Counterterrorism, ethics, and global health

June 18, 2014

The surge in murders of polio vaccination workers in Pakistan has made headlines this year, but little attention has been devoted to the ethical issues surrounding the global health impact of current counterterrorism policy and practice. An essay in the Hastings Center Report reviews the range of harms to population health traceable to counterterrorism operations.

It also identifies concerns involving moral agency and responsibility – specifically of humanitarian , military medical personnel, and national security officials and operatives – and it highlights policy issues.

The authors describe a broad trend in the war on terror: "the militarization of ," in which medicine is incorporated into warfare. As an example, they cite the covert operation involving a vaccination program that led to the killing of Osama bin Laden, which contributed to fear and distrust among populations in need of services.

"Counterterrorism frameworks promulgated by the United States and adopted by other countries are also implicated in undermining ," write the authors, Lisa Eckenwiler, associate professor of philosophy and health administration and policy at George Mason University, and Matthew Hunt, an assistant professor in the School of Physical and Occupational Therapy of McGill University. "Policies that prohibit a wide range of activities regarded as providing material support to terrorists have adversely affected health program and funding."

Counterterrorism-related harms also exacerbate global health inequities. "Populations in places like Afghanistan, Pakistan, Somalia, and Yemen – already vulnerable by global health standards – are more precariously positioned as a result of the war on terror," the authors write.

The authors identify profound moral distress and fear among humanitarian and health workers who are professionally committed to neutrality and independence and yet are treated as tools in the war on terror.

"As the global war on terror has evolved – or devolved – the military's effort to 'win hearts and minds' through such strategies as providing medical care to local populations has situated military medical personnel in the midst of ethical controversy," they write. "Deploying for the sake of advancing strategic aims seems to violate obligations at the core of health professionals' identity, including the obligations to respect patients as ends in themselves, to avoid treating them as instruments for other purposes, and to serve their particular health interests rather than state interests."

The authors conclude that the most pressing policy issue is how to integrate concern for health in efforts to prevent terrorism: "Identifying threats to posed by counterterrorism strategies, analyzing them in relation to anticipated gains, and determining the proper assignment of responsibilities for harms done to health and health systems are morally pressing tasks that existing structures and processes lack the capacity to carry out."

Explore further: Better community engagement and stronger health systems are needed to tackle polio

Related Stories

Better community engagement and stronger health systems are needed to tackle polio

October 8, 2013
In this week's PLOS Medicine two independently written articles call for a shift away from the leader-centric approach that polio eradication campaigns are currently pursuing in the three countries (Nigeria, Pakistan and ...

Implications of mandatory flu vaccinations for health-care workers

May 26, 2014
Employers planning to implement mandatory influenza vaccination policies for health care workers need to understand the implications, according to an analysis published in CMAJ (Canadian Medical Association Journal).

New book diagnoses Australia's policy failures in health care

June 12, 2014
Australia is sleepwalking down the US path; headed towards a two-tiered health care system that is increasingly inequitable, warns leading Australian health academics and authors of the highly regarded book, Health Care and ...

Nearly 370,000 kids 'will miss' Pakistan polio drive

May 26, 2014
Pakistan launched a fresh polio vaccination drive in its restive tribal belt Monday, but officials warned that nearly 370,000 children are likely to miss out because of security problems.

Community and health system approaches improves mental health in Afghanistan

May 29, 2012
"Treatment of mental disorders within the health care system needs to be accompanied by a community-based approach that focuses on psychosocial problems," say the authors of a case study from Afghanistan published in this ...

Integrating mental health care: New series

April 30, 2013
The first article in a landmark series to help health care workers and providers, donors, and decision makers understand the importance of including mental health care in global health programs is being published in this ...

Recommended for you

Sugar not so sweet for mental health

July 27, 2017
Sugar may be bad not only for your teeth and your waistline, but also your mental health, claimed a study Thursday that was met with scepticism by other experts.

Could insufficient sleep be adding centimeters to your waistline?

July 27, 2017
Adults in the UK who have poor sleep patterns are more likely to be overweight and obese and have poorer metabolic health, according to a new study.

Vitamin E-deficient embryos are cognitively impaired even after diet improves

July 27, 2017
Zebrafish deficient in vitamin E produce offspring beset by behavioral impairment and metabolic problems, new research at Oregon State University shows.

The role of dosage in assessing risk of hormone therapy for menopause

July 27, 2017
When it comes to assessing the risk of estrogen therapy for menopause, how the therapy is delivered—taking a pill versus wearing a patch on one's skin—doesn't affect risk or benefit, researchers at UCLA and elsewhere ...

Blowing smoke? E-cigarettes might help smokers quit

July 26, 2017
People who used e-cigarettes were more likely to kick the habit than those who didn't, a new study found.

Brain disease seen in most football players in large report

July 25, 2017
Research on 202 former football players found evidence of a brain disease linked to repeated head blows in nearly all of them, from athletes in the National Football League, college and even high school.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.