ACORNS - POLICY - KING

All of the scenarios in the policy suit should be considered from the perspective of a health professional in a staff appointment as the lead officer for medical policy within a Ministry of Defence (rank equivalent of OF4/Commander/Lieutenant Colonel/Wing Commander).

Step 1 – IDENTIFY THE PROBLEM(S)

• Briefly state the Scenario: The medical services are asked for their judgement on the military effectiveness of a new weapon that uses sound to incapacitate the enemy. Is this ethical?
• List the Issues that arise from the scenario.
• Identify Critical Information required and Assumptions to be made:

This scenario covers the ethics and law regarding the development of military technologies for the conduct of war. The term ‘military effectiveness’ implies a judgement on the effect of the weapon on the human body and the utility of this effect for military purposes. It also depends on whether the question relates to ‘offensive use of sound weapons’ or ‘the measures to protect against a sound weapon’. This crosses many legal and ethical boundaries for military health practitioners and also the conduct of research to answer these questions. There are multiple conventions and professional declarations on the limits of biomedical research and the conduct of healthcare practitioners in the development of military weapons. You should search for those covering general medical research, nuclear weapons, chemical weapons, biological weapons, and others. You should also search for information on the use of sound as a weapon to provide a basic background to the physiological effects of such weapons.

You could review the BIOMEDICAL RESEARCH resources on the KCME website at: https://militaryethics.uk/en/resources/medical/biomedical-research

Step 2 – ANALYSE

Patient: your first duty to do no harm.

Clinical: Therefore you might consider how an understanding of the pathophysiological effects of sound as a weapon might be understood.

Legal: you should consider the legal dimensions of conducting research on the effects of sound on the human body. What type of research might be ethical?

Societal/Military: You might consider the governance of a policy decision to develop or employ such weapons by police or armed forces. Where does a health adviser sit in this process.

Step 3 – FUSE

• Summarise conclusions
• Insert citations to key reference sources for your analysis
• Determine the exact Decision(s) to be made

This scenario touches on the law and ethics associated with weapons development. As well as considering what you should not do, you might also consider what might be appropriate to do – e.g. any research?

Step 4 – DECIDE

• What is your Decision?
• Why (can you justify it)?
• Residual uncertainly, need for review?

It would be unethical for a healthcare practitioner to express an opinion on the military effectiveness of a weapon for offensive purposes. You might decide that would be appropriate to conduct biomedical research to investigate the effects of sound as a weapons on the human body and measures to protect against this (like research on chemical weapons). You might have specific advisory bodies/committees that can consider such a question so that the responsibility for any decisions arising from this scenario have proper governance and oversight. Examples from the UK are the Advisory Group on Military and Emergency Response Medicine (https://www.gov.uk/government/organisations/advisory-group-on-military-medicine) and the Scientific Advisory Committee on the Medical Implications of Less-Lethal Weapons (https://www.gov.uk/government/organisations/science-advisory-committee-on-the-medical-implications-of-less-lethal-weapons)    

Contributor – Air Vice Marshal (Rtd) Alastair Reid CB FFOM, Surgeon General UK Defence Medical Services 2019-2021.