Centre for Military Ethics

Medical Resources

Medical rules of eligibility

This section includes general materials on Medical rules of eligibility.

Key references

Convention (I) for the Amelioration of the Condition of the Wounded and Sick in Armed Forces in the Field. Geneva, 12 August 1949. PROTECTION AND CARE OF THE WOUNDED AND SICK. ARTICLE 12
Convention (II) for the Amelioration of the Condition of Wounded, Sick and Shipwrecked Members of Armed Forces at Sea. Geneva, 12 August 1949. PROTECTION AND CARE OF THE WOUNDED, SICK AND SHIPWRECKED ARTICLE 12
Protocol Additional to the Geneva Conventions of 12 August 1949, and relating to the Protection of Victims of International Armed Conflicts (Protocol I), 8 June 1977. PROTECTION AND CARE. ARTICLE 10
Convention (IV) relative to the Protection of Civilian Persons in Time of War. Geneva, 12 August 1949. FIELD OF APPLICATION OF PART II. ARTICLE 13
Protocol Additional to the Geneva Conventions of 12 August 1949, and relating to the Protection of Victims of International Armed Conflicts (Protocol I), 8 June 1977. PROTECTION AND CARE. ARTICLE 10.
Protocol Additional to the Geneva Conventions of 12 August 1949, and relating to the Protection of Victims of Non-International Armed Conflicts (Protocol II), 8 June 1977. PROTECTION AND CARE. ARTICLE 7
World Medical Association. Policy Tag: Geneva Convention.

Academic Papers

Druce, P., Bogatyreva, E., Siem, F.F. et al. Approaches to protect and maintain health care services in armed conflict – meeting SDGs 3 and 16. Confl Health 13, 2 (2019).
Ryan JM, Sibson J, Howell G. Assessing injury severity during general war. Will the Military Triage system meet future needs. Journal of the Royal Army Medical Corps. 1990 Feb 1;136(1):27-35.

Ryan JM, Sibson J, Howell G. Assessing injury severity during general war. Will the Military Triage system meet future needs. Journal of the Royal Army Medical Corps. 1990 Feb 1;136(1):27-35.

Falzone E, Pasquier P, Hoffmann C, Barbier O, Boutonnet M, Salvadori A, Jarrassier A, Renner J, Malgras B, Mérat S. Triage in military settings. Anaesthesia Critical Care & Pain Medicine. 2017 Feb 1;36(1):43-51.

Falzone E, Pasquier P, Hoffmann C, Barbier O, Boutonnet M, Salvadori A, Jarrassier A, Renner J, Malgras B, Mérat S. Triage in military settings. Anaesthesia Critical Care & Pain Medicine. 2017 Feb 1;36(1):43-51.

Bricknell MC. Reflections on medical aspects of ISAF IX in Afghanistan. BMJ Military Health. 2007 Mar 1;153(1):44-51.

Bricknell MC. Reflections on medical aspects of ISAF IX in Afghanistan. BMJ Military Health. 2007 Mar 1;153(1):44-51.

Henning J. The Ethical Dilemma of Providing Intensive Care Treatment to Local Civilians on Operations. BMJ Military Health 2009;155:84-86.

Henning J. The Ethical Dilemma of Providing Intensive Care Treatment to Local Civilians on Operations. BMJ Military Health 2009;155:84-86.

Causey M, Rush RM Jr, Kjorstad RJ, Sebesta JA. Factors influencing humanitarian care and the treatment of local patients within the deployed military medical system: casualty referral limitations. Am J Surg. 2012 May;203(5):574-577
Michael Woll, MC USA, Paul Brisson, MC USA, Humanitarian Care by a Forward Surgical Team in Afghanistan, Military Medicine, Volume 178, Issue 4, April 2013, Pages 385–388
Caring for Compatriots. Military Necessity before Medical Need? Military-medical.com Journal. 18 Aug 2017.
Gross ML. Saving Life, Limb, and Eyesight: Assessing the Medical Rules of Eligibility During Armed Conflict. Am J Bioeth. 2017 Oct;17(10):40-52.
Jessica P. Miller (2017) A Care Ethics Approach to Medical Eligibility in Armed Conflict, The American Journal of Bioethics, 17:10, 61-63
Antoine Lamblin, Clément Derkenne, Marion Trousselard et al. Ethical challenges faced by French military doctors deployed in the Sahel (Operation Barkhane): a qualitative study., 28 April 2021, PREPRINT (Version 1) available at Research Square

Policy Publications

AMedP-1.10. Medical Aspects In The Management Of A Major Incident/Mass Casualty Situation. Edition B, Version 1. NATO. Oct 2021.
Joint Doctrine Note JDN 3/14. The Military Medical Contribution to Security and Stabilisation.

Playing Card Scenarios

2 Clubs – In a mass casualty situation, is it ethical for a military medical unit to keep beds empty for new military casualties?
4 Spades – How do you decide the first person to treat or the allocation of single resources between two casualties with the same triage score?
8 Spades – There is a shortage of beds and you have a stable but ventilated patient who can be moved to a local hospital but you know there are no nurses on night shifts. This could mean a death sentence. What do you do?
King Spades – If you were faced with limited resources, how would you balance palliative care priorities with pain relief for incoming trauma patients?
Ace Spades - With modern medicine it is possible to save the lives of people with devastating injuries that will profoundly change their lives forever.Are there limits to how far treatment should be taken? Who decides?