Military Medicine in Iraq and Afghanistan

Although there will is an emphasis on trauma, this book also captures lessons from internal medicine and infectious disease, ethics (for example dealing with detainees – a particularly controversial subject), human factors, mental health ...

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Author: Ian Greaves

Publisher: CRC Press

ISBN: 9781351372152

Category: Medical

Page: 688

View: 133

Many, if not most, of the recent improvements in trauma care in civilian practice have developed from military experience. The British Defence Medical Services have been recognised as providers of exemplary health care. Although there will is an emphasis on trauma, this book also captures lessons from internal medicine and infectious disease, ethics (for example dealing with detainees – a particularly controversial subject), human factors, mental health issues and rehabilitation.Military Medicine provides the evidence and context for these innovations, and its unique and important account will be of interest to both military and civilian practitioners alike.

Out of the Crucible

Out of the Crucible: How the U.S. Military Transformed Combat Casualty Care in Iraq and Afghanistan edited by Arthur L. Kellermann, MD and MPH, and Eric Elster, MD is now available by the US Army, Borden Institute.

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Author: Arthur L. Kellermann

Publisher: Government Printing Office

ISBN: 0160943620

Category:

Page: 451

View: 305

Out of the Crucible: How the U.S. Military Transformed Combat Casualty Care in Iraq and Afghanistan edited by Arthur L. Kellermann, MD and MPH, and Eric Elster, MD is now available by the US Army, Borden Institute. This comprehensive resource, part of the renowned Textbooks of Military Medicine series, documents one of the most extraordinary achievements in the history of American medicine - the dramatic advances in combat casualty care developed during Operations Enduring Freedom and Operation Iraqi Freedom. Each chapter is written by one or more military health professionals who played an important role in bringing the advancement to America's military health system. Written in plain English and amply illustrated with informative figures and photographs, Out of the Crucible engages and informs the American public and policy makers about how America's military health system, devised, tested and widely adopted numerous inventions, innovations, technologies that collectively produced the highest survival rate from battlefield trauma in the history of warfare.

Returning Home from Iraq and Afghanistan

This initial book presents findings on the most critical challenges, and lays out the blueprint for the second phase of the study to determine how best to meet the needs of returning troops and their families.

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Author: Institute of Medicine

Publisher: National Academies Press

ISBN: 0309152852

Category: Medical

Page: 192

View: 374

Nearly 1.9 million U.S. troops have been deployed to Afghanistan and Iraq since October 2001. Many service members and veterans face serious challenges in readjusting to normal life after returning home. This initial book presents findings on the most critical challenges, and lays out the blueprint for the second phase of the study to determine how best to meet the needs of returning troops and their families.

Military Health Care

This edited volume surveys critical aspects of modern military health care in the US and various other Western countries with troops in Iraq and Afghanistan.

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Author: Jomana Amara

Publisher: Routledge

ISBN: 9781136742392

Category: History

Page: 344

View: 566

This edited volume surveys critical aspects of modern military health care in the US and various other Western countries with troops in Iraq and Afghanistan. In the United States, the military medical system, including care for veterans, is large and diverse and involves two institutions, the US Department of Defense (DoD) and the US Department of Veteran’s Affairs (VA). Studying the system gives practitioners and policy-makers an understanding of the larger picture of the military medical structure, facilitating thought about some of the difficulties and opportunities for coordinating treatments and preparing for the future. This book covers health care issues prior to deployment, such as screening for mental health, evaluating long-term consequences of exposure to military service, and provision of insurance; care during a conflict, primarily battlefield clinics, battlefield trauma care, and evacuation procedures; and post- combat care, including serious war injuries, psychiatric, and long-term care. Bringing together research from a wide range of contributors, the volume provides readers with an extensive, up-to-date source of information on military medicine. This book will be of great interest to students of public health, military sociology, the Iraq war, US public policy, and war and conflict studies in general.

War and Health

The volume considers the effect of the war on both civilians and on US service members, in war zones—where healthcare systems have been destroyed by long-term conflict—and in the United States, where healthcare is highly developed.

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Author: Catherine Lutz

Publisher: NYU Press

ISBN: 9781479894611

Category: Social Science

Page: 288

View: 805

Provides a detailed look at how war affects human life and health far beyond the battlefield Since 2010, a team of activists, social scientists, and physicians have monitored the lives lost as a result of the US wars in Iraq, Afghanistan, and Pakistan through an initiative called the Costs of War Project. Unlike most studies of war casualties, this research looks beyond lives lost in violence to consider those who have died as a result of illness, injuries, and malnutrition that would not have occurred had the war not taken place. Incredibly, the Cost of War Project has found that, of the more than 1,000,000 lives lost in the recent US wars, a minimum of 800,000 died not from violence, but from indirect causes. War and Health offers a critical examination of these indirect casualties, examining health outcomes on the battlefield and elsewhere—in hospitals, homes, and refugee camps—both during combat and in the years following, as communities struggle to live normal lives despite decimated social services, lack of access to medical care, ongoing illness and disability, malnutrition, loss of infrastructure, and increased substance abuse. The volume considers the effect of the war on both civilians and on US service members, in war zones—where healthcare systems have been destroyed by long-term conflict—and in the United States, where healthcare is highly developed. Ultimately, it draws much-needed attention to the far-reaching health consequences of the recent US wars, and argues that we cannot go to war—and remain at war—without understanding the catastrophic effect war has on the entire ecosystem of human health.

Out of the Crucible

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Author: Arthur Kellermann

Publisher:

ISBN: 0160941784

Category: Afghan War, 2001-

Page: 438

View: 834

War Surgery in Afghanistan and Iraq

Specialty Volume of Textbooks of Military Medicine. TMM. Edited by Shawn Christian Nessen, Dave Edmond Lounsbury, and Stephen P. Hetz. Foreword by Bob Woodruff. Prepared especially for medical personnel.

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Author: Shawn Christian Nessen

Publisher: U.S. Government Printing Office

ISBN: MSU:31293029711631

Category: History

Page: 441

View: 459

Specialty Volume of Textbooks of Military Medicine. TMM. Edited by Shawn Christian Nessen, Dave Edmond Lounsbury, and Stephen P. Hetz. Foreword by Bob Woodruff. Prepared especially for medical personnel. Provides the fundamental principles and priorities critical in managing the trauma of modern warfare. Contains concise supplemental material for military surgeons deploying or preparing to deploy to a combat theater.

Emergency War Surgery

Drafted by sub-specialty experts. Updated by surgeons returned from year-long deployments in Iraq and Afghanistan. A collaborative effort with the Army Medical Department Center & School. Includes bibliographical references and index.

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Author:

Publisher: Department of the Army

ISBN: 0160723868

Category: Medical

Page: 488

View: 803

3rd United States Edition. Although it does not state that it is part of a series, it is listed on the Borden Institute's web-site under "Textbooks of Military Medicine." Represents an entirely new handbook. Revised to reflect lessons learned from ongoing American involvement in Southwest Asia. Is an essential tool for the management of forward combat trauma. Takes a bulleted manual style in order to optimize its use as a rapid reference. Drafted by sub-specialty experts. Updated by surgeons returned from year-long deployments in Iraq and Afghanistan. A collaborative effort with the Army Medical Department Center & School. Includes bibliographical references and index.

Between Flesh and Steel

Between Flesh and Steel is the most comprehensive book on the market about the evolution of modern military medicine.

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Author: Richard A. Gabriel

Publisher: Potomac Books, Inc.

ISBN: 9781612344201

Category: History

Page: 312

View: 422

Over the last five centuries, the development of modern weapons and warfare has created an entirely new set of challenges for practitioners in the field of military medicine. Between Flesh and Steel traces the historical development of military medicine from the Middle Ages to modern times. Military historian Richard A. Gabriel focuses on three key elements: the modifications in warfare and weapons whose increased killing power radically changed the medical challenges that battle surgeons faced in dealing with casualties, advancements in medical techniques that increased the effectiveness of military medical care, and changes that finally brought about the establishment of military medical care systems in modern times. Other topics include the rise of the military surgeon, the invention of anesthesia, and the emergence of such critical disciplines as military psychiatry and bacteriology. The approach is chronological—century by century and war by war, including Iraq and Afghanistan—and cross-cultural in that it examines developments in all of the major armies of the West: British, French, Russian, German, and American. Between Flesh and Steel is the most comprehensive book on the market about the evolution of modern military medicine.

Civil Military Medicine On Dangerous Ground

The interaction between armed forces and civilian organizations providing medical and health aid in insecure environments is increasing.

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Author:

Publisher:

ISBN: OCLC:318694069

Category:

Page: 113

View: 885

The interaction between armed forces and civilian organizations providing medical and health aid in insecure environments is increasing. Recent examples include a U.S.-led anti-insurgent Joint Task Force providing disaster relief after mud slides in the Philippines, the international response to the Asian tsunami, and operations in Iraq and Afghanistan. Practitioners and scholars alike have noted that the rising incidence of civil-military medical assistance increases the need for better operational coordination and cooperation among the actors in the medical and health sector of humanitarian assistance. From January 29 to February 2, 2006, representatives from the U.S. Government, United Nations, and international nongovernmental organizations (NGOs) participated in an educational game at the Center for Stabilization and Reconstruction Studies (CSRS) at the Naval Postgraduate School in Monterey, California. The game focused on the operational challenges associated with providing medical and health assistance as part of disaster relief and development assistance in regions of conflict or instability. Three scenarios were used, and participants took the role of representing their respective medical communities: military, civilian government, international organization, and international nongovernmental organization. The first scenario focused on disaster relief in a post-conflict setting, the second posed a situation of a natural disaster occurring during ongoing combat operations, and the third concerned an epidemic of avian influenza among a mixed population of civilians and insurgent forces.

Military Medical Ethics in Contemporary Armed Conflict

"The goal of military medicine is to conserve the fighting force necessary to prosecute just wars.

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Author: Michael L. Gross

Publisher: Oxford University Press

ISBN: 9780190694944

Category: Medical

Page: 352

View: 425

"The goal of military medicine is to conserve the fighting force necessary to prosecute just wars. Just wars are defensive or humanitarian. A defensive war protects one's people or nation. A humanitarian war rescues a foreign, persecuted people or nation from grave human rights abuse. To provide medical care during armed conflict, military medical ethics supplements civilian medical ethics with two principles: military-medical necessity and broad beneficence. Military-medical necessity designates the medical means required to pursue national self-defense or humanitarian intervention. While clinical-medical necessity directs care to satisfy urgent medical needs, military-medical necessity utilizes medical care to satisfy the just aims of war. Military medicine may therefore attend the lightly wounded before the critically wounded or use medical care to win hearts and minds. The underlying principle is broad, not narrow, beneficence. The latter addresses private interests, while broad beneficence responds to the collective welfare of the political community"--

Women at War

In the very first text of its kind, Women at War brings together all available information and experience on women's physical and mental health in one resource to enlighten the practitioners caring for them.

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Author: Elspeth Cameron Ritchie

Publisher: Oxford University Press

ISBN: 9780199344550

Category: Medical

Page: 416

View: 242

In the very first text of its kind, Women at War brings together all available information and experience on women's physical and mental health in one resource to enlighten the practitioners caring for them. Our U.S Department of Defense is approximately 15% women with over 300,000 women having deployed since September 11th, 2001. This book reviews the epidemiology, changes in policy and demographics of women in the services, the factors affecting their health and health care while serving in austere environments, issues related to reproductive and urogenital health and how health care providers can help prepare and prevent illness. The book also looks at mental health issues to include PTSD and other psychological effects of war, intimate partner violence, sexual assault and suicide, as well as the veteran experience. The book brings together researchers, clinicians, and service member experience and presents the information in a practical, actionable format. It also highlights areas where data is lacking and more study is demanded.

Returning Home from Iraq and Afghanistan

Returning Home from Iraq and Afghanistan: Assessment of Readjustment Needs of Veterans, Service Members, and Their Families fulfills the requirement for Phase 2.

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Author: Institute of Medicine

Publisher: National Academies Press

ISBN: 9780309264273

Category: Medical

Page: 794

View: 942

As of December 2012, Operation Enduring Freedom (OEF) in Afghanistan and Operation Iraqi Freedom (OIF) in Iraq have resulted in the deployment of about 2.2 million troops; there have been 2,222 US fatalities in OEF and Operation New Dawn (OND)1 and 4,422 in OIF. The numbers of wounded US troops exceed 16,000 in Afghanistan and 32,000 in Iraq. In addition to deaths and morbidity, the operations have unforeseen consequences that are yet to be fully understood. In contrast with previous conflicts, the all-volunteer military has experienced numerous deployments of individual service members; has seen increased deployments of women, parents of young children, and reserve and National Guard troops; and in some cases has been subject to longer deployments and shorter times at home between deployments. Numerous reports in the popular press have made the public aware of issues that have pointed to the difficulty of military personnel in readjusting after returning from Iraq and Afghanistan. Many of those who have served in OEF and OIF readjust with few difficulties, but others have problems in readjusting to home, reconnecting with family members, finding employment, and returning to school. In response to the return of large numbers of veterans from Iraq and Afghanistan with physical-health and mental-health problems and to the growing readjustment needs of active duty service members, veterans, and their family members, Congress included Section 1661 of the National Defense Authorization Act for fiscal year 2008. That section required the secretary of defense, in consultation with the secretary of veterans affairs, to enter into an agreement with the National Academies for a study of the physical-health, mental-health, and other readjustment needs of members and former members of the armed forces who were deployed in OIF or OEF, their families, and their communities as a result of such deployment. The study consisted of two phases. The Phase 1 task was to conduct a preliminary assessment. The Phase 2 task was to provide a comprehensive assessment of the physical, psychologic, social, and economic effects of deployment on and identification of gaps in care for members and former members, their families, and their communities. The Phase 1 report was completed in March 2010 and delivered to the Department of Defense (DOD), the Department of Veterans Affairs (VA), and the relevant committees of the House of Representatives and the Senate. The secretaries of DOD and VA responded to the Phase 1 report in September 2010. Returning Home from Iraq and Afghanistan: Assessment of Readjustment Needs of Veterans, Service Members, and Their Families fulfills the requirement for Phase 2.

Long Term Health Consequences of Exposure to Burn Pits in Iraq and Afghanistan

The Department of Veterans Affairs asked the IOM to form a committee to determine the long-term health effects from exposure to these burn pits. Insufficient evidence prevented the IOM committee from developing firm conclusions.

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Author: Institute of Medicine

Publisher: National Academies Press

ISBN: 9780309217552

Category: Medical

Page: 192

View: 461

Many veterans returning from the conflicts in Iraq and Afghanistan have health problems they believe are related to their exposure to the smoke from the burning of waste in open-air "burn pits" on military bases. Particular controversy surrounds the burn pit used to dispose of solid waste at Joint Base Balad in Iraq, which burned up to 200 tons of waste per day in 2007. The Department of Veterans Affairs asked the IOM to form a committee to determine the long-term health effects from exposure to these burn pits. Insufficient evidence prevented the IOM committee from developing firm conclusions. This report, therefore, recommends that, along with more efficient data-gathering methods, a study be conducted that would evaluate the health status of service members from their time of deployment over many years to determine their incidence of chronic diseases.

Fields of Combat

Both heartbreaking and hopeful, Fields of Combat tells the story of how American veterans and their families navigate the return home.

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Author: Erin P. Finley

Publisher: Cornell University Press

ISBN: 0801461189

Category: Psychology

Page: 240

View: 709

"If you consider Iraq—like I do, probably twenty-nine out of thirty days—to be the pinnacle of your life, then where do you go from there? And I'm sure that a lot of veterans feel that way. To them, that was it. That was everything. So now what? They have to find something meaningful and purposeful." "When I got back from Afghanistan, there was not even so much as a briefing that said, 'Let us know if you're having problems.' There wasn't so much as a phone number. There was literally nothing." "I knew it was crazy. I was thinking, the guy on the roof's either a sniper or he's going to radio ahead. And then I thought, this is San Antonio. There's not snipers on the roof, nobody's going to blow me up here." "Whenever I look at people back here at home, I know what they're going to look like dead. I know what they look like with their brains blown out or jaws blown off or eyes pulled out. When I look at somebody I see that, to this day." —Voices of veterans interviewed in Fields of Combat For many of the 1.6 million U.S. service members who have served in Iraq and Afghanistan since 2001, the trip home is only the beginning of a longer journey. Many undergo an awkward period of readjustment to civilian life after long deployments. Some veterans may find themselves drinking too much, unable to sleep or waking from unspeakable dreams, lashing out at friends and loved ones. Over time, some will struggle so profoundly that they eventually are diagnosed with post-traumatic stress Disorder (PTSD). Both heartbreaking and hopeful, Fields of Combat tells the story of how American veterans and their families navigate the return home. Following a group of veterans and their personal stories of war, trauma, and recovery, Erin P. Finley illustrates the devastating impact PTSD can have on veterans and their families. Finley sensitively explores issues of substance abuse, failed relationships, domestic violence, and even suicide and also challenges popular ideas of PTSD as incurable and permanently debilitating. Drawing on rich, often searing ethnographic material, Finley examines the cultural, political, and historical influences that shape individual experiences of PTSD and how its sufferers are perceived by the military, medical personnel, and society at large. Despite widespread media coverage and public controversy over the military's response to wounded and traumatized service members, debate continues over how best to provide treatment and compensation for service-related disabilities. Meanwhile, new and highly effective treatments are revolutionizing how the Department of Veterans Affairs (VA) provides trauma care, redefining the way PTSD itself is understood in the process. Carefully and compassionately untangling each of these conflicts, Fields of Combat reveals the very real implications they have for veterans living with PTSD and offers recommendations to improve how we care for this vulnerable but resilient population.

A Forgotten Point of View in the Treatment of Massive Bleeding Economic Study on Hemotherapy about 1 1 1 Protocol Based on Clinical and Analytical Criteria Vs Hemotherapy Guided by Masimo Radicalu00ae Rotemu00ae Monitoring in Massive Bleeding Casualties Spanish Military Medicine Experience

Treating a patient with massive bleeding is a challenge for the anesthesiologist, who is responsible for assessing the epidemiology, physiology, clinical, treatment, monitoring and prognosis of these patients.

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Author: Ricardo Navarro-Suay

Publisher:

ISBN: OCLC:1163805227

Category:

Page:

View: 631

Treating a patient with massive bleeding is a challenge for the anesthesiologist, who is responsible for assessing the epidemiology, physiology, clinical, treatment, monitoring and prognosis of these patients. However, the economic criteria are not always adequately known.In the recent conflicts in Iraq and Afghanistan, Military Medicine has implemented new protocols (some based on high ratios of units of packed red blood cells, fresh frozen plasma units and platelet units) and new monitors as Rotemu00ae or Massimou00ae in order to improve battle casualties care.The goal of this study is to analyze cost-benefit of treatment according to protocol 1: 1: 1 (1 unit of packed red blood cells: 1 unit of fresh frozen plasma: 1 unit of platelets) vs guided therapy goals with monitoring devices Masimo Radical 7 / Rotem in patients with massive bleeding in military environment.Material and MethodsWe performed a cost-benefit analysis of two treatments used in massive bleeding patients. We employ a model with a time horizon of seven years, based on data collected in the Spanish Military Hospital in Herat (Afghanistan).Because there are various prices in the market, we have selected the official cost of blood products published by the Ministry of Defense of Spain, and the cost of different monitors was provided by commercial agents in contact to the Ministry of Defense (Spain).The combat casualty data were obtained from the record of Spanish Military Hospital in Herat (Afghanistan). The data sent and blood products consumed throughout the study period has been provided by the Transfusion Centre of the Armed Forces and the service laboratory and clinical analysis of the Spanish Military Hospital in Herat. They have achieved the appropriate permissions to obtain such information. It has been used based Excel (Microsoftu00ae) data for data processing.ResultsDuring the study period, 3582 units of packed red blood cells (15.7%, 565 consumed), 278 units of fresh frozen plasma (66%, 184 consumed) and 47 units of frozen platelets (31%, 21 consumed) were sent to Afghanistan. The cost of blood products was 1 unit of packed red blood cells: 140 u20ac, 1 unit of fresh frozen plasma: 7 u20ac, 1 unit of frozen platelets: 450u20ac. The cost of blood products shipped (+ not consumed) was 542,090u20ac (101,430 u20ac+440,660u20ac). The price offered by commercial agents was Masimo. Radicalu00ae 7: 5,712u20ac and consumables (100 patients): 1,000u20ac while Rotemu00ae device was 29,546u20ac, consumables (20 measurements): 1062u20ac and disposables and pipettes (200 measurements): 1,351u20ac. The number of casualties with massive bleeding was 36. According to several studies the Monitor Masimo reduces by 47% the units of packed red blood cells and monitor Rotem reduces 84% units of fresh frozen plasma and 41% platelet units. It is assumed as the 80/20 rule hypothesis: patients with massive bleeding have required 80% of total consumption. A half-life of the monitors 10 years is assumed for wear material. Therapy 1: 1: 1 could be started since 2010 (not before the lack of logistical capacity).The cost of blood units consumed in massive bleeding casualties was 55,950u20ac, while ROTEM and Masimo monitors (monitors + consumables + units of blood) cost was u20ac 57,455. The total cost of blood units not consumed was 294,570u20ac, however total cost of blood units not employed with two monitors and ensuring logistical support was u20ac 103,740. ConclusionGuided therapy by Masimo Radical 7 + Rotem devices is 2,7% more expensive than 1:1:1 treatment in massive bleeding casualties. However, cost of blood products units shipped and not used (294,570u20ac), compared to units shipped and not used employing both monitors (103,740u20ac) is higher (190,830u20ac).

A National Trauma Care System

A National Trauma Care System defines the components of a learning health system necessary to enable continued improvement in trauma care in both the civilian and the military sectors.

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Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

ISBN: 9780309442855

Category: Medical

Page: 530

View: 592

Advances in trauma care have accelerated over the past decade, spurred by the significant burden of injury from the wars in Afghanistan and Iraq. Between 2005 and 2013, the case fatality rate for United States service members injured in Afghanistan decreased by nearly 50 percent, despite an increase in the severity of injury among U.S. troops during the same period of time. But as the war in Afghanistan ends, knowledge and advances in trauma care developed by the Department of Defense (DoD) over the past decade from experiences in Afghanistan and Iraq may be lost. This would have implications for the quality of trauma care both within the DoD and in the civilian setting, where adoption of military advances in trauma care has become increasingly common and necessary to improve the response to multiple civilian casualty events. Intentional steps to codify and harvest the lessons learned within the military's trauma system are needed to ensure a ready military medical force for future combat and to prevent death from survivable injuries in both military and civilian systems. This will require partnership across military and civilian sectors and a sustained commitment from trauma system leaders at all levels to assure that the necessary knowledge and tools are not lost. A National Trauma Care System defines the components of a learning health system necessary to enable continued improvement in trauma care in both the civilian and the military sectors. This report provides recommendations to ensure that lessons learned over the past decade from the military's experiences in Afghanistan and Iraq are sustained and built upon for future combat operations and translated into the U.S. civilian system.

Military Medical Ethics for the 21st Century

As such, military necessity suggests only a defensible exception to the rule ... Two-Tiered Medical Care in Iraq and Afghanistan To support its soldiers, ...

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Author: Michael L. Gross

Publisher: Routledge

ISBN: 9781317096108

Category: History

Page: 320

View: 369

As asymmetric ’wars among the people’ replace state-on-state wars in modern armed conflict, the growing role of military medicine and medical technology in contemporary war fighting has brought an urgent need to critically reassess the theory and practice of military medical ethics. Military Medical Ethics for the 21st Century is the first full length, broad-based treatment of this important subject. Written by an international team of practitioners and academics, this book provides interdisciplinary insights into the major issues facing military-medical decision makers and critically examines the tensions and dilemmas inherent in the military and medical professions. In this book the authors explore the practice of battlefield bioethics, medical neutrality and treatment of the wounded, enhancement technologies for war fighters, the potential risks of dual-use biotechnologies, patient rights for active duty personnel, military medical research and military medical ethics education in the 21st Century.