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Education And Debate

Abhorrent weapons and “superfluous injury or unnecessary suffering”: from field surgery to law

BMJ 1997; 315 doi: (Published 29 November 1997) Cite this as: BMJ 1997;315:1450
  1. Robin M Coupland, surgeona
  1. a Health Operations Division, International Committee of the Red Cross, 1202 Geneva, Switzerland

    Weapons: a surgeon's view

    Buried or “point detonating” antipersonnel mines are the only conventional weapons which cause specific and severe injury resulting in specific and permanent disability. The treatment of the injury requires, on average, twice as many operations and four times as many blood transfusions as injury from other weapons. This is a surgeon's view.

    Summary points

    Antipersonnel mines are an example of weapons that cause more injury than is necessary militarily to disable a soldier

    The Geneva Conventions prohibit the use of weapons that cause “superfluous injury or unnecessary suffering”

    The SirUS project, run by the International Committee of the Red Cross, uses the nature of the injury it causes to deem a weapon illegal

    Individual doctors and medical organisations are asked to endorse the SIrUS project

    There was no particular point at which I became interested in the global problem of antipersonnel mines: I was just confronted with people injured by mines. From 1987 to 1991 I worked in hospitals set up by the International Committee of the Red Cross on the borders of Afghanistan and Cambodia, two of the most heavily mined countries in the world. During those last years of the cold war the full extent of the impact of mines on whole societies was yet unknown. New international legislation to ban the devices was not being discussed; I simply found myself dreading the radio call announcing that another mine injured person was on his or her way to hospital. The dread was generated by the knowledge that my team would be faced with a long and difficult operation which entailed excising large amounts of damaged tissue or amputating a limb. This quickly turned into abhorrence for the weapons which caused such injury as a function of their design. In brief, my own reason for finding these weapons abhorrent was the …

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