Intended for healthcare professionals

Observations Ethics Man

The medical ethics of the battlefield

BMJ 2011; 343 doi: https://doi.org/10.1136/bmj.d3877 (Published 20 July 2011) Cite this as: BMJ 2011;343:d3877

Is battlefield ethics an oxymoron?

The predominant aim in the battlefield is to kill, maim and conquer.
So the 'normal rules' are suspended for the combatants. Peacetime ethics
is a luxury for those combatants under mortal danger (1). The loss of US
troops in Afghanistan over the weekend reinforces the point that trying to
rescue colleagues in a battlefield is fraught with danger (2).

Evolution has hardwired the Human mind for a 'Fight or flight
reaction' at times of imminent or perceived danger. Ethics and morality,
probably a higher brain function, is an unlikely option in face of danger.
(3)(4).

The ethics of initiating a war and its effects on civilians is
altogether a different matter. (Is it to save people from tyranny or is it
an oil grab?).

Boosting the morale of the troops is more related to having an
'efficient killing squad' and ethical issues are probably quite peripheral
to it.

The use of a vaccination programme involving non-combatant minors to
ensnare Osama bin laden is a pertinent case for ethical arguments. Do ends
justify means? One might even argue that making the world a safer place
is also in the interests of those 'violated' minors. (5).

References:
1. Sokol D. The medical ethics of the battlefield.BMJ 2011; 343:d3877 doi:
10.1136/bmj.d3877 (Published 20 July 2011)

2. US helicopter shot down in Afghanistan was sent in after night
raid went awry. http://www.guardian.co.uk/world/2011/aug/08/us-helicopter-
afghanistan-night-raid

3. Young L et al. Disruption of the right temporo-parietal junction
with transcranial magnetic stimulation reduces the role of beliefs in
moral judgments.
http://www.pnas.org/content/early/2010/03/11/0914826107.full.pdf+html

4. Lehrer J . Free Will and Ethics
http://scienceblogs.com/cortex/2009/12/free_will_and_ethics_1.php

5. Lenzer J. Fake vaccine campaign in Pakistan could threaten plans
to eradicate polio .BMJ 2011;343:doi:10.1136/bmj.d4580 (Published 19 July
2011)

Competing interests: No competing interests

10 August 2011
S Sundar
Consultant Oncologist
Nottingham University Hospital NHS trust