University of Minnesota in Minneapolis, MN, USA.
Bioethics. 2013 Mar;27(3):117-23. doi: 10.1111/j.1467-8519.2011.01920.x. Epub 2011 Jul 13.
United States military medical ethics evolved during its involvement in two recent wars, Gulf War I (1990-1991) and the War on Terror (2001-). Norms of conduct for military clinicians with regard to the treatment of prisoners of war and the administration of non-therapeutic bioactive agents to soldiers were set aside because of the sense of being in a 'new kind of war'. Concurrently, the use of radioactive metal in weaponry and the ability to measure the health consequences of trade embargos on vulnerable civilians occasioned new concerns about the health effects of war on soldiers, their offspring, and civilians living on battlefields. Civilian medical societies and medical ethicists fitfully engaged the evolving nature of the medical ethics issues and policy changes during these wars. Medical codes of professionalism have not been substantively updated and procedures for accountability for new kinds of abuses of medical ethics are not established. Looking to the future, medicine and medical ethics have not articulated a vision for an ongoing military-civilian dialogue to ensure that standards of medical ethics do not evolve simply in accord with military exigency.
美国军事医学伦理在其参与的两次近期战争(海湾战争 I (1990-1991 年)和反恐战争(2001-))中不断发展。由于身处“新型战争”的感觉,军事临床医生在对待战俘和向士兵施用非治疗性生物活性剂方面的行为规范被搁置一旁。同时,由于在武器中使用放射性金属以及能够衡量对脆弱平民的贸易禁运对健康造成的后果,人们对战争对士兵、其后代以及生活在战场上的平民的健康影响产生了新的担忧。在这些战争期间,民间医学协会和医学伦理学家断断续续地参与了医学伦理问题和政策变化的演变。专业医学规范并没有实质性的更新,也没有为新形式的医学伦理滥用制定问责程序。展望未来,医学和医学伦理尚未为持续的军民对话制定一个愿景,以确保医学伦理标准的演变不仅仅是根据军事需要。