Military Physicians’ First Ethical Obligation Is to Patients.

January 31, 2019
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A Navy physician takes the temperature of a Guantanamo detainee.
A Navy hospital corpsman takes the temperature of a Guantanamo detainee.

In 2011, the Assistant Secretary of Defense tasked the Defense Health Board with putting together a report on medical ethics for military physicians. The board submitted their guidelines in 2015, affirming that a military physician’s “first ethical obligation is to the patient.” As of today, these guidelines have still not been implemented.

In a new Journal of the Royal Army Medical Corps review article, two School of Public Health researchers urged the Department of Defense (DoD) to finally implement the Ethical Guidelines and Practices for US Military Medical Professionals.

“The future should be one in which military physicians never question that they are physicians first, bound by universal medical ethics,” wrote George Annas, William Fairfield Warren Distinguished Professor of health law, ethics & human rights, and Sondra Crosby, associate professor of health law, ethics & human rights.

The proposed guidelines say that the DoD should ensure that military healthcare professionals are held to the same universal ethical standards as their civilian counterparts, Annas and Crosby explained. The guidelines also say commanding officers “should excuse health professionals from performing medical procedures that violate their professional codes of ethics.”

One problem with current DoD guidelines, Annas and Crosby wrote, is that they treat hunger strikes as suicide attempts, which justifies involuntary medical intervention including forced feeding. The World Medical Association, however, has a clear ethical policy prohibiting physicians from force-feeding competent hunger strikers, calling it “inhuman and degrading treatment.”

“To the best of our knowledge, this is the only time US military medical ethics standards have been adopted that explicitly permit physicians in the military to act in a manner that contravenes applicable worldwide medical ethics standards,” Annas and Crosby wrote.

Official military medical ethics should not remain “in limbo” like this, they wrote. They urged the Department of Defense to officially adopt and formally implement the long-overdue guidelines that its own Defense Health Board put forward in 2015, affirming and protecting military physicians’ universal ethical obligations.

—Michelle Samuels

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Military Physicians’ First Ethical Obligation Is to Patients

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There is 1 comment on Military Physicians’ First Ethical Obligation Is to Patients

  1. hi, i have a quick question i’d appreciate your input on:

    my husband, LT (USN) Nathan Kipkurui Magare, who represented the Navy in the search for 2015 Military Pharmacist of the Year and has been nominated for a similar honor this year by Pharmacy Times, was born without a conscience, but he has a highly evolved sense of his own infallibility and superiority.

    he frequently derives great pleasure from orchestrating little games at others’ expense to amuse himself.

    reason i’m writing today is that in 2018, our daughter came down with a kidney infection, which, after she developed a high fever and began vomiting, Dr. Magare allowed to go untreated for many hours.

    Dr. Magare can generally not be left unattended with our children due to the abuses he brings on them, but this day i had to attend something mandatory out of the home, and so our 11-year old son was the only person left at home to supervise his father with his sister.

    as our son watched his sister suffer many hours, he got scared for her and he kept asking dad if she might get some medicine or something.

    in the house at the time, we had Tylenol, kids’ Tylenol, kids’ cold medicine with Tylenol, Motrin, kids’ Motrin, kids’ cold medicine with Motrin, and 81 mg-dose aspirin.

    we also had a bottle of plain dextromethorphan in the cabinet, which helps a patient who has a cough by loosening mucus.

    In order to quiet my son and appear to be “doing something”, at this time my husband chose to give our daughter a dose of dextromethorphan.

    my son reports his sister did not sleep that night, but kept whimpering and vomiting and complaining of pain all night.

    the kids’ father then left them alone 9am the next morning, without giving our daughter a second dose of anything. during the morning, our son called his dad panicked many times at work, worried about his sister who was now vomiting almost constantly. my husband, who was 30 minutes away at work, told him he was “on his way home right now” and would get there any minute.

    i finally arrived home after 1pm, recognized in less than 5 minutes what my daughter was suffering from, dosed her with motrin which she threw up, gave her another dose of motrin and some tylenol, took her temp (over 104), packed her in bags of frozen vegetables from the freezer and carried her to the car to drive us all to the civilian E.R. because i feared the possibility that if i took her to the military hospital, Dr. Magare might give her something to kill her, to keep his little “game” quiet.

    by the time my daughter checked in her meds had brought her temp down. i then informed the pediatrician my kid needed to be treated for a kidney infection, and everything turned out well.

    Dr. Magare finally reached home 7pm that evening, and when i asked him how such a simple diagnosis could have escaped his detection, he replied in a condescending tone, “don’t be silly. i knew all along it was polynephritis.”

    Not long after this incident, we went to marital counselling at Family Advocacy at the Marine Corps Air Station with Wanda Burns Bostick, where i reported my husband’s little game that he had played, as well as a multitude of other horrific crimes and abuses he has committed and how scary it is, living with a psychopath.

    in response, Wanda informed me she does not know what a psychopath is, she is not convinced that psychopaths exist; she informed me of my husband’s moral superiority to me and told me my duty is to be supportive of him, and that means i should not discuss events in the home with outsiders and that i should give up all my friends that my husband doesn’t like.

    Wanda also said my husband’s burning our house down, anal raping me in my sleep for years, and running over a human being on purpose (according to him), were all my fault because i am, she said, a “weak woman. just a little girl.”

    Regarding my daughter’s deadly infection and the way her father decided to “treat” it in order to prolong her suffering and thus proling his game, Wanda pronounced that “there is nothing wrong with giving a child a wrong medicine,” and the matter should be dropped.

    So anyway, just wondering/hoping, do you guys know if there are any laws in the works or provisions which could be added to the UCMJ which might make it mandatory for military health practitioners to treat their family members as well as Prisoners of War?

    thanks,
    -N

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