Physicians at War

There are a range of ethical issues that confront physicians in times of war, as well

as some of the uses of physicians during wars. This book presents a theoretical

apparatus which undergirds those debates, namely by casting physicians as

being confronted with dual-loyalties during times of war. While this theoretical

apparatus has already been developed in other contexts, it has not been specifically

brought to bear on the ethical conflicts that attain in wars. Arguably, wars thrust

physicians into ethical conflicts insofar as these wars create a tension between a

physician’s obligation to heal and an obligation to serve some other good (e.g.,

military chain of command, national security, the greater good, etc.). Alternatively,

we can debate whether this conception is appropriate. For example, one could

argue that that non-medical duties cannot attach to physicians (e.g., due to nonoverlapping

spheres of justice), thus abrogating the dual-loyalty challenge. Or else

one could argue that these medically-trained personnel do not act qua physicians

at all (but rather partisan advocates) and therefore duties that would otherwise

attach to physicians do not attach here.

In the first part of this book, these issues are debated. In the second part of

the book, the dual-loyalities frame is used to explore various substantive debates

that obtain when the military makes use of physicians. Physician involvement

in torture is a heated topic, and certainly the most visible element of the debate.

Also, however, we could use the dual-loyalties framework to explore issues in

other arenas, such as: development of chemical and biological weapons, medical

neutrality/battlefield triage, and so on. In each of these cases, the same tensions

arguably exist: physicians have duties both to their patients and “elsewhere”

(which, depending on the details of the view, could be any of the above-mentioned

ends).