Military Medical Ethics: Issues Regarding Dual Loyalties: Workshop Summary (2009)

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B Workshop Agenda INSTITUTE OF MEDICINE National Academy of Sciences Workshop on Military Medical Ethics: Issues Regarding Dual Loyalties Monday, September 8, 2008 National Academy of Sciences Lecture Room 2100 C Street, NW Washington, DC 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 a.m. Continental Breakfast 39 

40 MILITARY MEDICAL ETHICS: ISSUES REGARDING DUAL LOYALTIES 8:00 Welcome and Opening Remarks James Childress, Chair Harvey Fineberg, President, Institute of Medicine Joseph Kelley, Deputy Assistant Secretary of Defense for Clinical and Program Policy 8:40 Setting the Context for the Discussion James Childress, Chair 9:00 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 Cameron Ritchie, U.S. Army • Parallels in Occupational Health Myron Harrison, ExxonMobil • Parallels in Sports Medicine Kurt Spindler, Vanderbilt University 10:00–10:30 Panel Discussion 10:30–10:45 General Discussion 10:45 Break 11:00 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 

APPENDIX B 41 • 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 p.m. Lunch 1:45 General Discussion—Follow-up from Morning Discussions Moderator: James Childress 2:15 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 Ethical Values—Organizational Structure and Culture 

42 MILITARY MEDICAL ETHICS: ISSUES REGARDING DUAL LOYALTIES Moderator: Linda Emanuel, Northwestern University 3:15–3:50 Panel Presentations • Overview of the Issues Linda Emanuel, 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 Emanuel, Northwestern University 3:50–4:15 Panel and General Discussion 4:15 Next Steps James Childress, Chair Joseph Kelley, Deputy Assistant Secretary of Defense for Clinical and Program Policy 5:00 Adjourn