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Weaponising medicine: “Tutti fratelli,” no more
  1. T Koch
  1. Correspondence to:
 Professor Tom Koch
 University of British Columbia, Department of Geography (Medical), 1984 West Mall, Vancouver, BC, Canada V6T 2Z1; tomkoch{at}

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The acceptance of military directives violating medical ethics and international covenants encouraged by the demonisation of the enemy by the US president in 2002 has effectively removed the right of medical personnel to refuse participation in internationally proscribed actions

Medicine and its traditional ethic of care is today a victim of the current conflict in Iraq and Afghanistan, its uniquely humanising mission rejected by US President George W Bush and his advisors. In denying the applicability of international agreements guaranteeing medicine’s ecumenical role in this conflict they have transformed medicine into just another weapon of tactical significance. The result, predictable in retrospect, has been to make military physicians and nurses complicit—actively or passively—in what Litton calls an “atrocity-producing situation”, resulting in detainee or prisoner abuse.1

From the first revelations of detainee torture in US detention camps (2004) to recent allegations of continued abuse (2006), the focus of international attention has shifted from the US prosecution of low ranking, non-commissioned military personnel to the context in which the atrocities they committed occurred. “No one up the chain of command has ever been held accountable for what is in these horrifying images,” Center for Constitutional Rights Director Bill Goodman said of recently published photographs of 2004 prisoner torture and abuse.2 “The situation in several areas violates international law and conventions on human rights and torture,” said the UN Special Rapporteur on Torture following a 2006 investigation.3

The denial of international law and convention involved the overt disavowal of covenants and conventions that for almost 150 years required medical personnel in the US military to act within the guidelines of a Hippocratic vision of medicine. To understand how fundamental this change has been requires a brief review of the history of medicine’s previously protected status and then a description of …

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  • Tom Koch, PhD is a bioethicist, gerontologist, and medical geographer with appointments at the University of British Columbia and Simon Fraser University in Vancouver, Canada. He is the author of a number of books on medicine and ethics, including the 2005 Cartographies of Disease.

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