Medical education in the US is four grueling years on top of four years of undergraduate college education. The spectrum of topics is hugely wide and the depth of coverage hugely uneven. Some things are covered in ridiculous detail and others with breathtaking superficiality. And some things hardly at all:
Medical students are woefully uninformed about military medical ethics and a physician’s responsibilities under the Geneva Conventions, a situation that could be a problem if they’re ever drafted, according to an article by Harvard Medical School researchers.
The researchers surveyed students at eight medical schools nationwide, and 94 percent said they had received less than one hour of instruction about military medical ethics.
Just 37 percent knew that the Geneva Conventions applied whether or not war was officially declared, and the same percentage were unaware that the conventions prohibit threatening or demeaning prisoners, or withholding food or water for any length of time. The survey found that 34 percent did not know that the conventions call on doctors to “treat the sickest first, regardless of nationality.” An equal percentage did not know when they would be required to ignore an unethical order from a superior. (Chronicle for Higher Education)
Failure to comply with the Geneva Conventions seems fine to the Bush administration but that doesn’t make it ethically acceptable for physicians. It’s not just theoretical. There have recently been cases where doctors have falsified death certificates to cover up mistreatment related deaths of prisoners and some doctors have advised US military interrogators on how much torture a prisoner could tolerate without dying.
Here’s another thing over 95% of medical students didn’t know:
Only 3.5 percent of the students surveyed knew that in 1987 Congress established a process for drafting civilian physicians if they’re in short supply in the military. That prospect is becoming more likely, the authors say, because of the drop in the number of doctors volunteering for the military and in students accepting medical-school scholarships in exchange for military service, as well as “a war on terror that has no end in sight.”
Some of us remember what a doctor’s draft means. We went through the wrenching ethical issues in the Vietnam years. Now it is our students that may be facing the anguish we faced. It’s a pity there is little or no time set aside to prepare them to think it through and so few of us left on the faculty who know what it means from personal experience.
American medicine has changed a great deal in the thirty plus years since the end of the war in Vietnam. But it hasn’t changed so much that torture is now acceptable. We can hope it never does.