Bioethics and Armed Conflict: Moral Dilemmas of Medicine and War (Basic Bioethics) [Hardcover]

Michael L. Gross (Author)

Book Description

ISBN-10: 0262072696 | ISBN-13: 978-0262072694 | Publication Date: June 10, 2006

Is medical ethics in times of armed conflict identical to medical ethics in times of peace, as the World Medical Association declares? In Bioethics and Armed Conflict, the first comprehensive study of medical ethics in conventional, unconventional, and low-intensity war, Michael Gross examines the dilemmas that arise when bioethical principles clash with military necessity—when physicians try to save lives during an endeavor dedicated to taking them—and describes both the conflicts and congruencies of military and medical ethics.

Gross describes how the principles of contemporary just war, unlike those of medical ethics, often go beyond the welfare of the individual to consider the collective interests of combatants and noncombatants and the general interests of the state. Military necessity plays havoc with such patients' rights as the right to life, the right to medical care, informed consent, confidentiality, and the right to die. The principles of triage in battle conditions dictate not need-based treatment but the distribution of resources that will return the greatest number of soldiers to active duty. And unconventional warfare, including current "wars" on terrorism, challenges the traditional concept of medical neutrality as physicians who have sworn to "do no harm" are called upon to lend their expertise to "interrogational" torture or to the development of biological or chemical weapons. Difficult dilemmas inevitably arise during armed conflict, and medicine, Gross concludes, is not above the fray. Medical ethics in time of war cannot be identical to medical ethics in peacetime.

Editorial Reviews

Review

"Best book of the year" selection in military, science, and technology
— Lawrence D. Freedman, Foreign Affairs

"In this erudite and most engaging book, Michael Gross probes, with singular depth and breadth, the philosophical underpinnings of ethical problems in military medicine, especially since 9/11. His topics range from doctors' 'higher calling' to the use of interrogational torture; his sources, from Crito to Robert J. Lifton. Gross's incisive perspectives are 'must thinking' for all those wanting to have credible views on these issues."
—Edmund G. Howe, III, Professor of Psychiatry and Director, Programs in Medical Ethics, Uniformed Services University of the Health Sciences

"Bioethics and Armed Conflict is a trenchant, unflinching, and in many ways highly original analysis of some of the most complex problems in human affairs. Perhaps even more impressive, Michael Gross opens up new dimensions for bioethical debate that will keep future scholars busy for a long, long time."
—Jonathan D. Moreno, Director, Center for Biomedical Ethics, University of Virginia

"Michael Gross is one of the few authors who have looked at the medical ethics of war. He surveys this alien landscape, points out where the battles will be fought, and proposes positions to hold. His map will be of great value to medical ethicists, military clinicians, and policymakers."
—Steven H. Miles, M.D., Professor of Medicine, Center for Bioethics, University of Minnesota

"This book has the potential to become a scholarly classic. The work is extremely well-researched and original, and this is the most complete treatment of the subject matter with which I am familiar."
—Malham Wakin, Professor Emeritus of Philosophy, U. S. Air Force Academy

About the Author

Michael L. Gross is Codirector of the Graduate Program in Applied and Professional Ethics in the Division of International Relations at the University of Haifa. He is the author of Ethics and Activism: The Theory and Practice of Political Morality.

Product Details

• Hardcover: 400 pages
• Publisher: The MIT Press (June 10, 2006)
• Language: English
• ISBN-10: 0262072696
• ISBN-13: 978-0262072694
• Product Dimensions: 9.1 x 6.2 x 1 inches
• Shipping Weight: 1.4 pounds
• Average Customer Review: 5.0 out of 5 stars  See all reviews (2 customer reviews)
• Amazon Best Sellers Rank: #6,352,652 in Books (See Top 100 in Books)

More About the Author

Michael L. Gross is professor of political science and chair of the Department of International Relations at the University of Haifa in Israel. He specializes in military ethics and military medical ethics especially during asymmetric wars such as those fought in Iraq, Afghanistan and Lebanon. He is the author of several books including Ethics and Activism: The Theory and Practice of Political Morality, Bioethics and Armed Conflict: Moral Dilemmas of Medicine and War and, most recently, Moral Dilemmas of Modern War: Torture, Assassination and Blackmail in an Age of Asymmetric Conflit. Reviews of his books, articles and excerpts can be found at his website: http://poli.haifa.ac.il/~mgross/

Customer Reviews

Most Helpful Customer Reviews

3 of 3 people found the following review helpful:

5.0 out of 5 stars Bioethics and Armed Conflict, November 21, 2007

By 

Jim (Highland, California) - See all my reviews

Amazon Verified Purchase

This review is from: Bioethics and Armed Conflict: Moral Dilemmas of Medicine and War (Basic Bioethics) (Paperback)

This is an excellent coverage of the issues that we are facing in the conflict with Asysmetric war from an Israeli perspective. Unforunately, there are no easy answers or quick formulas that can be converted into nice presentable sound-bytes. What role does medical staff play and what are the trade-offs. Who gets treated first and if supplies are limited do you treat the general first or the dying private, the STD inflected soldier or the soldier with a serious wound? The answers are fascinating and the reasons behind each decision while puzzling at first make sense.

3 of 3 people found the following review helpful:

5.0 out of 5 stars Bioethics and Armed Conflict, May 6, 2007

By 

Michael Rubin "Middle East Quarterly" (Washington, DC) - See all my reviews
(REAL NAME)   

This review is from: Bioethics and Armed Conflict: Moral Dilemmas of Medicine and War (Basic Bioethics) (Paperback)

In 2004, the World Medical Association declared that "medical ethics in times of armed conflict is identical to medical ethics in times of peace." Gross, an ethicist at the University of Haifa, takes issue with this conclusion. "Military personnel do not enjoy a right to life, personal autonomy, or a right to self-determination to any degree approaching that of ordinary patients," he observes. While bioethics focuses on the rights of an individual, military necessity places paramount authority in the state.

Many bioethicists, insulated by peace, wallow in theory and philosophy. Living in Israel - in Haifa, at that - and facing war, Gross infuses his study with reality. As commentators and human rights activists criticize U.S. participation in Iraq and Israeli actions, Gross examines a number of bioethical quandaries that have consequences for contemporary militaries and physicians. He offers rich historical background.

While doctors pledge to do no harm, war creates dilemmas. Is it right for surgeons to operate in order to enable soldiers to return to harm's way? The Geneva Conventions imply triage to be based upon the principle of need, but the North Atlantic Treaty Organization (NATO) prioritizes triage by ability to salvage soldiers. More broadly, Gross examines whether policymakers have an obligation to always preserve soldiers' lives or whether soldiers forfeit a right to life when they enlist. Can policymakers sacrifice soldiers or order them to take extreme risks? He also explores ethical dilemmas of resource allocation in cases where having more doctors means skimping on essential non-medical equipment.

For Middle East specialists, Gross's treatment of asymmetric warfare and the distinctions between combatants and noncombatants is a must-read. He illustrates theoretical discussions with examples drawn from the Iran-Iraq war and the Arab-Israeli conflict. For example, how should armies balance the need to protect medical facilities in combat zones when Palestinian terrorists use them as firing bases? What obligations is Israel under to allow medical access to besieged cities when terrorists ferry weapons and personnel in U.N. ambulances?

Gross also addresses issues such as the role of medical professionals in interrogations and ethical dilemmas posed by torture. With real-world examples, he explores the ethics behind the "ticking bomb scenario" when rigorous interrogation has prevented attacks by Palestinian terrorists. Also interesting is his discussion of the ethics of non-lethal chemical or biological weapons. Can doctors participate in studies that determine the greatest non-lethal level of incapacitation enemy soldiers can endure in the course of battle? What if such weapons affect civilians in urban combat?

The real value of Gross's book, though, is that he neither preaches nor resorts to demolishing straw-man arguments but rather seeks to outline contrasting arguments fairly. He discusses preexisting academic theories but does so without excessive jargon, making his book accessible to a wide audience. As such, Bioethics and Armed Conflict becomes an invaluable manual addressing some of the ethical issues of the day, useful not only for Middle Eastern specialists and military commanders but also for physicians and the general reader.

Michael Rubin
Middle East Quarterly
Summer 2007