Chapter 3

Moral Reasoning in Military Medical Ethics

The turn from principles to practice is dynamic. The previous chapters outlined a theory of military medical ethics and patient rights that draw from two major norms of political theory, sovereignty and human rights, subsidiary principles of just war theory anchored in the just ends and means of war, together with such justificatory conditions as necessity and proportionality. Military medicine provides medical care to serve the greater ends of just war (broad beneficence) by effective, proportionate and necessary means (military-medical necessity). With principles tentatively in place, the next question is, “How do they work in practice?”

A Sample Case: What would you do? And why?

You are the GDMO (General Duties Medical Officer) detached to a Forward Operating Base (FOB). One of your soldiers was close to an explosion. Although he was not physically injured, he complains of deafness and tinnitus in both ears. He is the unit's only Unmanned Aerial Vehicle (UAV) pilot. He is seen at Camp Bastion where he had an audiogram which shows his hearing is below deployable standard and indicates his return to the UK. The CO of the FOB needs the soldier to stay at the FOB as he is "so essential and losing him may cost lives". He may still have to go out on patrol. The CO is adamant about this, and is getting very angry at the prospect of losing him. As a GDMO you recommend... (from: Coetzee, Simpson and Sharpley 2010).

What does military-medical necessity demand?

What do patient rights demand?