Military Medical Ethics – Scenario Database

(Forced) Dialysis for a Prisoner of War

ID/Number: 102
Last updated: 12 Aug, 2019
Revision: 1
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"United States Special Forces capture a combatant in the mountains of Eastern Afghanistan whom they believe has vital information that would help lead to the arrest of a major suspected terrorist. He is transferred to a U.S. military hospital at an undisclosed location. The physicians at the hospital soon discover that he is suffering from renal failure, and they prepare to provide dialysis. The combatant refuses, however, stating that he would rather die than live as a prisoner of the United States.

Uncertain how to proceed, the military nephrologist asks her commanding officer for guidance. The question of whether to override the prisoner's refusal of treatment is quickly relayed up the military hierarchy. Two days later, the Secretary of Defense delivers the order to initiate dialysis, despite the prisoner’s refusal. The order cites as justification the pressing national security interest in keeping the prisoner alive for a thorough interrogation that would lead to the arrest of an important terrorist suspect."

Questions for the discussion of this scenario

Can dialysis be applied against the stated wishes of the patient?

Source: Zupan, Daniel, et al. (2004), 'Dialysis for a prisoner of war', The Hastings Center Report, 34 (6), 11.

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Related scenarios and readings
item Estimating the age of captured persons
item Treatment of Detainees: Role of Military Health Professionals

This scenario is also listed in the following categories
folder Military Medical Ethics Scenarios -> Treatment of captured/ detained persons -> Informed consent and medical confidentiality
folder Military Medical Ethics Scenarios -> Neutrality of the medical personnel