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ABSTRACT: The survival rate of American military personnel seriously wounded in combat has risen dramatically in recent decades. But situations still arise when wounded soldiers cannot be saved, nor their suffering sufficiently palliated, creating difficult ethical dilemmas for their fellow troops. The Geneva Conventions and most codes of medical ethics prohibit direct and intentional killing of wounded, and changing our relevant treaty obligations would have serious strategic consequences. Battlefield euthanasia can be morally justified, but the military profession should not argue for its legality.
I have never experienced war directly. But in teaching and writing about the subject for over 15 years, I have tried to imagine vividly what such an experience must be like for combatants and civilians caught up in its destruction. Surely one of the most horrifying aspects of war occurs when soldiers are seriously wounded in combat, grievously suffering, and facing little or no prospect of medical cure or pain relief as their lives ebb away.1 Military historian John Keegan estimates that one third of the 21,000 British soldiers killed in the battle of the Somme in early July 1916 died of wounds that would not have been fatal had the men been evacuated quickly, but the appalling number of casualties overwhelmed the resources and best efforts of military medical personnel.2
To be sure, the care available to American and other allied soldiers now is dramatically better than in previous decades, let alone previous centuries. The survival rates of our wounded soldiers rose dramatically between the two world wars, even more during the Korea and Vietnam conflicts with the advent of speedy evacuations by helicopter, and still more during our recent wars in Iraq and Afghanistan: in 2005 nearly 20 percent of wounded US soldiers died from their injuries, but in 2010, fewer than 8 percent died.3
However, situations still arise occasionally today-and could occur as well in some future wars-in which the wonders of modern military medicine are unable to reach all seriously wounded combatants in time to save them or sufficiently palliate their suffering. Such situations engender difficult ethical dilemmas for other soldiers witnessing their miserable condition.
The law in these cases is clear: simply stated, no soldiers today (including military medical personnel) are legally authorized to intentionally...