Editorials

"Non-lethal" weapons: precipitating a new arms race

Armies are purported to have already deployed dazzling devices, calmatives, entangling agents, adhesives ("stickums"), material that makes any surface too slippery to walk on ("slickums"), devices generating infrasound or electromagnetic waves, and devices for riot control.^{1 2} Other possible devices are sprays to weaken vehicle or plane parts, electromagnetic beams to confuse computers, and bacteria to degrade fuel. The term applied to this new generation of military technology is "non-lethal" weapons; it implies that military operations can avoid death and serious injury. Should not the medical profession rejoice?

Let us first examine the terminology. A "weapon" is something that is designed to cause bodily harm; technologies designed specifically to damage inanimate objects should not be considered in the same context.¹ "Non-lethal" implies zero fatalities, but such an objective is acknowledged to be unrealistic, giving rise to alternative phrases such as "less than lethal" or "sub-lethal."¹ These terms carry the further implication that conventional antipersonnel weapons are "lethal." However, rifles and fragmentation weapons kill (only) 20-25% of the casualties.^{3 4 5} A buried antipersonnel mine containing 30 grams of explosive is designed to blow off or disrupt the foot; few victims die from this injury if treatment is available. Does this make it a "non-lethal" weapon? Eye attack laser weapons and other "optical munitions" have been produced in line with the "non-lethal" concept, supported by the argument that it is better to blind enemy soldiers than to kill them. The euphemisms and political correctness that surround the moral, legal, media, and tactical aspects of warfare of the future are complex and bizarre.

Before making military surgeons redundant, we must also examine the intended effects of "non-lethal" weapons on humans. Such an examination is not reassuring.^{2 6} The purpose is to "disable." This sounds better than inflicting disability and does not immediately beg the difficult question of how long the person will be disabled for. Will blinding be permanent? Will the various energy forms that target the function of the central nervous system leave the victim with permanent neurophysiological effect? Can entangling agents asphyxiate? Will a "calmative" agent only calm? If it is established what energy output or concentration is non-lethal or temporary, you have also discovered what is lethal or permanent. Likewise, since the only difference between a poison and a drug is the dose, do military planners really believe that they can control the "dose" on a battlefield? In brief, will these new weapons have a switch giving the operator a choice between non-lethal and lethal? Rather than sutured wounds, skin grafts, or amputations, will the soldiers who have survived battlefields of the future return home with psychoses, epilepsy, and blindness inflicted by weapons designed to do exactly that? Should not these questions be considered before such weapons are deployed?

The precise effects of each of these new weapons are unknown, in particular to civilian doctors. How will the "wounded" of future wars be treated? In addition, "non-lethal" weapons will always be backed up by or used in conjunction with conventional weapons.¹ This may mean that the lethality of conventional weapons is potentiated and that doctors may have to treat people suffering from the effects of both conventional and new weapons.

There is also a fundamental ethical dilemma for doctors. The development of this new generation of weapons incorporates knowledge from the remarkable advances made in medical science; two examples are calmatives and eye attack lasers.^{2 7 8} The ultimate expression of this dilemma is the potential development of race specific weapons based on knowledge of genetic engineering and human genome diversity. This can no longer be regarded as science fiction.^{9 10} The medical profession must guard against use of its knowledge for the purposes of weapon development. Also, will the development of this kind of weapon by the "haves" be perceived in only tactical terms by the "have nots" so precipitating a new form of arms race? If so, the focus of research and development will not be confined to "non-lethal" aspects of this technology.^{1 2}

Governments have given serious consideration to at least one such "non-lethal" weapon system. Blinding laser weapons were prohibited at a United Nations conference in 1995. The abhorrent notion of the effects of this kind of weapon—intentional blinding—contributed to this decision.^{8 11 12} However, there is no specific international treaty that covers other new weapons. Is it not the responsibility of doctors to recommend some kind of proactive control based on a comparison between the known effects of conventional weapons and the purported effects of new weapons?⁵ The public may be seduced by the term "non-lethal." There are reasons why the medical profession should not be.

Robin M Coupland, Surgeon ^a

^a Division of Health Operations, International Committee of the Red Cross, CH-1202 Geneva, Switzerland

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7. International Committee of the Red Cross. The medical profession and the effects of weapons: the symposium. Geneva: International Committee of the Red Cross, 1996.
8. Weapons intended to blind [editorial]. Lancet 1994;344:1649-50. [Medline]
9. Pearson GS, Dando MR. Strengthening the biological weapons convention. Geneva: Quaker United Nations Office, 1996.
10. Gene warfare—unless we keep our guard up [editorial]. Lancet 1996;348:1183. [Medline]
11. Doswald Beck L, ed. Blinding weapons. Geneva: International Committee of the Red Cross, 1993.
12. Coupland RM. The effects of weapons on health. Lancet 1996;347: 450-1.