ABSTRACT
This chapter aims to address the developments in the ethical and managerial aspects of deployed medical operations that arose as a result of the Iraq and Afghanistan campaigns. It discusses the challenges of maintaining standards and effective relationships in a multinational, multiagency environment, the problems of managing medical major incidents, where the issues associated with engagement with humanitarian agencies, naturally cautious regarding the development of links with uniformed and armed forces. The main themes affecting military operations in these challenging environments include inequality, uncertainty, constraint, and duty of care. The main ethical and non-clinical challenges faced by a cohort of deployed medical directors fell into the following five domains. These include resource constraints and rationing, the conflict between military and professional (clinical) obligations, end-of-life care, patient consent for treatment and withdrawal of treatment, and working in multinational contexts. The chapter discusses the key areas of ethical training and development introduced as a consequence of the increased awareness of ethical issues.
