Care to the Wounded: A Core Duty of Humanity

Military doctors and medics have an ethical duty to treat the sick and wounded, without discriminating between friend and foe. For Paul Bouvier, this duty is a central humanitarian precept that must not be weakened under any circumstances. Otherwise there is a risk of catastrophic consequences: exploitation and abuse of patients, or even the participation of doctors in torture.

For more than 150 years, the obligation to rescue and treat the wounded and sick has been enshrined in International Humanitarian Law. Humanitarianism, impartiality, inviolability and functional independence of helpers are key ethical principles for military medical services and humanitarian aid missions. Even in war, doctors and nursing staff have a duty of unconditional medical loyalty to their patients. This includes patient-physician confidentiality. Bouvier admits that this precept can be a difficult emotional challenge in present-day crises and conflicts. When medical helpers are expected to treat criminals or terrorists, for example, this can often produce contradictory feelings. Nevertheless, Bouvier argues, emotions should not influence medical decisions. Neither can a sense of belonging to the team justify giving preferential treatment to fellow soldiers. Nor is it acceptable for the obligations and loyalty which (military) doctors have towards their respective employers to affect patient care. Medical assistance should never be subordinated to strategic, political or intelligence objectives.

Bouvier takes an ethical approach to resolving the tensions which doctors and medics often encounter in armed conflict. He calls on decision-makers to recognize impartial assistance for people in danger as being an essential ethical imperative, and to ensure that the role and actions of medical personnel are free from interference by government and the military. Bouvier also believes it is vital that military physicians and medics receive in-depth education in medical ethics. This can help them deal with contradictory emotions, and guard against demonizing or even dehumanizing the enemy. Anyone who can recognize a wounded enemy as being a fellow human in need and provide assistance despite all circumstances, Bouvier summarizes, is setting an example of humanitarianism in practice.