Medical Neutrality and Political Activism: Physicians' Roles in Conflict Situations

  • Justin M. List
Part of the International Library of Ethics, Law, and the New book series (LIME, volume 41)

Physicians in conflict situations juggle myriad duties and experience many ethical dilemmas in caring for the sick and wounded. Issues of how to triage care, allocate resources, and knowledge of injustices committed against patients by warring parties are among these concerns. Medical neutrality-care given based on criteria of medical need and urgency-has been strongly instantiated as a core value in the moral fabric of medicine and international medical ethics. Yet, physician political neutrality or activism regarding war crimes and injustices against people wartime physicians serve has been met with controversy. Medical neutrality, political neutrality, and political activism can be construed as types of moral goods in the practice of medicine. I argue that medical neutrality in the provision of care and political neutrality in conflict situations are not equivalent goods. Physicians have duties to provide care on the basis of medical neutrality, but they also have an obligation to be politically active in certain conflict situations and report allegations and abuses revealed during either the clinical encounter or in the field.


Political Activism Medical Neutrality World Medical Association Conflict Situation Moral Duty 
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  1. Allhoff, Fritz. 2006. Physician involvement in hostile interrogations. Cambridge Quarterly of Healthcare Ethics 15.4: 392–402 (reprinted in this volume).Google Scholar
  2. Baker, Robert and Martin Strosberg. 1992. Triage and equality: an historical reassessment of utilitarian analyses of triage. Kennedy Institute of Ethics Journal 2: 103–123.Google Scholar
  3. Beam, Thomas E. and Linette R. Sparacino, eds. 2003. Military Medical Ethics vols. 1–2 (Textbooks of Military Medicine series). Washington, DC: Office of the Surgeon General, Department of the Army, and Borden Institute.Google Scholar
  4. Bloche, M. Gregg and Jonathan Marks. 2005. When doctors go to war. New England Journal of Medicine 352.1: 3–6.CrossRefGoogle Scholar
  5. Borden Institute. 2004. Emergency War Surgery. Washington, DC: Borden Institute.Google Scholar
  6. Bortolotti, Dan. 2004. Hope in Hell: Inside the World of Doctors Without Borders. Buffalo: Firefly.Google Scholar
  7. Carter, Brian S. 1994. Ethical concerns for physicians deployed to Operation Desert Storm. Military Medicine 159: 55–59.Google Scholar
  8. Council on Ethical and Judicial Affairs. 2004. Code of Medical Ethics. Chicago, IL: American Medical Association.Google Scholar
  9. Farley, Margaret A. 1986. Personal Commitments: Beginning, Keeping, Changing. New York: HarperCollins.Google Scholar
  10. Geiger, H. Jack and Robert M. Cook-Deegan. 1993. The role of physicians in conflicts and humanitarian crises: case studies from the field missions of physicians for human rights, 1988 to 1993. JAMA 270: 616–620.CrossRefGoogle Scholar
  11. Gibson, Kevin. 1999. Mediation in the medical field. Hastings Center Report 29.5: 6–14.CrossRefGoogle Scholar
  12. Gross, Michael L. 2004. Bioethics and armed conflict: mapping the moral dimensions of medicine and war. Hastings Center Report 34.6: 22–30.CrossRefGoogle Scholar
  13. International Committee of the Red Cross. How does Humanitarian Law Adapt to New Developments and What is the ICRC’s Role in the Process? Cited 3 September 2005.
  14. International Committee of the Red Cross. The ICRC’s Mission Statement. Cited 3 September 2005.
  15. International Committee of the Red Cross. Promoting International Humanitarian Law. Cited 3 September 2005.
  16. International Physicians for the Prevention of Nuclear War. IPPNW Homepage. Cited 31 December 2006.
  17. Integrated Regional Information Networks. Chad: MSF Worker Killed, Clinic Looted. Cited 31 December 2006.
  18. Jean, François ed. 1993. Life, Death and Aid: The Médecins Sans Frontiéres Report on World Crisis Intervention. New York: Routledge.Google Scholar
  19. Leaning, Jennifer. 2000. Health and human rights in times of conflict. In Health and Human Rights in Times of Peace and Conflict, 45–49. Boston, MA: Francois-Xavier Bagnoud Center for Health and Human Rights.Google Scholar
  20. Meilaender, Gilbert C. 1981. Friendship: A Study in Theological Ethics. South Bend: University of Notre Dame Press.Google Scholar
  21. Merskey, Harold. 1978. Political neutrality and international cooperation in medicine. Journal of Medical Ethics 4.2 (1978): 74–77.CrossRefGoogle Scholar
  22. Neier, Aryeh. 2006. Preface to Trust is Not Enough: Bringing Human Rights to Medicine by David J. Rothman and Sheila M. Rothman, vii–xiv. New York: New York Review of Books.Google Scholar
  23. Office of the United Nations High Commissioner of Human Rights. Protocol Additional to the Geneva Conventions of 12 August 1949, and relating to the Protection of Victims of International Armed Conflicts (Protocol 1). Cited 3 September 2005.
  24. Physicians for Human Rights. Rape as a Weapon of War in Darfur. Cited 31 December 2006.
  25. Rawls, John. 1998. A Theory of Justice, rev. ed. Cambridge, MA: Belknap.Google Scholar
  26. Roth, Kenneth. 2001. Health-related aspects of international humanitarian law. In Health and Human Rights in Times of Peace and Conflict, 73–80. Boston, MA: Francois-Xavier Bagnoud Center for Health and Human Rights.Google Scholar
  27. Russbach, Remi and Daniel Fink. 1994. Humanitarian action in current armed conflicts: opportunities and obstacles. Medicine & Global Survival 1.4: Cited 3 September 2005.
  28. Santa Barbara, Joanna. 1997. Physicians and the prevention of war. Medicine & Global Survival. Cited 3 September 2005.
  29. Winslow, Gerald R. 1982. Triage and Justice. Berkeley, CA: University of California Press.Google Scholar
  30. World Medical Association. 1975. Declaration of Tokyo.Google Scholar
  31. World Medical Association. The World Medical Association Regulations in Times of Armed Conflict. Cited 24 January 2005.
  32. World Medical Association. World Medical Association Condemns Human Rights Violations in Kosovo. Cited 24 January 2005.
  33. Wynia, Matthew K. et al. 1999. Medical Professionalism in Society. New England Journal of Medicine 341: 1612–1616.CrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media B.V 2008

Authors and Affiliations

  • Justin M. List
    • 1
  1. 1.University Chicago Stritch School of MedicineUSA

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