and Deceptive American Medical Experimentation
    Susan E. Lederer, PhD
    Examination of the history of experimentation in America before, during, and after World War II provides an opportunity to review unethical research in a democratic society so that one can learn and possibly prevent their ever occurring again.
18. Medical Ethics in Military Biomedical Research
    Michael E. Frisina, MA
    The very concept of biomedical research in the military raises ethical questions. However, it is possible to obtain good data while adhering to principals of research ethics.
19. The Human Volunteer in Military Biomedical Research
    Paul J. Amoroso, MD and Lynn L. Wenger, MSBA
    Human subject research within the military raises unique issues, including concerns for coercion, adequacy of informed consent, and use of epidemiologic data obtained for different purposes. There are more stringent regulations in place within the military than in the civilian sector to safeguard against potential violations of human subject research ethics.
20. Nursing Ethics and the Military
    Janet R. Southby, RN, DNSc
    Ethics in nursing has a rich history, one which the military has helped developed. Ethics as viewed by nurses is complementary to that of physicians.
21. Religious and Cultural Considerations in Military Healthcare
    David M. DeDonato, MDiv, MA, BCC and Rick D. Mathis, JD, MDiv, MA
    Religion and cultural practices are extremely important to medicine in the military due to frequent opportunities for interaction with other cultures. the study of views of wellness and illness can assist health care professionals address conflicts arising from religious and cultural differences.
22. Societal Influences and the Ethics of Military Healthcare
    Jay Stanley, PhD
    In a civilian controlled military, societal influences are a major factor in military medicine and its ethics.
23. Military Medicine in War: The Geneva Conventions Today
    Lewis C. Vollmar, Jr., MD, MBA, MA (Law)
    The Geneva Conventions, as they pertain to medical personnel and their patients, provide specific reciprocal privileges and obligations. They exist to attempt to ensure safety and an appropriate level of care for those sick, wounded, or captured.
24. Military Medicine in Humanitarian Missions
    Joan T. Zajtchuk, MD, Spec in HSA
    Examining the history of military medicine in humanitarian missions provides an understanding of its changing role. Lessons learned from past efforts can help develop effective programs in the future.
25. Military Humanitarian Assistance, The Pitfalls and Promise of Good Intentions
    Elspeth Cameron Ritchie, MD and Robert L. Mott, MD, MPH
    Peacetime engagement projects and conflict-related contingency operations require different methods of planning and execution. Mistakes made in past missions highlight some of the problems associated with well-intentioned efforts. There are also unique stresses experienced by healthcare professionals working in these environments.
26. A Look Toward the Future
    Thomas E. Beam, MD and Edmund G. Howe, MD, JD
    Technological advances currently being considered provide an opportunity to develop a method for ethical analysis of those in the future. Compensatory justice may require earlier introduction of some of these lifesaving technologies within the military.
27. A Proposed Ethic for Military Medicine
    Thomas E. Beam, MD and Edmund G. Howe, MD, JD
    A possible military medical ethic could include concepts of acting primarily as a physician in almost all circumstances, voluntarily limiting the exercises of power, and advancing the concept of compensatory justice. Exceptions of these general precepts need careful analysis and justification.

Back Matter

Afterword
Abbreviations and Acronyms
Index

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