Physicians at War: The Dual-Loyalties Challenge

This project began during the 2004-2005 academic year, when I was on a research fellowship at the Institute for Ethics of the American Medical Association (AMA). Just after I began the fellowship, two articles were published in The Lancet by Steve Miles in which he discussed alleged violations of military medical ethics that may have transpired through physician involvement in hostile interrogations.1,2 Then, right before the holiday break, we received notice that the New England Journal of Medicine would be publishing a similar essay by Gregg Bloche and Jonathan Marks, in its first issue of 2005.3 The American Medical Association in general, and the Institute for Ethics in particular, was extremely concerned about Miles’s papers and the forthcoming one by Bloche and Marks. Not only were these extremely visible publications, but many thought that the allegations they contained were of grave ethical concern. The AMA, which publishes The Code of Medical Ethics, takes very seriously the moral status of the medical profession and therefore was very interested in these articles. (Recently, the AMA’s Council on Ethical and Judicial Affairs published an opinion on physician involvement in interrogation,4 which represents the culmination of its thinking on these topics.)