Dual Loyalties in Military Medicine. Some Lessons from the Past—Challenges for the Future

Physicians have sworn the oath of Hippocrates and are bound in loyalty to their patients. But they may also face loyalty to their employer, government or commanding officer. Such dual loyalty problems exist inter alia in the armed forces and can lead to ethical dilemmas. This chapter describes dual loyalty problems of health professionals in the context of a human rights-based approach, describes medical involvement and complicity in violations of human rights, but also the mobilization of medical knowledge in the defense and promotion of human rights. History and cases from the past can provide lessons, and challenges for the future. Focusing on military health professionals, the chapter concludes that the military health professional’s first and overruling identity and priority is that of a health professional, positioned in the medical community at large—on individual and organizational basis—and should be facilitated to report and expose violations of international human rights law and international humanitarian law. The author stresses that physicians and other health professionals should never remain silent about human rights violations and always defend patient rights and professional medical ethics when they witness human rights abuses, in general and in the armed forces.