The responsibility to prevent, the duty to educate

We are participants and instructors of Yale University’s 2015 Sherwin B. Nuland Summer Institute in Bioethics. We took part in a seminar that critically examined the problem of dual loyalty and medical ethics in times of conflict, war, and genocide. While health care professionals (HCPs) commit themselves to the health and wellbeing of their individual patients, they may occasionally be called upon to serve the governing authority in ways that conflict with this commitment. Specifically, military HCPs may encounter situations in which ethical tensions arise between the obligations owed to individual patients and those owed to their commanders and the military mission. This seemingly conflicting set of obligations held by the military HCP is commonly referred to as ‘the problem of dual loyalty’ or ‘mixed-agency’ [1, 2].