Triage Priorities and Military Physicians

In this paper, I will first outline briefly the general triage practices that are common in both civilian and military contexts. The triage procedures which are of current interest, of course, are not these general practices that both civilian and military triage procedures share; rather, of primary interest are those procedures which military commanders mandate during severe battle conditions. In these extreme situations, military protocol mandates the reversal of normal triage procedures, with the least wounded being treated first so that they can rapidly return to the battlefield. It is during these times that tension between two competing loyalties seems to occur.

After discussing the battle conditions under which these triage procedures are recommended, I will argue on the grounds that military commanders possess fiduciary obligations that these triage procedures during extreme battle conditions are not only morally permissible but, moreover, that in certain cases they are required so that military commanders may fulfill their obligations. Furthermore, I will contend that, given seemingly subtle differences between the civilian patient-physician relationship and the relationship into which military physicians enter with those needing medical attention, there are instances in which it is appropriate for the military physician to act in accordance with the chain of command’s desires and not enter into this relationship. We should perhaps view the military physician in these circumstances as acting in a different role than the civilian physician, i.e., acting to maintain the strength of the fighting force. In other words, the relationship into which military physicians and the wounded that are in need of treatment enter is dissimilar enough to warrant the difference in care priorities during extreme battle conditions.