Exitus Acta Probat?
- Exitus Acta Probat?
- To the Editor
In "Medicalized Weapons and Modern War" (Jan-Feb 2010), political scientist Michael L. Gross argues that physicians would not violate their oath to do no harm by helping to develop and test weapons that induce physical pain, abnormal psychological states, or unconsciousness to temporarily incapacitate a victim. Because of their potential utility in asymmetric warfare, he writes, such weapons are justified in order to save the lives of civilians caught in battle.
When an individual considers a weapon necessary to a just war, according to Gross, "the duties of citizenship supersede professional obligations." This negates the very essence of the physicians' oath. We should not lightly abandon two thousand years of ethical practice in medicine to serve the political and military goals of the moment.
A central question is whether it would be possible to develop and employ weapons that can incapacitate human beings without serious consequences. Whatever the developer's intent, the outcome will always be uncertain. The safe, effective dose of an incapacitant varies from person to person; at the average incapacitating dose, more sensitive individuals, those with compromised health, or those unable to flee could be permanently injured or killed. And the dose delivered during battle will rarely be controllable. This was demonstrated in one of the few documented cases of incapacitant use: the 2002 Moscow theater siege, in which over 15 percent of the hostages died from—and many more were permanently injured by—the anesthetic used to incapacitate the hostage-takers. For comparison, the overall lethality of gunshot wounds inflicted in battle is 20 to 27 percent, according to the International Committee of the Red Cross.
Whether incapacitating weapons save civilians or not, "force multiplication" seems intrinsic to their use. The U.S. Army plans to use its new "non-lethal" microwave weapon "to deny the enemy the use of its weapons" when attacking targets populated by combatants and civilians. Similarly, in Vietnam, the United States justified the immense quantities of tear gas used as a humane way to target enemy troops mixed with civilians. Yet the army's exhaustive study of after-action reports found not a single instance of "humanitarian" use. Instead, the gas was used to force enemy troops from cover, to break contact during an ambush, or to deny terrain. Resulting public revulsion led the negotiators of the Chemical Weapons Convention of 1993 to prohibit riot control agents in warfare. Chemical agents, both "nonlethal" and lethal, are now explicitly illegal as weapons of war. But other types of incapacitating weapons are now being developed that use, for example, acoustics or electromagnetic radiation.
Incapacitating weapons take advantage of the knowledge that medical scientists and practitioners have accumulated throughout history for the purpose of healing. They target intimate aspects of the human person in specific, recondite ways without consent and for hostile purposes, setting fearsome precedents for physiological manipulation. And as they become more widely available, despots, terrorists, criminals, and torturers will likely find them more useful than responsible governments.
We have finally succeeded in outlawing toxic chemicals and biological agents as weapons of war. It would be a grave folly to undermine these achievements—and the foundation of medical ethics—by pursuing weapons of war that have such potential for abuse.
Washington, D.C.
- To the Editor
Michael L. Gross believes that physicians are not ethically prevented from developing—and may even be ethically obligated to develop—"medicalized" weapons for use in armed conflict. As a major case in point, he advocates developing pharmacological "calmatives" that could incapacitate combatants. The general reader may not appreciate that this ethical issue arises for only a very limited number of physicians—specifically, those practicing in Israel, Myanmar, Angola, North Korea, Egypt, Somalia, and the Syrian Arab Republic. This is because all other physicians work in nations that are state parties to the Chemical Weapons Convention. This treaty unequivocally bans not only use but also development or possession of any chemical weapon, regardless of its lethal potential, unless it is suitable for and used only in domestic, civilian law enforcement applications. Gross proposes developing and...
