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'Do no harm' vs 'legitimate use of force'

Universite de Montreal News Mar 23, 2017

Should a military doctor obey an order to not treat an enemy combatant? Or certify a sick soldier as fit to fight? Should a nurse take part in interrogations? Ride along on medical caravans to build trust with locals? Violate patient privacy for military ends? These and other questions are being studied by Canadian researchers with the Ethics in Military Medicine Research Group, led by UdeM bioethicist Bryn Williams–Jones with colleagues at McGill and McMaster universities.

Their latest paper, published in December in the winter issue of The Journal of Law, Medicine & Ethics, compares the ethics codes of the Canadian Medical Association and the Department of National Defence and the Canadian Armed Forces. At issue: the ongoing debate over the "dual loyalty" of military healthcare professionals' and whether the two codes – civilian and military – are "necessarily incompatible."

"To put it bluntly, how can the military profession, whose mission of defending state interests can involve the use of deadly force, be compatible with the medical profession whose primary mission is to heal and save lives?" asks lead author Christiane Rochon. Her conclusion, with co–author Williams–Jones, her PhD thesis supervisor: The two codes are not mutually exclusive. In fact, they support each other, with the military one turning out to be even more comprehensive than the medical profession's.

The researchers studied the issue for three years, interviewing over 50 Canadian military health professionals – physicians, nurses, physiotherapists, medical technicians, almost all of them high–ranking officers. "We wanted to understand the perspectives of health professionals working in a range of very challenging environments, from combat missions to humanitarian and peacekeeping missions," Williams–Jones told UdeM Nouvelles.

"They have a lot of tools to help them think through the ethical challenges they face, but those tools are not specifically adapted to their role as health professionals. As non–combatants they face different sorts of challenges." For instance, what is a military physician to do if asked by a commanding officer not to provide care to an enemy combatant? The easy answer: Obey medical ethics codes and international humanitarian law and treat the enemy; health care is a human right.
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