Ethical and existential issues on healthcare in a combat environment

Ethical and existential issues on healthcare in a combat environment

To provide care in a combat environment poses ethical dilemmas for medical personnel, particularly of a prioritization nature, where personnel may need to make choices between different people who are in need of care. Similarly, the requirements of defence tactics can come into conflict with medical priorities.

In the Swedish context of health and medical care, which also includes international combat, such priorities are to be based on the ethical platform presented in the Priority Setting in Health Care Bill and which is regulated in Health and Medical Service (HSL) legislation.

There are signs that the priorities made in a combat environment may in different ways be at variance with these guidelines. Perhaps it is also the case that these guidelines are ill-suited for a combat environment and need to be supplemented or developed in various ways. We do not currently know much about which ethical dilemmas (especially with a focus on priorities) are encountered in medical care in a combat environment or how these are dealt with. In order to develop ethically founded strategies to deal with such dilemmas, further knowledge is required.

Another aspect of care in a combat environment is the existential vulnerability it puts the caregiver in. Care takes place in a situation of ever-imminent threats to one's own and one's comrades' lives and where the threat comes from other people, who in connection with combat operations may be injured in a way that requires medical care. Again, there is limited knowledge about the existential situation of medical personnel and how it affects their view of patients and care. Nor do we know whether this can affect personnel in their daily lives after returning home.

The purpose of this project is to study the ethical and existential dilemmas of military medical personnel in connection with care in a combat environment based on the following issues:

  1. how is the existential situation of administering care in a combat environment experienced?
  2. how is care after coming home affected by having administered care in a combat environment from an ethical and existential perspective?
  3. How can normative arguments be made in relation to the ethical prioritization dilemmas of a combat environment?