Ethics surrounding the medical evacuation of catastrophically injured individuals from an operational theatre of war

Abstract

Although prolonging life is usually in the best interests of patients, the British Medical Association states that it is not appropriate to prolong life with no regard to its quality. Medical advances both on the battlefield and within the field hospitals have resulted in the unexpected survival of a number of British personnel, and in some cases, soldiers are being repatriated with injuries categorised as ‘catastrophic’. This paper considers medical ethics based on the Beauchamp and Childress Four Principles framework with regard to whether catastrophically injured individuals should be repatriated without any prior advanced directive and without evaluation of future quality of life.

Medical evacuation from abroad of critically ill patients

“…Bennett [ 2 ] has written on the ethical implications of evacuating catastrophically injured individuals from operational theaters of war. In her conclusion, she argues that aeromedical repatriation is to be favored in this type of situation, regardless of predicted outcome or substantial resources required.…”

“…Only an article on this has been published on ethical implications of evacuating catastrophically injured individuals from operational theaters of war. [ 2 ] A reflection on this subject could be useful for a better management of critically ill patients repatriated. We present the case of a patient repatriated from a hospital in a foreign country, who was infected with 2 strains of XDR bacteria and whose care was futile.…”

Medical Ethics for the Military Profession

“…Military healthcare personnel must be specifically aware of the application of IHL to the following topics: impartial provision of emergency care (Messelken, 2019), access to medical care (M. C. Bricknell & dos Santos, 2011), rights of specific groups of patients (especially prisoners) (Lillywhite, 2021), decisions to withdraw curative treatment in the face of catastrophic injuries (Bennett, 2016), the protection afforded to medical personnel (Goniewicz & Goniewicz, 2013;Waard & Tarrant, 2013), right to bear arms and self-defense, identification of medical units and personnel, and specific prohibitions that apply to medical personnel. Therefore, military medical personnel will need specific education in these topics and IHL provisions and medical ethics as part of their training for their operational role.…”