Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Nov 19;22(1):153.
doi: 10.1186/s12910-021-00723-2.

Ethical challenges faced by French military doctors deployed in the Sahel (Operation Barkhane): a qualitative study

Antoine Lamblin  1   2   3 , Clément Derkenne  4 , Marion Trousselard  5   6   7 , Marie-Ange Einaudi  8
Affiliations

Ethical challenges faced by French military doctors deployed in the Sahel (Operation Barkhane): a qualitative study

Antoine Lamblin et al. BMC Med Ethics. .

Abstract

Background: French military doctors are currently deployed in the Sahel to support the armed forces of Operation Barkhane, in medical or surgical units. As well as supporting French soldiers, their other missions are diverse and complex: medical assistance to civilians and persons under control (PUC), advice to commanding officers. These tasks can create ethical dilemmas when decisions are forced upon doctors that may be in conflict with medical values or fundamental principles. Little is known about the specific dilemmas experienced by French military doctors in overseas operations. We therefore conducted a qualitative study among doctors and surgeons recently deployed to the Sahel to explore and better understand this question.

Method: Semi-structured, face-to-face interviews were conducted with 20 French military doctors or surgeons deployed since January 2016 in medical or surgical facilities in Mali and Chad.

Results: All interviewed doctors reported having faced several ethical dilemmas during missions. All reported dilemmas involved the treatment of civilians (while delivering community medical assistance) or of PUC. The dilemmas involved choices as to which patients to treat, the use of care as a means to an end by military authorities, and the level of care attainable in the absence of any possible hospital follow-up. Questions of delivering care at the risk of their own safety or the mission's and of treating openly hostile patients were also brought up. Several dilemmas stemmed from the dual loyalty problem, namely the conflict between military doctors' duty of care to patients and to the military institution, but this was not the only factor involved. Contextual factors (restricted resources and security constraints) and psychological factors (especially hostility towards the enemy) were also associated with many of the reported dilemmas.

Conclusion: This is the first reported study focusing on the ethical dilemmas encountered by French military doctors in overseas operations. It provides unique insights into their ethical experiences and should prove useful in improving operational training for healthcare personnel deployed on overseas missions.

Keywords: Ethics; French military health service; Law of armed conflict; Military medical ethics; Qualitative research; War ethics.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no financial competing interests. AL, MT and CD are members of the French Military Health Service. MAE has no non-financial competing interests.

Similar articles

See all similar articles

Cited by

References

    1. North Atlantic Treaty Organization. Allied joint publication. Allied Joint Planning for Medical Support. AJP-4.10. Nato Standardization Office; Edition B version1; 2018.
    1. Bureau relations médias de l’État-major des armées-Ministère des Armées. Dossier de presse Opération Barkhane. 2018. https://www.defense.gouv.fr. Accessed 11 Nov 2020.
    1. Ministère des Armées, État-Major des Armées, and CICDE. DIA-4.0.10_SOUTMED-OPS (2014)—Doctrine du soutien médical aux engagements opérationnels. Doctrine interarmées n° 176/DEF/CICDE/NP du 31 juillet 2014. 72 p. https://www.cicde.defense.gouv.fr/images/documentation/DIA/20140731-NP-C.... Accessed 11 Nov 2020.
    1. Darré E, Rouanet P. Service de santé des armées et aide médicale aux populations object if ou moyen? Santé Décis Manag. 2008;11:183–199. doi: 10.3166/sdm.11.1-2.183-198. - DOI
    1. Barbier O, Racleb M, De Montleau F. Le médecin militaire entre impératifs militaires et exigences éthiques. Éthique Santé. 2015;12:258–262. doi: 10.1016/j.etiqe.2015.09.003. - DOI

Publication types