Military Medical Ethics – Scenario Database

Conflicting priorities in the laboratory (Ebola mission)

ID/Number: 85
Last updated: 06 Apr, 2020
Revision: 2
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You have just deployed to a lab that provides diagnostic laboratory services for two Ebola treatment units in a low-income country: one run by the military and one run by an NGO. The former is reserved for international (predominantly) and local healthcare workers and the latter serves the general population, but has a high proportion of child patients. You are told that you should always prioritise the providing of test results to the former, military-run unit.

Normally (back in the UK and on other deployments) you are guided by the principle that results should be provided according to how urgently they are needed, and this is determined by the extent to which significant treatment decisions depend on the information they provide. During quieter times, you are told, it is possible to 'batch' samples from both units so that results are available more or less simultaneously.

However, when you arrive both units are busy and you receive a sample from a very poorly child that is clearly urgent and the 'prioritised' batch from the military-run unit is full but contains some less urgent samples.

Source: This scenario is taken from material produced by the research project "Military healthcare professionals' experiences of ethical challenges whilst on Ebola humanitarian deployment (Sierra Leone)". The project was funded by the UK ESRC and the Royal Centre for Defence Medicine (Academic & Research).
See external links below to access the original material which also contains an analysis of the scenario.

Questions for the discussion of this scenario

Should you follow the SOP or should you prioritise the urgent sample?

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Keywords
Triage Disaster Level of care
This scenario is also listed in the following categories
folder Military Medical Ethics Scenarios -> Dual loyalty and/or mixed obligations -> Conflicting roles
folder Military Medical Ethics Scenarios -> Civil-military cooperation -> Cooperation in the field

External links
https://scenarios.militarymedicalethics.ch//client/images/icons/article_out.svg https://warwick.ac.uk/fac/sci/med/research/hscience/sssh/ethics/milmed/ebola/caseteaching/experiences/
https://scenarios.militarymedicalethics.ch//client/images/icons/article_out.svg https://warwick.ac.uk/fac/sci/med/research/hscience/sssh/ethics/milmed/ebola/caseteaching/experiences/case_4-_conflicting_priorities_in_the_laboratory_.pdf