Ethical Issues in Combat Psychiatry

Ethical challenges for the psychiatrist during the Vietnam conflict

“…42 The addition of recently discovered neuroleptics and anxiolytics in the Vietnam theater represented a powerful new tool to the armamentarium of combat psychiatrists. The numerous reports from those serving in South Vietnam [43][44][45][46] and the prescription prevalence study conducted there by Datel and Johnson 47 indicate the widespread, enthusiastic use by military psychiatrists and other military physicians of these newer psychoactive medications in the treatment of combat-related psychiatric symptoms. However, the effects of these drugs on soldiers and their combat performance have never been studied.…”

“…How many were later killed I do not know, nor do I wish to. 70(pp268-269) Compared with the more confident accounts by psychiatrists who served in the first half of the conflict, 43,46,58,[72][73][74] ones who went during the second half, such as Camp (as quoted in Ingraham and Manning), 18 Char, 75 Colbach, 45 Fisher, 76 Joseph, 77 and Ratner, 78 exhibited more frustration and cynicism. Collectively, they give the impression that conventional military psychiatric structures and doctrine were inadequate to address the burgeoning psychiatric and behavioral problems of the later years of the Vietnam conflict.…”

Ethics and National Defense: The Timeless Issues

“…In 1987 alone, the Army published three new official publications on leadership and related ethical issues.12 Military and federal courts have acknowledged the special trust, confidence, and responsibility required of military officers. 13 Professional ethics are the most critical aspect of Army leadership; competence in military leadership has a unique ethical dimension. 14 Ethical rules for lawyers who are part of such an environment must take into account such uncommon ethical demands.…”

“…Mistreatment can alienate the civilian population. 13 Abuses have a negative effect on public opinion, as evidenced by public reaction to the My Lai massacre. 14 But the instruction is given a common sense perspective in that it is acknowledged that civilians assume a certain degree of risk if they remain on the battlefield or in proximity to legitimate military targets, or participate in activities that directly support the war effort of the enemy.…”

“…By setting the ground rules out clearly, the Army as client guidance of rule 1. 13 fortifies an already sound relationship among staff judge advocates, commanders, and the Army client. No man can serve two masters.…”