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INSTITUTE OF MEDICINE
National Academy of Sciences
Workshop on Military Medical Ethics: Issues Regarding Dual Loyalties
September 8, 2008
National Academy of Sciences
Lecture Room
2100 C Street, NW
Washington, D.C.
Workshop Goals:
- Examine ethical challenges for physicians and other health professionals serving in the military that arise from conflicts between their responsibilities to patients and their duties as military officers
- Discuss parallels with other fields of health and draw on their efforts to develop ethical guidelines and training models
- Discuss effective organizational structures that support and promote a just work culture
7:30–8:00 a.m. Continental Breakfast - Lobby Area
8:00–8:40 Welcome and Opening Remarks
James Childress, Chair
Harvey Fineberg, President, Institute of Medicine
Ward Casscells, Assistant Secretary of Defense for Health Affairs
8:40–9:00 Setting the Context for the Discussion
James Childress, Chair
9:00–10:45 Case Study 1: Return to Duty: Ethical Issues for Military Health Professionals
Moderator: Paul Appelbaum, Columbia University
9:00–10:00 Panel Presentations
· Outline of the Case and Issues
Paul Appelbaum, Columbia University
· Military Policy and Data
Elspeth Ritchie, U.S. Army
· Parallels in Occupational Health
Myron Harrison, Exxon/Mobil
· Parallels in Sports Medicine
Kurt Spindler, Vanderbilt University
10:00–10:30 Panel Discussion
10:30–10:45 General Discussion
10:45–11:00 Break
11:00–1:00 Case Study 2: Treatment of Detainees: Role of Military Health
Professionals
Moderator: Richard Bonnie, University of Virginia
11:00–12:15 Panel Presentations
· Introduction and Outline of the Case
Richard Bonnie, University of Virginia
· Overview of the Issues
Hernan Reyes, International Committee of the Red Cross
· Military Policy
Jack Smith, Department of Defense
· Parallels in Correctional and Custodial Facilities
Scott Allen, Brown University
· Human Rights Issues
Leonard Rubenstein, Physicians for Human Rights
· Intercultural and Religious Issues
Mahmud Thamer, Johns Hopkins University
12:15–12:45 Panel Discussion
12:45–1:00 General Discussion
1:00–1:45 Lunch – NAS Cafeteria
1:45–2:15 General Discussion — Follow Up from Morning Discussions
Moderator: James Childress
2:15–3:15 Ethics Training for Military Health Professionals
Moderator: Randy Howe, Uniformed Services University of the
Health Sciences (USUHS)
2:15–2:55 Panel Presentations
· Ethics Training at the Uniformed Services
University of the Health Sciences
Randy Howe, USUHS
· Ethics Training in the Field and Continuing Education
Kenneth Schor, USUHS
· Improving the Teaching of Ethics
Joshua Hauser, Northwestern University
2:55–3:15 Panel and General Discussion
3:15–4:15 Ethical Values — Organizational Structure and Culture
Moderator: Linda Emanuel, Northwestern University
3:15–3:50 Panel Presentations
· Overview of the Issues
Linda Emmanuel, Northwestern University
· Nurturing a Just Culture
David Ozar, Loyola University Chicago
· Leadership and Vertical Integration
Daniel Federman, Harvard University
· Learning and Accountability within Organizational
Structures: Where Next?
Linda Emmanuel: Northwestern University
3:50–4:15 Panel and General Discussion
4:15–5:00 Next Steps
James Childress, Chair
Ward Casscells, Assistant Secretary of Defense for Health Affairs
5:00 p.m. Adjourn
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