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Ethical Considerations in Embedding a Surgeon in a Military or Civilian Tactical Team

Published online by Cambridge University Press:  21 August 2012

Lewis J. Kaplan ,
Mark D. Siegel ,
Alexander L. Eastman ,
Lisa M. Flynn ,
Stanley H. Rosenbaum ,
David C. Cone ,
David P. Blake  and
Jonathan Mulhern
Lewis J. Kaplan*
Affiliation:
Department of Surgery, Yale University School of Medicine, New Haven, Connecticut USA and North Haven/North Branford Police Departments, Special Weapons and Tactics Team, North Haven/North Branford, Connecticut USA
Mark D. Siegel
Affiliation:
Department of Medicine, Yale University School of Medicine, New Haven, Connecticut USA
Alexander L. Eastman
Affiliation:
The University of Texas Southwestern School Medical Center, Department of Surgery and The Dallas Police Department, Dallas, Texas USA
Lisa M. Flynn
Affiliation:
Department of Surgery, Wayne State University, Detroit, Michigan USA
Stanley H. Rosenbaum
Affiliation:
Department of Anesthesiology, Yale University School of Medicine, New Haven, Connecticut USA
David C. Cone
Affiliation:
Department of Emergency Medicine, Yale University School of Medicine, New Haven, Connecticut USA
David P. Blake
Affiliation:
United States Air Force, Wright Patterson Air Force Base, Ohio USA
Jonathan Mulhern
Affiliation:
North Haven Police Department, North Haven, Connecticut USA
*
Correspondence: Lewis J. Kaplan, MD, FACS, FCCM, FCCP Department of Surgery Section of Trauma, Surgical Critical Care, and Surgical Emergencies Yale University School of Medicine 330 Cedar Street, BB-310 New Haven, CT 06520 USA E-mail Lewis.Kaplan@yale.edu
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Abstract

Tactical emergency medical services (TEMS) bring immediate medical support to the inner perimeter of special weapons and tactics team activations. While initially envisioned as a role for an individual dually trained as a police officer and paramedic, TEMS is increasingly undertaken by physicians and paramedics who are not police officers. This report explores the ethical underpinnings of embedding a surgeon within a military or civilian tactical team with regard to identity, ethically acceptable actions, triage, responsibility set, training, certification, and potential future refinements of the role of the tactical police surgeon.

KaplanLJ, SiegelMD, EastmanAL, FlynnLM, RosenbaumSH, ConeDC, BlakeDP, MulhernJ. Ethical Considerations in Embedding a Surgeon in a Military or Civilian Tactical Team. Prehosp Disaster Med. 2012;27(6):1-6.

Keywords

emergency medical servicestactical medicinetactical emergency medical services
Type
Special Report
Information
Prehospital and Disaster Medicine , Volume 27 , Issue 6 , December 2012 , pp. 583 - 588
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2012

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References

1.Rinnert, KJ, Hall, WL. Tactical emergency medical support. Emerg Med Clin N Am. 2002;20(4):929-952.CrossRefGoogle ScholarPubMed
2. EMS. www.NTOA.org. Accessed July 18, 2011.Google Scholar
3.Vayer, JS, Schwartz, RB. Developing a tactical emergency medical support program. Top Emerg Med. 2003;25(4):282-298.Google Scholar
4.Yeskey, KS, Llewellyn, CH, Vayer, JS. Operational medicine in disasters. Emerg Med Clin N Am. 1996;14(2):429-438.CrossRefGoogle ScholarPubMed
5.Petro, JB, Plasse, TR, McNulty, JA. Biotechnology: impact on biological warfare and biodefense. Biosecurity and Bioterrorism. 2003;1(3):161-168.CrossRefGoogle ScholarPubMed
6.Socher, MM. NBC Delta: special training beyond Hazmat in the USA. Resuscitation. 1999;42(2):151-153.CrossRefGoogle ScholarPubMed
7.Metzger, JC, Eastman, AL, Benitez, FL, Pepe, PE. The lifesaving potential of specialized on-scene medical support for urban tactical operations. Prehosp Emerg Care. 2009;13(4):528-531.CrossRefGoogle ScholarPubMed
8.Donovan, W, Mellen, PF. Clinically intensive medical training for combat. Mil Med. 1989;154(11):546-548.CrossRefGoogle ScholarPubMed
9.Geneva Conventions of 1949. In: Human Rights Documents: Compilation of Documents Pertaining to Human Rights. Washington, DC: Government Printing Office; 1983.Google Scholar
10. Force Protection Program. http://www.tradoc.army.mil/tpubs/regs/r525-13.htm. Accessed August 1, 2011.Google Scholar
11.Harrison, BK, Fleming, DA. The Military Physician as a noncombatant: the concept of over identification. Military Med. 2006;171(10):4-6.Google ScholarPubMed
12. Instruction on Department of Defense Medical Program Support for Detainee Operations No. 2310.08E. http://www.dtic.mil/whs/directives/corres/html/231008.htm. Published June 6, 2006. Accessed August 2, 2011.Google Scholar
13.Sessums, LL, Colleen, JF, O'Malley, PG, Jackson, JL, Roy, MJ. Ethical practice under fire: deployed physicians in the global war on terrorism. Mil Med. 2009;174(5):441-447.CrossRefGoogle ScholarPubMed
14. Army Field Manual 27-10. The Law of Land Warfare. http://www.globalsecurity.org/military/library/policy/army/fm/27-10. Published July 18, 1956, updated July 15, 1976. Accessed August 1, 2011.Google Scholar
15.Vastyan, EA. Warfare: I. Medicine and War. In: Reich WT, ed. Encyclopedia of Bioethics, 2nd edition, Volume 4. New York: Macmillan; 1978:1695-1699.Google Scholar
16. The United States Army Medal of Honor. http://www.army.mil/medalofhonor/index.html. Accessed August 1, 2011.Google Scholar
17.Langer, E. The court-martial of Captain Levy: medical ethics v. military law. Science. 1967;56:1346.CrossRefGoogle Scholar
18.Moon, G, Kelly, K, Savage, SF, Bradshaw, Y. Developing Britain's police surgeon service. BMJ. 1995;311(7020):1587-1587.CrossRefGoogle ScholarPubMed
19.Hunziker, S, Tischan, F, Semmer, NK, et al. Hands-on time during cardiopulmonary resuscitation is affected by the process of teambuilding: a prospective randomized simulator based trial. BMC Emerg Med. 2009;9:3; doi:10.1186/1471-227X-9-3.CrossRefGoogle ScholarPubMed
20.Manthous, CA, Hollingshead, AB. Concise clinical review: team science and critical care. Am J Resp Crit Care Med. 2011;184(1):17-25.CrossRefGoogle Scholar
21.Smock, W, Hamm, M, Krista, M. Physicians in tactical medicine [abstract]. Ann Emerg Med. 1999;34(4, part 2):S73.CrossRefGoogle Scholar
22.Bourne, PG. Men, Stress, and Vietnam. Boston: Little, Brown and Company; 1970.Google Scholar
23.Gratton, L, Erickson, TJ. 8 ways to build collaborative teams. Harvard Bus Rev. 2007;85(11):100-109.Google ScholarPubMed
24.Tuck, JJ. Medical management of Iraqi enemy prisoners of war during Operation Telic. Mil Med. 2005;170(3):177-182.CrossRefGoogle ScholarPubMed