Military Medical Ethics – Scenario Collection

Treatment of Detainees: Role of Military Health Professionals

Page ID: 101
Last updated: 04 Aug, 2020
Page ID: 101
Last updated: 04 Aug, 2020
Revision: 4
Comments: 0

"Ten detainees in a national security facility have gone on a hunger strike to protest the conditions of their confinement.

Part 1: The strike has gone on for three days, and the detainees are taking only water and vitamins. The camp commander declares the strike a threat to security and order and directs the doctor to evaluate the medical condition of the detainees and to do whatever is necessary to bring this to an end. The doctor examines the detainees and finds no immediate threat to the health of any individual detainee at this point in the strike.

Part 2: The hunger strike has continued for 45 days. One striker has lost 30 percent of his initial body weight and is felt to be at risk of irreversible harm or even death. He has previously said to the physician that he does not intend to die, but is willing to die if there is no resolution to his grievances."

Source: IOM (Institute of Medicine). 2009. Military medical ethics: Issues regarding dual loyalties: Workshop summary. Washington, DC: The National Academies Press. Page 15.

Questions for the discussion of this scenario

Considerations:
What principles are in conflict?
What guides the clinician in approaching this conflict?
What about the setting makes this situation different from civilian settings? Are the differences enough to warrant a separate rule? What comparisons are there to civilian settings such as jails and prisons?
Who is the ultimate decision maker regarding a clinical intervention?
What mechanisms or resources would help the health professional in resolving this conflict?

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Page ID: 101
Last updated: 04 Aug, 2020
Revision: 4
Comments: 0
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