Medical ethics in times of conflict

December 11, 2017

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Medical ethics has a key role in discussing the effects of conflicts and other violent human rights abuses, John Chisholm and Julian Sheather of the British Medical Association argue in a recent Comment in the Indian Journal of Medical Ethics.

Recent history has seen a closer relationship and interdependency between medicine and the State. This has led, at times, to tension between professional obligations and State interests. Many would prefer medical ethics to step aside from sectarian politics and focus on the doctor-patient relationship and the objective and neutral medical sciences that underpin it. However, given the role that social inequities play in health outcomes, doctors have been obliged to speak out against such inequities or even against State practices which directly contribute to poor health. For those committed to the impartial practice of medicine, and to the promotion of human wellbeing, silence during times of conflict is seldom an option.

Where, for example, doctors are seeing patients who have sustained injuries as a result of state responses to civil unrest, the documentation and reporting of those injuries is a core part of the medical response. If doctors cannot speak out, if they cannot draw attention to the health-related impacts of conflicts, they risk the loss of professional independence. Paradoxically, it is the ability of doctors to speak out that best serves their neutrality. By contrast, any attempt to restrict the freedom of doctors to raise concerns threatens the principle of neutrality, risking the co-option of medical care into non-medical purposes. In our view vocal medical comment on the health impacts of conflict and of violence is a far better guarantee of the independence of the profession – and of the wellbeing of patients – than an imposed or self-imposed silence.”

Access the comment Medical ethics in times of conflict – why silence is not an option. John Chisholm & Julian Sheather, Indian Journal of Medical Ethics, 7 November 2017