Controversies in Military Ethics & Security Policy
"A citizen in uniform will always help the population"
The medical service of the German Armed Forces is also strongly challenged in the corona pandemic and supports the civil health sector. What insight have been gained from the first wave in spring, what motivates doctors and nursing staff, what helps them to cope with their experiences? How do physicians view developments in society, and what would they say to corona skeptics? Two doctors from the Bundeswehr central hospital in Koblenz have reflected on these and other topics for “Ethics and Armed Forces”.
From an intensive care point of view, the current preparations are essentially no different than those made in February during the first wave. What was planned back then proved effective in practice: we had capacity at all times, and never felt unable to provide treatment of any kind. Then and now, the key point was and is to ensure sufficient capacity in intensive care units. This time around, it is less a question of equipment like ventilators, and more about personnel. However, this applies not only to nurses but also to doctors. This point is somewhat overlooked at present in public perceptions.
The question of motivation almost answers itself. In such an all-encompassing and extremely threatening situation as this, as a doctor or a nurse it goes without saying that you do everything you can – and we really mean everything – to help alleviate suffering, and ideally provide treatment. Closely linked to this, however, is the possibility of failure – by not living up to this expectation, or only partially living up to it. Probably everyone who bears medical responsibility in the various roles and management levels at least respects, if not fears this possibility. It is an uncomfortable feeling that is surely experienced to differing degrees by different people, and it should certainly be addressed. We should be clear that this is not weakness or even cowardice. It is simply an understandable reaction to an enormous challenge. Being aware of one’s own fallibility as well as the limited possibilities in regard to one’s own actions can help us to cope better with the stresses of the crisis, and not collapse under the burden of responsibility. But success too can have a positive, strengthening effect. This is why it proved very helpful to see during the first wave that the chosen structure and associated processes worked almost perfectly, and really every single patient could be treated. Just the feeling of having been there to play a part in taking on this challenging situation gave strength and motivation to many members of the medical service. Successful emergency response is always a great motivator! Of course, this success is diminished by every patient who dies despite receiving optimal treatment. So dealing with such situations necessarily involves examining these supposed failures, to see whether there is a need for optimization, and whether anything can be learned from them. The quest for continuous improvement also includes exploiting scientific successes. Over the course of time, we have gained an ever better understanding of the disease. Old treatment methods have been abandoned and new ones successfully evaluated and implemented in clinical practice. As a result, the prospects of successful treatment have increased overall, which provides additional motivation and helps us to handle the situation. This motivation is urgently needed, because corona is not only a medical threat but also has an impact on social coexistence. By this we mean not only the continual discussions about appropriate protective measures, but also how the virus is influencing our thoughts and experiences. This includes, for example, the increased perception of our own vulnerability. It has become clear to everyone just how suddenly we can lose the ability to control our own fate. Of course we do not have complete control over our lives, not even under normal conditions – illness, injury and death are just too unpredictable and down to fate. But in normal times it is much easier to ignore this fact, at least as long as you are not affected by it yourself. The virus is currently making this convenient ignorance impossible to maintain. Comparable events in the past were the 1986 Chernobyl nuclear reactor accident, or the terror attacks of September 11, 2001. What these two events have in common is that they were a kind of time-stamp, and had a determining influence on world events for years afterwards. It could be similar with the corona epidemic.
So it was all the more important that the Bundeswehr, just like in 1986 and 2001, has functioned and continues to function perfectly. The Bundeswehr was on hand in the corona situation, acting as a stabilizing force and helping the public. They were fast, responsive to people’s needs, and direct. We can assume that large sections of the public see things this way. Trust in the German armed forces has therefore received a lasting boost. The Bundeswehr is and will remain a part of the state and will never be or become a state within a state. A citizen in uniform will always help the population and not look away when help is needed. This fundamental difference from the Reichswehr of the Weimar Republic is in the Bundeswehr’s DNA. For the Bundeswehr as a whole, dealing with the corona crisis is not really a new experience. It is more of a confirmation of its original purpose. For every individual member of the armed forces as well as for the many civilian employees, this means experiencing – for the first time or once again, depending on length of service – what it means to take responsibility for the people.
Skeptics in this regard are difficult to argue with, as there are plenty of rational and in particular scientifically based explanations of Covid and how to deal with it. But it is part of the essence of this new skepticism not to acknowledge reason and science, but instead to deny them. Nevertheless, there is no other way with even a minimal hope of success than to attempt a serious discussion. Whenever the opportunity arises, skeptics must be resolutely opposed. This applies all the more to those who are actively involved in fighting against the coronavirus. They should share their experiences and describe corona as it is: an absolutely deadly threat that can only be overcome if everyone pulls together. But we have to be aware that it is only possible to get through to a few, at best. And of these few, hardly any will change their point of view. But the simple fact that it might be possible to convince them should be motivation enough to try to do just that. After all, discussing with intransigent skeptics means attempting to defend reason against unreason. Any reason that tires of discussion will no longer be taken seriously, because this will be seen as an admission of its supposed weakness. And precisely this must not be allowed to happen!