How must military medical ethics adapt to the realities of modern warfare?

Mark D. White

The latest issue of Bioethics (27/3, March 2013) features a brief but provocative paper by Steven H. Miles (University of Minnesota in Minneapolis) titled "The New Military Medical Ethics: Legacies of the Gulf Wars and the War on Terror":

United States military medical ethics evolved during its involvement in two recent wars, Gulf War I (1990–1991) and the War on Terror (2001–). Norms of conduct for military clinicians with regard to the treatment of prisoners of war and the administration of non-therapeutic bioactive agents to soldiers were set aside because of the sense of being in a ‘new kind of war’. Concurrently, the use of radioactive metal in weaponry and the ability to measure the health consequences of trade embargos on vulnerable civilians occasioned new concerns about the health effects of war on soldiers, their offspring, and civilians living on battlefields. Civilian medical societies and medical ethicists fitfully engaged the evolving nature of the medical ethics issues and policy changes during these wars. Medical codes of professionalism have not been substantively updated and procedures for accountability for new kinds of abuses of medical ethics are not established. Looking to the future, medicine and medical ethics have not articulated a vision for an ongoing military-civilian dialogue to ensure that standards of medical ethics do not evolve simply in accord with military exigency.

"Don't Ask, Don't Tell" officially ends

Mark D. White

As this New York Times article celebrates, the U.S. military's "don't ask don't tell" policy is officially over. Military personnel who are gay or lesbian no longer have to suppress their identity and compromise their cherished virtue of honesty to serve their country.

(H/T: Erica Greider.)

We Should Not Celebrate the Death of Osama Bin Laden

I do not mourn the death of Osama bin Laden, but neither do I celebrate it. The impulse to cheer upon hearing the news of this man's death is understandable, but we as Americans can do better than flaunting our joy to the world. I would rather we acknowledge the work of our military in achieving it, and appreciate the fact that only a handful of others died in the operation. Justice was done, to be sure, but justice achieved in the context of an ongoing struggle is a solemn occasion, not a joyful one.

I remember being appalled and disgusted at the sight of bin Laden's supporters and admirers cheering the fall of the Twin Towers almost ten years ago. There is no moral equivalency between the deaths of thousands of innocent persons that day and the death of bin Laden now, but nonetheless the sight of Americans cheering in the streets this morning was unsettling to me. It will certainly embolden those who will continue his mission, but I'm more concerned with what it says about us.

For those of us too young to remember World War II, the events of 9/11 were our Pearl Harbor, made even more tragic by the fact that most of those who died were civilians. But bin Laden's death is not our V-Day; peace has not yet been achieved, our fighting men and women aren't all coming home, and the struggle continues. We should reserve our cheers and parades for when the fight is over—only then will we have something to celebrate.

I am very fortunate in that I lost no one close to me on 9/11, but I work with many who did. Staten Island is home to many of New York City's police officers and firefighters, and most everybody at my college who grew up here has a brother or cousin who was lost in the rescue efforts, as well as those who worked in the Towers themselves. On this occasion, let us not cheer the death of Osama bin Laden; even a death that is deserved and just does not merit celebration. Instead, let us honor those who gave their lives then and now, and those who continue to fight against his cause. Please remember those who died serving the cause of freedom, rather than a man worked to take it away.

The Moral Psychology of War (tpm's Idea of the Century #42)

Mark D. White

Sherman As Jonathan noted previously, the philosophers' magazine (tpm) has been running a series of the top 50 Ideas of the 21st Century, and today's entry, #42, is "The Moral Psychology of War" by one of my favorite philosophers, Nancy Sherman, author of The Untold War: Inside the Hearts, Minds, and Souls of Our Soldiers, Stoic Warriors: The Ancient Philosophy behind the Military Mind, Making a Necessity of Virtue: Aristotle and Kant on Virtue, and The Fabric of Character: Aristotle's Theory of Virtue.

From the article:

Going to war inevitably turns policymakers and academics to philosophical justifications of war and its conduct. And so, unsurprisingly, there has been a renaissance over the past ten years in just war theory. But what we need moral clarity about is not just whether a war or its prosecution is justified, but how soldiers bear the moral weight of war. Soldiers go to war to fight external enemies, in Iraq and Afghanistan today, or in Europe and the Pacific in my father’s era. But most, at least the honest among them, fight inner wars as well. They wrestle with the guilt of luck and accident, and the uneasy burden of killing and leaving the killing behind. For some, what weighs heavy is the sense of betrayal that is part of the moral shadowland of wartime interrogation – of building intimate rapport with a detainee only to exploit it. For others, the moral burden comes with killing civilians, as part of the permissible, but no less wrenching collateral damage of war.

One more step toward repeal of "don't ask, don't tell" (DADT)

Mark D. White

As I'm sure you already know, the U.S. Senate voted today to end the ban on open homosexuals in the military. I hope the president signs this bill and ends seventeen years of forcing gay and lesbian Americans who wish only to serve their country to either lie about or conceal an essential part of their identities.

Study Dismisses Concerns about Gays in Military, But Should It Matter?

Mark D. White

Today's news about a new study showing most military personnel do not oppose open service of gays and lesbians leads to mixed feelings. On the one hand, it should speak against those who argue that open homosexuals in the military will reduce morale, especially given the reported correlation between those who have served alongside (believed) homosexuals and acceptance of repeal of DADT. If this study is of use in achieving repeal--and it very well may, if early reports of its impact are any guide--all the better.

But at the same time, I find the study irrelevant in the more general, less political sense. As much as I respect, admire, and am grateful to our men and women in service, I don't think their opinions regarding who can or cannot serve alongside them should matter. That is the same "tyranny of the majority" that we see in calls for legislation dealing same sex marriage, wherein the majority would be granted improper influence over the essential rights of the minority (even if those rights are voted for). Homosexuals should be allowed to serve their country without hiding an important part of their identities, regardless of how active personnel, or anybody else, feel about it.

I fear that elation over this study, as politically efficacious as it may turn out to be, may lead people to forget the real nature of the wrong to the dignity of gay and lesbians perpetuated by DADT.

Federal judge orders injunction against "don't ask don't tell" policy

Mark D. White

This afternoon, U.S. District Judge Virginia Phillips ordered a worldwide injunction against the Clinton-era "don't ask don't tell" policy in the United States military, under which homosexual servicemen and women must keep silent about their sexual orientation. As I wrote earlier, this demeans our proud men and women serving their country, both straight and gay: the straight ones, for being presumed unable to serve among gay comrades, and the gay ones, for being blocked from military service and for being encouraged to lie rather than be duscharged. I hope this ruling stands.

An unintentional survey of the ethics of gays in the military in the WSJ

Mark D. White

In today's Wall Street Journal, Bret Stephens has a piece arguing why the GOP should let "Don't Ask Don't Tell" (DADT) lapse in the 2011 Defense Bill, and in it he happens to cover the three mainstream approaches to ethics: consequentialism (DADT forces the expulsion or rejection of qualified, eager men and women from the armed forces), deontology (DADT violates the rights of homosexuals), and virtue ethics (DADT discourages honesty). And, in a consequentialist twist on virtue ethics, he argues (correctly, in my opinion) that this incentive for dishonesty is what weakens the armed forces, not the existence of homosexual servicemen and women itself:

In the meantime, it's worth noting that there are an estimated 48,000 homosexuals on active duty or the reserves, many of them in critical occupations, many with distinguished service records. If they pose any risk at all to America's security, it is, paradoxically, because DADT institutionalizes dishonesty, puts them at risk of blackmail, and forces fellow warfighters who may know about their orientation to make an invidious choice between comradeship and the law. That's no way to run a military.

If you'll indulge me my comics habit for a moment, the origin of the new Batwoman included a similar message on DADT, when a young Kate Kane has to withdraw from the US Military Academy after word gets out that she is a lesbian. Her CO asks her to deny the rumor (subtly insinuating that he knows they're true), but she cites the military code of honesty, and chooses to accept a discharge rather than compromise that principle. (This scene can be found in Batwoman: Elegy, written by Greg Rucka and illsutrated by the incomparable J.H. Williams.)

This shows that DADT not only asks our men and woman in the armed forces to deny an essential part of themselves, but also to deny the very principles on which the military is grounded, in order to serve their country. Stephens emphasizes the more basic consequentialist argument (which is certainly valid as well), but I favor the others (naturally)--just ask Batwoman!

Health Care and Conscription (con’t)

Jonathan B. Wight

A few days ago we carried out an active debate about whether requiring someone to buy health insurance from private companies was a “new” event in American history.  It turns out it is not.

From Brad DeLong comes this extract from Second Congress, May 8, 1792.  The act provides federal standards for a militia and forces every free male to purchase various items from private sellers.  These purchases would not have been cheap back in 1792: 

Second Congress, Session I, The Militia Act of 1792

An ACT more effectually to provide for the National Defence, by establishing an Uniform Militia throughout the United States.:

1.                  Be it enacted by the Senate and House of Representatives of the United States of America, in Congress assembled, That each and every free able-bodied white male citizen of the respective States, resident therein, who is or shall be of age of eighteen years, and under the age of forty-five years (except as is herein after excepted) shall severally and respectively be enrolled in the militia.... That every citizen, so enrolled and notified, shall, within six months thereafter, provide himself with a good musket or firelock, a sufficient bayonet and belt, two spare flints, and a knapsack, a pouch, with a box therein, to contain not less than twenty four cartridges, suited to the bore of his musket or firelock, each cartridge to contain a proper quantity of powder and ball; or with a good rifle, knapsack, shot-pouch, and powder-horn, twenty balls suited to the bore of his rifle, and a quarter of a pound of powder; and shall appear so armed, accoutred and provided, when called out to exercise or into service...


Military virtues, and gays in the military (WSJ letters)

Mark D. White

Really two separate topics here, both inspired by recent articles in the Wall Street Journal regarding the issue of gays in the U.S. armed forces.

1. The Journal is printing one of my recent letters to the editor tomorrow (Thursday, February 11) under the heading "All Society Could Use Some Military Virtues":

In Bret Stephens's "Gays in the Militaries" (Global View, Feb. 9), he makes a very profound statement that speaks to much more than the topic at hand. Regarding the military, he writes, "Its value system of duty, honor and country is very nearly the opposite of life, liberty and the pursuit of happiness."

This perceived but false dichotomy explains so much of what is wrong with society these days. If we are to live together in any semblance of harmony, then our pursuit of happiness must be tempered by considerations of duty, honor and country. The men and women who choose to serve in the military know this and live by it; the rest of us could learn a thing or two from them.

2. As long as I'm here, here's an unpublished letter of mine from last week, actually on the issue of gays in the military (they published many letters on this piece earlier this week which together covered the same points I did):

As a lifelong supporter of our armed forces, I have the utmost respect for Mr. Owens' service and his reasoned arguments against open homosexuality in the military ("The Case Against Gays in the Military," Feb. 3). In particular, I appreciate that he does not rely on the tired argument that straight personnel will not work well alongside gay ones, one which does have direct parallels to the racial integration debates of old (which Mr. Owens rightly eschews). Yet I have to disagree with his central argument regarding inappropriate personal attachments if gays are allowed to serve openly.
While his description of the ideal state of philia among servicemen and women is inspiring, and the dangers of eros being realized in combat situations are significant, I think Mr. Owens overstates the threat of romantic or sexual love being "unleashed" if homosexuals are allowed to serve openly alongside heterosexuals. Yes, sexual orientation is an intrinsic part of who we are, gay or straight, but it does not determine our behavior. Let us trust the brave men and women who are willing and eager to risk their lives defending their country to be able to resist inappropriate impulses and focus on the mission. I think we owe them that.