There are a range of ethical issues that confront physicians in times of war, as well
as some of the uses of physicians during wars. This book presents a theoretical
apparatus which undergirds those debates, namely by casting physicians as
being confronted with dual-loyalties during times of war. While this theoretical
apparatus has already been developed in other contexts, it has not been specifically
brought to bear on the ethical conflicts that attain in wars. Arguably, wars thrust
physicians into ethical conflicts insofar as these wars create a tension between a
physician’s obligation to heal and an obligation to serve some other good (e.g.,
military chain of command, national security, the greater good, etc.). Alternatively,
we can debate whether this conception is appropriate. For example, one could
argue that that non-medical duties cannot attach to physicians (e.g., due to nonoverlapping
spheres of justice), thus abrogating the dual-loyalty challenge. Or else
one could argue that these medically-trained personnel do not act qua physicians
at all (but rather partisan advocates) and therefore duties that would otherwise
attach to physicians do not attach here.
In the first part of this book, these issues are debated. In the second part of
the book, the dual-loyalities frame is used to explore various substantive debates
that obtain when the military makes use of physicians. Physician involvement
in torture is a heated topic, and certainly the most visible element of the debate.
Also, however, we could use the dual-loyalties framework to explore issues in
other arenas, such as: development of chemical and biological weapons, medical
neutrality/battlefield triage, and so on. In each of these cases, the same tensions
arguably exist: physicians have duties both to their patients and “elsewhereâ€
(which, depending on the details of the view, could be any of the above-mentioned
ends).
