Intended for healthcare professionals

Editorials Christmas 2016

Medicine under fire

BMJ 2016; 355 doi: (Published 14 December 2016) Cite this as: BMJ 2016;355:i6464
  1. Julian Sheather, specialist adviser (ethics and human rights)1,
  2. Vickie Hawkins, executive director2
  1. 1BMA
  2. 2Médecins Sans Frontières UK
  1. JSheather{at}

Even in war there are moral boundaries—they must be strengthened

After the gunship had gone, Lajos Joltan Zecs fought his way back into the burning hospital. In what remained of the intensive care unit, six patients were burning in their beds. Zecs is a nurse. He was working at the Médecins Sans Frontières (MSF) trauma facility in Kunduz, Afghanistan. These were his patients. Colleagues were also killed. “Our pharmacist—I was just talking to him last night and planning the stocks, and then he died there in our office.”1 2

An internal investigation by the US described the targeting of the Kunduz facility as the result of “human error.” But for anyone involved in humanitarian medicine, two things stand out from the conflicts that have disfigured the world in recent years: the casting aside of moral boundaries; and its subsequent normalisation.

There is a shorthand for the moral boundaries that restrict indiscriminate force: international humanitarian law, principally the Geneva conventions.3 …

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