Abstract:
:This paper reviews changes in the ethical challenges that have arisen in military medicine over the past four decades. This includes the degree, if any, to which providers during the Vietnam conflict have carried out what we now refer to as harsh interrogation measures in an attempt to extract information from captured enemy soldiers, the extent, if any, to which the USA used medicine as a means to try to win over the hearts and minds of civilians in occupied territory and how providers should treat service members who return from the front with combat fatigue. An issue that arose during the first Gulf War in 1991 is discussed, namely US service persons being required to take botulism vaccine without their consent. Finally, present challenges are discussed including interrogation measures such as waterboarding and the ethical issues posed in the recent past by the exclusion of gay service members and those posed presently by the inclusion of transgender members. Two ethical values are suggested that have remained constant, namely giving priority to the individual needs of service personnel over those of the unit when there are no urgent combat needs and the reliance on individual virtue when what they should do is morally unclear.
journal_name
J R Army Med Corpsjournal_title
Journal of the Royal Army Medical Corpsauthors
Howe Edoi
10.1136/jramc-2018-001036subject
Has Abstractpub_date
2019-08-01 00:00:00pages
273-278issue
4eissn
0035-8665issn
2052-0468pii
jramc-2018-001036journal_volume
165pub_type
历史文章,杂志文章,评审abstract::A retrospective analysis of 53 consecutive cases of orchidopexy performed at the British Military Hospital Munster between 1984 and 1988 showed that the average of referral for orchidopexy was 4 years 7 months and that the average age at surgery for mal/un-descended testes was 5 years exactly. Sixty-four percent of al...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-136-01-08
更新日期:1990-02-01 00:00:00
abstract:BACKGROUND:Detailed knowledge of the likely volume and nature of the diseases presenting to deployed secondary care facilities aids operational planning. Now the British operation in Afghanistan has ended and a record of the experience is useful to preserve the lessons learned. METHODS:Over a 2-year period from April ...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2014-000385
更新日期:2016-02-01 00:00:00
abstract::A patient who presented with recurrent bilateral knee effusions was found to have positive serum syphilis serology. She was treated with oral erythromycin to a total of 40 grams and intra-articular injection of steroids in the right knee joint. Late congenital syphilitic arthritis is discussed with a review of the lit...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-135-02-11
更新日期:1989-06-01 00:00:00
abstract:BACKGROUND:During this conflict 34 Field Hospital, the sole Coalition field hospital located in Iraq, received and treated casualties with a wide range of injuries. Located very close to the front line during the period of combat hostilities, it was potentially going to deal with relatively fewer battle-injured extremi...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-150-03-06
更新日期:2004-09-01 00:00:00
abstract::Night vision goggles have become an essential component of military aviation. They provide superior visual capability over unaided night vision, but there are several inherent limitations associated with human factors and systems limitations. This study used a questionnaire survey of Army helicopter aircrew to investi...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-146-01-05
更新日期:2000-02-01 00:00:00
abstract::A case of a 28 years old Caucasian woman is presented with acute tibial compartment of her left leg secondary to repeated self inflicted soft tissue injuries, together with literature review on Dermatitis Artefacta. ...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章,评审
doi:10.1136/jramc-140-02-11
更新日期:1994-06-01 00:00:00
abstract:AIM:To quantify the risk for delivering care at Role 1 in the Land Environment (point of wounding to hospital care) on current operations and set the conditions for systematic change to enhance future capability. POPULATION:UK, US and Danish Army Role 1 Subject Matter Experts (SMEs) METHODS:(1) Questionnaire study of...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章,评审
doi:10.1136/jramc-158-03-04
更新日期:2012-09-01 00:00:00
abstract::Primary blast lung injury frequently complicates military conflict and terrorist attacks on civilian populations. The fact that it occurs in areas of conflict or unpredictable mass casualty events makes clinical study in human casualties implausible. Research in this field is therefore reliant on the use of some form ...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 社论,评审
doi:10.1136/jramc-2016-000678
更新日期:2017-04-01 00:00:00
abstract::Tattoo removal from the forearm often requires excision and split skin grafting. The authors propose the use of a bloodless field to facilitate accurate dermal peeling, to ensure complete removal of the pigment, and to reduce operative time. ...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-137-01-02
更新日期:1991-02-01 00:00:00
abstract::The Australian Army recently adopted the British concept of hospital exercise (HOSPEX) as a means of evaluating the capabilities of its deployable NATO Role 2E hospital, the 2nd General Health Battalion. The Australian approach to HOSPEX differs from the original UK model. This article describes the reasons why the Au...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2014-000378
更新日期:2015-12-01 00:00:00
abstract::The ten-week Professionally Qualified Officers (PQO) course has been running successfully for a number of years and focuses on the values of officership, leadership and command. This article compares the principals embodied in the "Sandhurst Ethos" and the General Medical Council's "Duties of a Doctor" and examines ho...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-158-04-21
更新日期:2012-12-01 00:00:00
abstract::Using a major ethics crisis as a methodological approach to study secret science environments, part II examines the origins and organisation of the Applied Biology Committee (ABC), the first independent research ethics committee (REC) at Porton Down, Britain's biological and chemical warfare establishment since the Fi...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 历史文章,杂志文章
doi:10.1136/jramc-2019-001207
更新日期:2019-08-01 00:00:00
abstract::Pneumorrhachis or intraspinal air is an increasingly encountered phenomenon in the management of severe trauma. The case of a 23-year-old soldier, who sustained a gunshot wound to the chest, is presented and the subsequent discussion illustrates that while often benign this phenomenon may indicate serious occult injur...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-156-04s-09
更新日期:2010-12-01 00:00:00
abstract::Decision Support Aids (DSAs) have been widely used throughout industry and one (known as Table 7) is available to support British Army Medical Officers (MOs) grade soldiers against the Joint Medical Employment Standards. It is unknown how useful this DSA is in practice. An electronic questionnaire was distributed to B...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2015-000553
更新日期:2015-12-01 00:00:00
abstract::The Defence Clinical Psychology Service (DCPS) is the professional clinical psychology service and community of clinical psychology practice within UK Ministry of Defence (MoD). The DCPS provides professional clinical care, consultation and research in support of the UK Armed Forces. Regulated by the Health and Care P...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2018-001044
更新日期:2019-04-01 00:00:00
abstract::Tracheobronchomalacia is a rare cause of respiratory distress in children. An infant with tracheobronchomalacia is presented. The aetiology, pathophysiology and management are discussed. ...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-138-02-08
更新日期:1992-06-01 00:00:00
abstract::In the decade 1968-77, 203 (12%) of the 1723 deaths in off duty British Army males were associated with a blood alcohol concentration (BAC) in excess of 80 mgs/100 mls. These deaths occurred in road traffic accidents (49%), acute alcohol poisoning (23%), suicide (9%), drowning (8%), falling from a height (7%), burns (...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-133-01-06
更新日期:1987-02-01 00:00:00
abstract::Under the laws of armed conflict military medics are deemed non-combatants, and as such are subject to certain protections and limitations. The non-combatant status is defined in the famous Geneva Conventions, which form the basis of the international law of armed conflict. The protections afforded to medical personne...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 社论
doi:10.1136/jramc-2016-000732
更新日期:2017-12-01 00:00:00
abstract::Modern drug treatment, added to our previous experience of surgery and radiotherapy, is currently producing nearly 90% cure of all patients with testicular tumours. Most of the failures of treatment today occur in patients with a large mass of diseased tissue which has accumulated due to delayed diagnosis. A retrospec...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-131-03-04
更新日期:1985-10-01 00:00:00
abstract:BACKGROUND:In a care under fire situation, a first line response to haemorrhage is to apply a tourniquet and return fire. However, there is little understanding of how tourniquets and other haemorrhage control devices impact marksmanship. METHODS:We compared the impact of the iTClamp and the Combat Application Tourniq...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章,随机对照试验
doi:10.1136/jramc-2016-000664
更新日期:2017-06-01 00:00:00
abstract::A case of pentazocine induced hallucinations which responded to treatment with Naloxone is reported. ...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-130-01-10
更新日期:1984-02-01 00:00:00
abstract::The physical mechanism of blunt impact injuries to thoracic and abdominal viscera is often conveniently described simply in terms of "crush"--this is an over-simplification. Any impact to the torso does result in the rapid displacement of the body wall which may lacerate and contuse underlying viscera, but this simple...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-135-02-04
更新日期:1989-06-01 00:00:00
abstract:AIM:To determine the prevalence of tourniquet use in combat trauma, the contribution to lives saved and the complications of their use in this environment. POPULATION:All casualties treated at UK field hospital facilities in Iraq and Afghanistan and meeting criteria for entry into UK Joint Theatre Trauma Registry (JTT...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-153-04-19
更新日期:2007-12-01 00:00:00
abstract::It has been stated that the application of a pre-hospital tourniquet could prevent 7% of combat deaths, however their widespread use has been questioned due to the potential risk from prolonged ischaemia. We reviewed members of the UK Armed Forces who sustained severe limb-threatening injuries in Iraq and Afghanistan,...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-155-03-06
更新日期:2009-09-01 00:00:00
abstract::We performed a study to assess the effectiveness of a fluid infusion strategy currently used in the military pre-hospital environment using the patient's own body weight as an infusion device. Thirteen healthy volunteers were cannulated and 0.9% sodium chloride infused over a period of ten minutes. The volumes infused...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-153-03-06
更新日期:2007-09-01 00:00:00
abstract::We describe a case of anaerobic streptococcal myonecrosis as a rare complication after pilonidal sinus excision with primary closure. The recognition of the disease in any patient who has early septic deterioration after a surgical procedure requires aggressive management for survival. ...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-140-03-09
更新日期:1994-10-01 00:00:00
abstract::We describe a case of malignant duodenocolic fistula in which after a radical resection of right hemicolectomy and pancreaticoduodenectomy, the duodenal defect was reconstructed using a conduit of transposed ileum. This technique, not previously described, offers an alternative to 'duodenal patching', which allows onl...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-139-02-08
更新日期:1993-06-01 00:00:00
abstract::In response to an Urgent Operational Requirement, the UK Ministry of Defence (MoD) investigated, designed, developed, trialled and subsequently fielded a Tiered Pelvic Protection System to service personnel deployed on Operation HERRICK in Afghanistan. An Urgent Statement of User Requirement (USUR) was drafted in orde...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2013-000026
更新日期:2013-03-01 00:00:00
abstract::A case of ovarian ectopic pregnancy is described which satisfies all of Spiegelberg's criteria and in the discussion the reasons for the apparent association with an intrauterine contraceptive device are examined. :A case is reported of ovarian pregnancy in a woman wearing a Copper 7 IUD for 2 years. She has 2 weeks...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-133-02-09
更新日期:1987-06-01 00:00:00
abstract:PURPOSE:The purpose of this study was to find out the risk value of functional fitness test (FFT) results for low back pain (LBP) among fixed-wing military pilots. METHODS:A total of 104 male military pilots were recruited for this study. The study was conducted with a self-administered questionnaire and FFT. The func...
journal_title:Journal of the Royal Army Medical Corps
pub_type: 杂志文章
doi:10.1136/jramc-2015-000510
更新日期:2017-02-01 00:00:00