Mixed Agency in Military Medicine: Ethical Roles in Conflict

332 Franklin Boggs Pill Call circa 1944 " Soldiers suffering from malaria get their daily quota of atabrine tablets from the Medical Corps captain. Artist Boggs caught this scene in the South Pacific. " This image clearly captures the doctor, attired in his crisp uniform, clipboard in hand, dispensing medicine to protect and " conserve the fighting force. INTRODUCTION that would depart from military law or regulations. Conversely, military physicians adopting an exclusively medical role-specific ethic would strictly follow the principles of the medical profession that generally require physicians to put their patients' interests first. Their always adopting a medical role-specific ethic could result in their failing to uphold the military requirements they and their patients have sworn to serve. These requirements include their willingness to sacrifice their life for their country , if necessary. Both soldiers and military physicians know or should know this when they enter the military. In general, soldiers understand and expect that military physicians will sacrifice a soldier's individual interest for the sake of the mission or greater numbers of soldiers if necessary. The military physician, at least implicitly, promises to support the mission or greater good when and if this is necessary, even if this requires subordinating the medical well-being of the individual soldier. Soldiers do not, of course, willingly give their lives so that the war can be lost. A soldier makes such a sacrifice only with the expectation that all measures possible will be taken by everyone in the military, physicians included, to ensure that if soldiers must die, it will have been for a valid reason. This is respecting soldiers as individuals because they autonomously choose to sacrifice for a greater good, even to the point of making the supreme sacrifice of giving their lives. On what grounds, however, could ethical stances that deviate from the law be justified? The answer to this question will depend, in part, on which of two views one has regarding the potential that ethical analysis has for discerning sound moral views. One view is that ethical analysis can provide " right " answers. This view is problematic because different core values may have comparable merit such that the issue of which core value should prevail cannot be resolved. This is especially true in a plu-ralistic society such as the United States in which values are highly variable. A second view (whose claim for what ethical …