MME Scenario Collection

Dream assignment

A 40 year old male senior enlisted has received his dream tasking. He will be stationed at an embassy in Africa. He receives orders and is ready to out-process his base.

However, his healthcare provider notes a distant history of uveitis. She realizes the patient has had recurrent uveitis of unclear origin for 10 years. About every 3 years he has a reoccurrence. Multiple ophthalmologists have documented high intra-occular pressure when this occurs and his right optic nerve is thinning.

He is referred to another specialist for a recommendation who notes that he needs to be seen every 6-12 months and is moderate to high risk for needing medical evacuation during this two year remote assignment.

The patient is very distraught. He feels perfectly fine and his last episode was over two years ago.

The embassy insists they can probably handle this issue but they would be working with a downtown out of network clinic that has limited capabilities. Evacuation would be to another country by air and likely take days.

As the medical waiver authority you get to decide if he can go to the embassy next week or if his orders must be canceled. His command is upset that medical is interfering and they insist he is a good candidate for this job and should be allowed to proceed.

What will you do?

Source: Report from course participant

Questions for the discussion of this scenario

– Can it be morally justifiable to waive the patient's medical condition, knowing he will likely have another episode and being in a resource limited setting might lead to permanent damage including loss of sight in the eye?
– Can it be morally justifiable to waive the patient's medical condition knowing it will likely lead to an expensive medical evacuation which will cost the government a lot of money and can put other people in harms way?
– Can it be morally justifiable to disapprove the waiver for a theoretical risk in a fit soldier who has chosen to put service before self?

Page ID: 116
Last updated: 09 Sep, 2021
Revision: 3
Military Medical Ethics Scenarios -> Dual loyalty and/or mixed obligations -> Fitness for duty -> Dream assignment

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