你站在哪一边?军事医务人员的非战斗人员身份所引起的复杂性。

IF 1.6 Q2 ETHICS Monash Bioethics Review Pub Date : 2023-06-01 DOI:10.1007/s40592-022-00168-2
Michael C Reade
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引用次数: 1

摘要

自19世纪中期以来,神职人员、医生、其他临床医生和专门协助他们工作的军事人员被指定为“非战斗人员”,保护他们不成为目标,以回报他们仅根据临床需要提供护理。虽然允许使用武器来保护自己和病人,但他们不得试图获得对对手的军事优势。这些条例的基本原理是基于合理的论点,目的在于减少人类的痛苦,同时也在于民族国家部署非战斗人员的最终利益。然而,这一点有时并不能立即体现在好斗的同事身上。武装部队的临床医生也是军官,由于“双重忠诚”,如果他们的非战斗人员身份没有得到很好的了解,可能会造成冲突。医生违反其责任的历史例子包括:将作战能力置于士兵个人权利之上(例如,将稀缺的医疗资源分配给更有可能重返战场的士兵,而不是那些最有可能在没有医疗的情况下死亡的士兵),利用医生促进对囚犯的审讯、医学研究或治疗,以牺牲健康为代价提高身体表现,根据临床需要以外的因素适用《医疗资格规则》,根据对军事目标的支持提供治疗,以及利用医学知识改进武器。然而,不是冲突的战斗方并不意味着非战斗临床医生不能为国家利益行事。事实上,通过坚持与文职同事相同的普遍伦理,军事临床医生为自己的部队提供最佳护理,促进东道国的行动自由,并在冲突期间和冲突后国家建立积极的国际关系。
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Whose side are you on? Complexities arising from the non-combatant status of military medical personnel.

Since the mid-1800s, clergy, doctors, other clinicians, and military personnel who specifically facilitate their work have been designated "non-combatants", protected from being targeted in return for providing care on the basis of clinical need alone. While permitted to use weapons to protect themselves and their patients, they may not attempt to gain military advantage over an adversary. The rationale for these regulations is based on sound arguments aimed both at reducing human suffering, but also the ultimate advantage of the nation-state fielding non-combatant staff. However, this is sometimes not immediately apparent to combatant colleagues. Clinicians in the armed force are also military officers, owing a "dual loyalty" that can create conflict if their non-combatant status is not well understood. Historical examples of doctors breaching their responsibilities include prioritisation of combat capability over the rights of individual soldiers (as occurred when scarce medical resources were allocated to soldiers more likely to return to battle in preference to those most likely to die without them), use of physicians to facilitate prisoner interrogation, medical research or treatment to enhance physical performance at the expense of health, application of Medical Rules of Eligibility according to factors other than clinical need, provision of treatment contingent upon support for military objectives, and use of medical knowledge to enhance weapons. However, not being a combatant party to a conflict does not imply that the non-combatant clinician cannot act in the national interest. Indeed, by adhering to the same universal ethics as their civilian colleagues, military clinicians provide optimal care to their own troops, facilitate freedom of action in host nations, and build positive international relationships during the conflict and in the post-conflict state.

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来源期刊
CiteScore
2.70
自引率
6.20%
发文量
16
期刊介绍: Monash Bioethics Review provides comprehensive coverage of traditional topics and emerging issues in bioethics. The Journal is especially concerned with empirically-informed philosophical bioethical analysis with policy relevance. Monash Bioethics Review also regularly publishes empirical studies providing explicit ethical analysis and/or with significant ethical or policy implications. Produced by the Monash University Centre for Human Bioethics since 1981 (originally as Bioethics News), Monash Bioethics Review is the oldest peer reviewed bioethics journal based in Australia–and one of the oldest bioethics journals in the world. An international forum for empirically-informed philosophical bioethical analysis with policy relevance. Includes empirical studies providing explicit ethical analysis and/or with significant ethical or policy implications. One of the oldest bioethics journals, produced by a world-leading bioethics centre. Publishes papers up to 13,000 words in length. Unique New Feature: All Articles Open for Commentary
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