Friday 20 Jul 2018 | 18:37 | SYDNEY
Friday 20 Jul 2018 | 18:37 | SYDNEY

Reader riposte: More on medics at war

21 May 2010 15:19

Dr Nick Chapman again:

I thank Jim Molan for his response to my criticisms of his original post (on Adelaide surgeon Craig Jurisevic and the broader issue of medics at war). It is a well argued and comprehensive reply.

Unfortunately, however, I believe Jim has not only misinterpreted one of my remarks, but also missed the intent behind my original criticisms. At no stage did I suggest that Craig Jurisevic had sought the protection of a medical symbol whilst he was fighting in the Balkans; what I said, rather, was that he was free to take up arms provided he didn't seek this protection.

My intent in making this statement was threefold. Firstly, and most simply, it was to clarify one point that I felt was obscured in Jim's original post, rather than a comment on Juresivec's actions. This point being that medics wearing international medical insignia are classified as non-combatants under the Geneva Convention, and though they are permitted (and even expected) to kill in order to protect themselves or their patients, their role is not primarily a combat one and they may not use their weapons in an offensive capacity. 

This is not an idle point restricted to discussions of an 'idealised world': whilst I fully accept Jim's point about the realities of asymmetrical warfare and the targeting of the red cross, and defer to his experience in noting that the further one gets from a secure base area the fewer red crosses one sees, my argument is rather that there is significant utility in maintaining the integrity of the symbol. 

Any blurring of the line between doctor and combatant may severely compromise the operative capacity of those medics (and other groups) who do seek the symbol's protection on the battlefield. Even in the face of an enemy who refuses to recognise it, it behooves us to try and maintain this distinction.

Secondly, my intent was to explicitly recognise Jurisevic's right to become a combatant if he so chose. As Jim points out, he is not defined by his profession as a doctor, but rather as an individual faced with a difficult moral choice. Craig Jurisevic confronted this dilemma and made his choice. He will have both his supporters and his detractors for the choice he made, but making it was entirely his prerogative. I would never claim that to have sworn an oath such as the Declaration of Geneva would preclude someone from later choosing to fight and kill others — to do so would indeed be living in that idealised world to which Jim refers. 

My final, and perhaps more elliptical, argument was in support of the AMA President's assertion that there was, ultimately, a conflict between Jurisevic's roles as a doctor and a combatant. In Jim's response he even concedes this point (unintentionally I believe) when he notes that, '(w)hen Craig was a combatant, he was not a doctor.' 

I fail to see why Dr Pesce's comments are any more difficult to understand in the context of Jurisevic's case than in the absolute: there is a fundamental contradiction between the two roles. One cannot be both whilst remaining true to the core principles of either — being one necessarily entails a diminution of the other role (and this is true in both the philosophical and the practical sense). 

Doctors in the military who are involved in combat are faced with an unenviable set of ethical dilemmas when reconciling contradictions. To deny that these dilemmas exist does them a disservice: to read a thoughtful and nuanced exploration of these issues would, in my view, be a real and persuasive reason for recommending Jurisevic's book.