Dual loyalty among military health professionals: Human rights and ethics in times of armed conflict

Cambridge Quarterly of Healthcare Ethics

Volumn 15, Issue 4, 2006, Pages 381-391

  London, Leslie ^a   Rubenstetn, Leonard S ^a   Baldwin Ragaven, Laurel ^a   Van Adriaan, E S ^a  

^a NONE

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CONFLICT; CONFLICT OF INTEREST; ETHICS; HUMAN; HUMAN RIGHTS ABUSE; MEDICAL ETHICS; MILITARY MEDICINE; PERSONNEL MANAGEMENT; PRACTICE GUIDELINE; SOLDIER; TORTURE; WAR;

CONFLICT (PSYCHOLOGY); CONFLICT OF INTEREST; ETHICS, MEDICAL; GUIDELINES; GUIDELINES AS TOPIC; HUMAN RIGHTS ABUSES; HUMANS; MILITARY MEDICINE; MILITARY PERSONNEL; PERSONNEL LOYALTY; TORTURE; WAR;

EID: 33749340359     PISSN: 09631801     EISSN: 14692147     Source Type: Journal    
DOI: 10.1017/S096318010606049X     Document Type: Article

References (69)

1. Howe EG. Point/Counterpoint - A response to Drs Sidel and Levy (Physician-Soldier: A Moral Dilemma). In: Beam TE, Spradno LR, eds. Military Medical Ethics, Volume 1. Falls Church, Va.: Office of the Surgeon General; 2003:312-20 at p. 320.
2. Sidel VW, Levy BS. Physician-Soldier: A Moral Dilemma. In: Beam TE, Spracino LR, eds. Military Medical Ethics, Volume 1. Falls Church, Va.: Office of the Surgeon General; 2003:293-312 at p. 296.
3. Marshall T. Doctors at Guantanamo Bay are at risk of being accessories to torture. British Medical Journal 2002;324:235.
4. Miles SH. Abu Ghraib: Its legacy for military medicine. Lancet 2004;364:725-9;
5. Lifton RJ. Doctors and torture. New England Journal of Medicine 2004;351:415-6;
6. Anonymous. How complicit are doctors in abuse of detainees? Lancet 2004;364:637-8;
7. Bloche MG, Marks JH. When doctors go to war. New England Journal of Medicine 2005;352:3-6.
8. Howe EG. Mixed agency in military medicine: Ethical roles in conflict. In: Beam TE, Spracino LR, eds. Military Medical Ethics, Volume 1. Falls Church, Va.: Office of the Surgeon General; 2003:331-65.
9. Dual Loyalty Working Group. Dual Loyalty and Human Rights in Health Professional Practice. Proposed Guidelines and Institutional Mechanisms. Washington: Physicians for Human Rights. Available at: http://www.phrusa.org/healthrights/dual_loyalty.html (accessed May 2005);
10. Singh JA. Military tribunals at Guantanamo Bay: Dual loyalty conflicts. Lancet 2003;362:573.
11. See note 6, Dual Loyalty Working Group 2005.
12. World Medical Association. International Code of Medical Ethics: Declaration of Geneva. Adopted by the 3rd General Assembly of the World Medical Association. London, England, Oct 1949. Amended by the 22nd World Medical Assembly, Sydney, Australia, Aug 1968, and the 35th World Medical Assembly, Venice, Italy, Oct 1983. Available at: www.wma.net/e/policy/ 17-a_e.html.
13. Bloche MG. Clinical loyalties and the social purposes of medicine. JAMA 1999;281:268-74;
14. British Medical Association. Medical Ethics Today: Its Practice and Philosophy. London: BMJ Publishing Group; 1993.
15. See note 9, Bloche 1999.
16. Bloche MG. Uruguay's military physicians: Cogs in a system of state terror. JAMA 1986;255:2788-93.
17. Stover E, Nightingale EO, eds. The Breaking of Bodies and Minds. New York: W.H. Freeman and Co; 1985:32;
18. British Medical Association. Medicine Betrayed. London: Zed Books; 1992.
19. Brennan TA, Kirscher R. Medical ethics and human rights violations: The Iraqi occupation of Kuwait and its aftermath. Annals of Internal Medicine 1992;117:78-82.
20. Rayner M. Turning a Blind Eye: Medical Accountability for Torture in South Africa. Washington: American Association for the Advancement of Science; 1987.
21. Burger M, Gould C. Secrets and Lies. Wouter Basson and South Africa's Chemical and Biological Warfare Programme. Cape Town: Zebra Press; 2002.
22. Baldwin-Ragaven L, de Gruchy J, London L. An Ambulance of the Wrong Colour. Health Professionals, Human Rights and Ethics in South Africa. Cape Town: UCT Press; 1999.
23. See note 6, Dual Loyalty Working Group 2005.
24. Incidenten bij de medische hulpverlening aan burgers door de krijgsmacht hospitaal organisatie in voormalig Joegoslavië. [Incidents in medical care for civilians by the military medical organization in former Yugoslavia.] Rijswijk: Report of the Health Inspectorate, June 12, 1996;
25. Siemons GHA. Medische Hulp aan burgerslachtoffers, Srebrenica, onder de loep. [Medical care for civilian casualties, Srebrenica investigated]. Medisch Contact 1996;51:1465.
26. See note 4, Miles 2004.
27. See note 6, Dual Loyalty Working Group 2005.
28. Bloche MG, Marks J. Doctors and interrogators at Guantanamo Bay. New England Journal of Medicine 2005;353:1.
29. See note 5, Howe 2003.
30. Mallak CT. Doctors and torture. New England Journal of Medicine 2004;351:1572.
31. Winkenwerder W, Kiley KC, Arthur DC, Taylor GP, Porr DR. Doctors and torture. New England Journal of Medicine 2004; 351: 1573.
32. See note 4, Lifton 2004, and note 4, Miles 2004.
33. See note 4, Lifton 2004, note 4, Miles 2004, note 4, Anonymous 2004, and note 6, Singh 2003.
34. Madden W, Carter BS. Physician-soldier: A moral profession. In: Beam TE, Spracino LR, eds. Military Medical Ethics, Volume 1. Falls Church, Va.: Office of the Surgeon General; 2003:269-91 at p. 285.
35. See note 5, Howe 2003:341.
36. World Medical Association. World Medical Association Regulations in Time of Armed Conflict. Adopted by the 10th World Medical Assembly, Havana, Cuba, Oct 1956. Edited by the 11th World Medical Assembly, Istanbul, Turkey, Oct 1957. Amended by the 35th World Medical Assembly, Venice, Italy, Oct 1983. Available at: www.wma.net/e/policy/17-50_e.html; Baccino-Astrada, A. Manual on the Rights and Duties of Medical Personnel in Armed Conflicts. Geneva: International Committee of the Red Cross; 1982.
37. See note 27, Madden, Carter 2003:282.
38. See note 5, Howe 2003.
39. See note 5, Howe 2003:335.
40. Rubenstein LR. Medicine and war. Hastings Center Report 2004;34:3.
41. Beam T, Howe EG. A proposed ethic for military medicine. In: Beam TE, Spracino LR, eds. Military Medical Ethics, Volume 2. Falls Church, Va.: Office of the Surgeon General; 2003:851-65.
42. London L. Dual loyalties and the ethical and human rights obligations of occupational health professionals. American Journal of Industrial Medicine 2005;47:322-32.
43. See note 6, Dual Loyalty Working Group 2005.
44. Beam T. Military ethics on the battlefield: The crucible of military medical ethics. In: Beam TE, Spracino LR, eds. Military Medical Ethics, Volume 2. Falls Church, Va.: Office of the Surgeon General; 2003:369-402.
45. Moskop JC. Ethics and military medicine: New developments and perennial questions. Ethics and Health Care 1998;7. Available at: http://www.edu.edu/medhum/newsletter/spring2004_p1.htm.
46. See note 5, Howe 2003:341.
47. See note 1, Howe 2003.
48. See note 4, Bloche, Marks 2005.
49. Gruskin S, Tarantola D. Health and human rights. In: Last J, ed. Oxford Textbook of Public Health. New York: Oxford University Press; 2002:311-35; UNECOSOC (United Nations Economic and Social Council). The Siracusa Principles on the limitations and derogation provisions in the international covenant on civil and political rights. UN Document E/CN.4/1985/4, Annex. Geneva: UN; 1985.
50. Bowden M. The dark art of interrogation: The most effective way to gather intelligence and thwart terrorism can also be a direct route into morally repugnant terrain. A survey of the landscape of persuasion. The Atlantic Monthly 2003;292(3):51-76;
51. see note 38, Moskop 1998.
52. Gross M Bioethics and armed conflict: Mapping the moral dimensions of medicine and war. Hastings Center Report 2004;34:22-30.
53. See note 12, Stover, Nightingale 1985.
54. See note 44, Gross 2004.
55. Nathanson V. Doctors and torture. British Medical Journal 1999;319:397-8;
56. Pellegrino E. Medical ethics subordinated by tyranny and war. JAMA 2004;291:1505-6.
57. Amnesty International. High Court should end the shame of torture. AI INDEX: MDE 15/05/ 98. Jan 12, 1999. Available at: http://web.amnesty.org/library/Index/engMDE150051999 (accessed May 7, 2005).
58. Hall P. Doctors and the war of terrorism. British Medical Journal 2004;329:66;
59. Bygrave H. Medical education should include human rights component. British Medical Journal 2004;329:1103.
60. Amnesty International. The Israeli Government should implement the High Court decision making torture illegal. AI INDEX: MDE 15/68/99. Sep 6, 1999. Available at: http://web.amnesty.org/library/Index/ENGMDE150681999?open&of=ENG-ISR A (accessed May 7, 2005).
61. Cilasun U. Torture and the participation of doctors. Journal of Medical Ethics 1991;17(Suppl.):S21-2.
62. See note 6, Dual Loyalty Working Group 2005.
63. Schwapowal AG, Baer H. Medical ethics in peace and in the armed conflict. Military Medicine 2002;167(8 Suppl.):26-31.
64. See note 34, Beam, Howe 2003.
65. See note 27, Madden, Carter 2003.
66. Rascona DR. Point/counterpoint-A response to Drs Sidel and Levy (Physician-Soldier: A Moral Dilemma). In: Beam TE, Spracino LR, eds. Military Medical Ethics, Volume 1. Falls Church, Va.: Office of the Surgeon General; 2003:320-5.
67. Jones JJ, McCullogh LB, Richman BW. The military physician's ethical response to evidence of torture. Surgery 2004;136:1090-3.
68. Jacoby D. Doctors and torture. New England Journal of Medicine 2004;351:1572.
69. See note 4, Miles 2004.