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Medical Decision Making Under Fire: Military Medical Ethics in War Zones- LTC Jeanne Krick, MD.

In the latest episode of WarDocs, a podcast that offers an intimate glimpse into military healthcare, listeners are granted an excellent opportunity to explore the ethical considerations of military medicine with Lieutenant Colonel Dr. Jeanne Krick. Dr. Krick, a consultant for Medical Ethics to the Army Surgeon General, brings her invaluable insights from neonatology to the forefront of ethical discussions within the military's medical sphere.


Navigating the Battlefield of Ethics


Military medicine presents a unique array of ethical challenges, often blending the rigors of military duty with the sanctity of medical care. Dr. Krick delves into this complex interplay, examining how ethical decisions are made when they may impact a soldier's readiness or the success of a mission. She draws on her background in the Essex education system, emphasizing the importance of analytical thinking—a skill that is vital when confronting moral dilemmas in the military's clinical settings.


The Role of Ethics Committees


One significant takeaway from the episode is the establishment and crucial role of ethics committees within Military Medical Treatment Facilities (MTFs). Dr. Krick discusses how these committees navigate scenarios where a service member's autonomy in medical decisions may be in tension with military objectives. Whether it's a soldier refusing medication or a commander needing to make a mandated treatment call, the ethics committee is essential in reaching resolutions that honor both the individual and the mission.


Facing the Future: AI and Beyond


Looking ahead, Dr. Krick explores the ethical horizon as it expands to include artificial intelligence and human enhancement technologies. The implications of AI in decision-making processes and the potential biases in algorithms are scrutinized. Additionally, Dr. Krick offers an ethical perspective on the military's stance during pandemics and vaccinations, which became particularly relevant during the COVID-19 crisis.


Ethical Challenges in Deployed Settings


The episode also sheds light on the ethical challenges that arise in deployed settings, where resources are scarce, and decisions must be made under extreme pressure. Dr. Krick stresses the importance of pre-established protocols that can guide healthcare providers when facing dilemmas like allocating limited medical supplies or treating enemy combatants.


Cultural Sensitivity and Confidentiality


Another focal point of the discussion is the importance of cultural sensitivity and the balance between maintaining patient confidentiality and fulfilling military needs. Dr. Krick's experiences offer listeners a candid look at the intricate dance between respecting cultural differences and adhering to military protocols.


Equipping the Next Generation


Dr. Krick concludes by addressing the significance of equipping medical students with a robust ethical toolkit, ensuring that the next generation of military healthcare professionals can navigate the moral terrain with confidence and compassion.


Final Thoughts


The conversation with Dr. Jeanne Krick is more than an academic exercise; it's an invitation to understand the gravity of ethical decision-making in military medicine. For those in the field, aspiring medical professionals, or anyone fascinated by the moral complexities of healthcare in a military context, this episode of WarDocs is an essential listen. As we continue to push the boundaries of what's possible in medicine, the insights shared by Dr. Krick remind us that the heart of care must remain steadfast in its rhythm, guided by a strong and principled moral compass.


Other Medical Ethics Resources


-DoD Medical Ethics Center- The DMEC is situated out of USUHS and has several resources for those in uniform on medical ethics (I am a little embarrassed that I forgot to mention them in the actual interview last night...). Their website has a link to their internal training course, which is really a series of YouTube videos that cover some basic bioethics topics. They also have an app (I believe it's available through all the usual sources and on all devices) that is free to download and has plenty of resources. The app could be a great resource for folks looking for more material, especially in austere environments. 


-American Society for Bioethics and Humanities- This is the main organization for medical ethics within the US. There are links to many helpful resources on their site, including professional development, endorsed meetings, and guidelines/standards for clinical ethics consultation. 

The interview featuring Dr. Krick is available on all major podcast platforms and YouTube.  Here are some popular links that will bring you directly to the episode:

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