Allhoff, Fritz. ed. 2008. Physicians at war: The dual-loyalties challenge

Abstract

Physicians at war: The dual-loyalties challenge is a collection of essays which provide philosophical, political, and legal perspectives on many of the conflicting obligations which physicians may face during times of armed conflict. “Armed conflict” is best understood here as broadly construed. While some aspects of the book focus specifically on military physicians and/or the actions of physicians in traditional wars, the majority of the articles deal with issues relating to physician participation in activities in support of national security and/or national defense more generally. In the introduction to this volume Fritz Allhoff grounds the discussion by first identifying what he understands to be the dual-loyalties challenge in the context of armed conflict. The challenge is that there may be a conflict between one’s medical obligations to those under one’s care: for example, in the case battlefield triage or interrogation/torture; or to those who would suffer from one’s actions, as in the case of weapons development; and in one’s non-medical obligations to one’s commander, one’s nation, or those who would suffer as a result of one’s failure to act. Once he has explained the problem Allhoff discusses ways that the challenge is addressed in this book. The first way is to acknowledge the existence of the conflicting obligations, and then to determine which obligation carries the greatest weight. This might take the form of a utilitarian analysis weighing the harms against the benefits of a proposed action. The second option is to deny the force of one of the obligations. The most common form of this would be to deny that extramedical considerations carry any weight in medical considerations. The final option is to deny that there are dual-loyalties at all. This entails the claim that medical obligations apply only to physicians qua physician. That is, only those individuals acting in the role of physician garner medical obligations. In this light a distinction would be made between a person working in the role of physician and a person with medically training working in the role of an interrogator.