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  • Medical Ethics/Politics and Afghanistan

    I wanted to post this article from The Journal of Medical Ethics to make a glaring point and remedy away this notion that somehow, outside powers can ever have, as Mr. Karzai puts it, interests that counter balance those of the Afghan nation. These are powerful evidence based quotes from medical professionals in the theater of war to show how Afghan National Army soldiers (not Taliban) and other hired locals are triaged in a direction that will award their sacrifices with less than optimal medical care. This is NOT circa 2001 but circa 2007.

    The point of this is not to bring any criticism towards NATO or the US since any nation will put their own people and their own interests first... rather its to shift the onus to Karzai and the effeminate emigre elite in Kabul who actually think that they can convince the average Afghan that they are going to be the next Japan or Germany thanks to the largesse of outside donors. Rather, the goal is to show that no one can do for you what you cannot do for yourself - and one should not expect anyone else utilizing a military force in your land to treat you as co-equals or have your best interests in mind - ever- period.

    http://medicalethicist.net/documents...hics%20BMJ.pdf

    Title: The Medical Ethics of the Battle Field by Dr Daniel K Sokol:

    "In one scenario, a member of the local Afghan security forces
    has suffered massive injuries from an improvised explosive
    device. He has lost both his legs and both his forearms. The
    blast has removed his entire face. Tourniquets are controlling
    the bleeding from the legs. He is still alive. If he can be saved
    by use of the coalition forces’ state of the art medical services,
    what of his future once he is transferred to a local health centre,
    whose facilities pale in comparison?

    One Canadian paramedic working in Kandahar, Afghanistan,
    in 2007 described the transfer of patients to the local hospital
    as a “death sentence.”
    1 The hospital had no ventilators,
    resuscitation equipment, laryngoscope, or monitoring devices.
    Kevin Patterson, a Canadian doctor also posted to Afghanistan,
    recalls a mass casualty incident involving a mixture of coalition
    personnel and Afghans.
    2 The doctors were told not to intubate
    any of the Afghans with burns exceeding 50%. Without a burns
    unit, those patients would be doomed. The coalition patients,
    on the other hand, could be repatriated to their home countries

    to obtain high quality burn care. Such divergent treatment is
    hard to bear and highlights the need to develop local healthcare
    infrastructure, but what are the immediate alternatives?"

    Now the kicker is how this approach is VALIDATED by the author by trying to somehow disingenously trying to construct a nonexistent ethical conundrum:

    "If our Afghan patient is treated and survives to discharge, what
    kind of life awaits him back in his village, where the realities
    of survival and attitudes to profound disability may be a far cry
    from our own?"

    This is said as if they can predict how an Afghan family will react to their loved one's injuries and as if they can predict that Afghans will respond in a manner different than most human beings to the injuries sustained by their loved ones.
    "2 crackheads don't become any better or stronger by sharing the same crack pipe." - Greatest PF quote

  • #2
    And then i also want to draw attention to the dramatic difference in triaging afforded to that simple Afghan National Army soldier by those that Karzai deems as benefactors and the treatment afforded to Asadullah Khalid:

    http://www.tolonews.com/en/afghanist...in-us-hospital

    Note that contrary to the treatment afforded the Afghan National Army Soldier - Mr. Khalid is afforded state of the art healthcare and shipped to Virginia. How Dr. Sokol would justify the ethics of assuming that Mr. Khalid's family would react differently to a debilitated and possibly disabled Mr. Khalid versus the presumed Spartan die and let die attitude supposedly held by the family of the rural/urban commoner who joins the ANA reacting to their loved one's medical challenges creates a conundrum.
    Last edited by BarakzaiAbdali; 01-06-2013, 11:19 PM.
    "2 crackheads don't become any better or stronger by sharing the same crack pipe." - Greatest PF quote

    Comment


    • #3
      And the point made by Dr. Sokol in the quotes above is to show that the NATO troops can be send for care abroad, emergently, to Germany and then staged to the US... yet the Afghan is left to be triaged to Mir Wais. He has to explain how and why Mr Khalid can be triaged abroad for cutting edge care but the soldier in question is basically euthanized instead of rewarded for his service? How do these approaches reconcile? Why would other ally nations not have tertiary care centers set up for ANA army injured in local states that profess to be United Nation members? Was this thought even considered??? Is the canard of "building up local care centers" supposed to be the excuse that makes it so that the coalition members get better care than their Afghan compatriots?


      So on the one hand the UN service members claim they "fear" their Afghan partners and now have a mistrust after insider attacks. Its a wonder why the Afghan National Army heirarchy and Karzai himself dont retort: perhaps they ought to trust you less since you put them on the front lines but treat them with the equivalent of Jim Crow Law type approaches to saving their lives versus your own.
      "2 crackheads don't become any better or stronger by sharing the same crack pipe." - Greatest PF quote

      Comment


      • #4
        This brand of thought is so wrong and so against the medical code of ethics. It is clear violation of the hippocratic oath. In this nation no one can be turned away from an ED or denied care irrespective of their creed. American Physicians who work with compatriots to make these algorithmic approaches to triaging ANA soldiers to anything less than the same route given to UN soldiers are violating their hippocratic oath and out to protest this vigorously.
        "2 crackheads don't become any better or stronger by sharing the same crack pipe." - Greatest PF quote

        Comment


        • #5
          Originally posted by Toramana
          Condolence to you on the sudden demise of one of your spiritual elders Qazi Hussain Ahmad. I have heard he was a close buddy of Osama. Bakhshana ghwarama.
          I have no idea who Qazi Hossain Ahmad is. I do however know that you are still itching a little bit after our last encounter - so I will let it slide.

          Any idea yet as to when you are going to take up the challenge and approach a Canadian military family to serve as a surrogate for their child in the theatre of war to pay them back for educating you?

          Perhaps a video can be made called with its lengthy title: Toramana Actually Agrees to Put his Own Life in Danger to Help Canada instead of letting Canadians and Americans perish for his goals.

          Or in the least you can post your writ for when you joined the Canadian Armed forces.
          "2 crackheads don't become any better or stronger by sharing the same crack pipe." - Greatest PF quote

          Comment


          • #6
            i don't think medical ethics apply by the aggressor nations within an unethical war.
            There are people today who think that admitting God’s absolute greatness decreases the value and importance of humans in the creation, as if God and mankind are rivals competing in greatness and power. Meanwhile I feel that whenever our perception of God’s greatness increases, with it we become greater, because we are the creation of a great God.

            Sayyid Qutb

            Comment


            • #7
              I don't think all US soldiers are sent home for special treatment, only the top brass, or dare I say the 'important' ones are exported(think Mr.Khalid).
              Even Adobe Photoshop can't change me.

              A line[Durrand line] of hatred that raised a wall between the two brothers -Hamid Karzai

              For generations, the Hindus of India prayed for deliverance from "the venom of the cobra, the teeth of the tiger and the vengeance of the Afghan."


              The men of Kábul and Khilj also went home; and whenever they were questioned about the Musulmáns of the Kohistán (the mountains), and how matters stood there, they said, "Don't call it Kohistán, but Afghánistán; for there is nothing there but Afgháns and disturbances." Thus it is clear that for this reason the people of the country call their home in their own language Afghánistán, and themselves Afgháns. The people of India call them Patán; but the reason for this is not known. But it occurs to me, that when, under the rule of Muhammadan sovereigns, Musulmáns first came to the city of Patná, and dwelt there, the people of India (for that reason) called them Patáns—but God knows!

              -Ferishta, 1560–1620

              Comment


              • #8
                Originally posted by Admin Khan View Post
                I don't think all US soldiers are sent home for special treatment, only the top brass, or dare I say the 'important' ones are exported(think Mr.Khalid).

                Major injury salvagable and stabilizable soldiers are sent ASAP to Landstuhl or less commonly dubai. That is the type of soldier they describe that was wounded from the ANA. They are then staged to the hospital associated with the uniformed services academy in Washington. That is what Sokol discusses and the reference or subreference in Mother Jones confirms. I used to tour UHSIS and have a few colleagues I collaborate on research work with and can confirm this is the case. Moreover, when the veteran enters the VA pool he is able to be treated extensively under enduring freedom privileges. And I dont find fault with this - its the least they can do for the innocents they are sending to fight Karzai's war for him.

                But the ambiguity comes not from them but from effeminate elite emigres who think that they are somehow taking America for a ride - whereas this is hardly the case. Super powers are not taken for rides - they have puppets and Karzai and Zardari (father and son) ensure that is the case.
                "2 crackheads don't become any better or stronger by sharing the same crack pipe." - Greatest PF quote

                Comment


                • #9
                  Reference:
                  http://articles.latimes.com/2010/aug...unded-20100831

                  "Some of the wounded are patched up and sent back to frontline duty. Many others are taken to the U.S. for advanced treatment at military hospitals in Washington, D.C.; Bethesda, Md.; San Antonio; or San Diego."
                  "2 crackheads don't become any better or stronger by sharing the same crack pipe." - Greatest PF quote

                  Comment


                  • #10
                    with all the billions that have supposedly been spent to upgrade afghanistan, one would expect there to be top class medical facilities and burns units.

                    Comment


                    • #11
                      Originally posted by faye View Post
                      with all the billions that have supposedly been spent to upgrade afghanistan, one would expect there to be top class medical facilities and burns units.
                      Well Faye, Karzai, Spanta, and Ghani and the whole lot of them, who think that they are somehow enlightened, educated, and chosen to lead the Afghan masses to Hollywoodghanistan are the ones who have to answer for this imbalance. Americans and any other peoples will deal on a basis that is best for their interests. Karzai claimed, in his "Afghanistan is a Lion" speech that he was a the master orchestrator of the concept of "strategic balancing" a concept that seems eerily similar to strategic depth. In reality, what is Karzai balancing? What benefits has he garnered for the people? How has he ensured that the benefits are for, by and of the people? How have his cronies and the naysayers that lament how "well this government is better than before" strategically balanced anything, even when it comes for the young men that fight their battles on the front lines?

                      So I repeat, this failing is one that can be pinned squarely on Karzai as these differences in patient-care are known to everybody since '07 and has he done a darn thing about them.

                      If Pakistan can manage to get Malalai air lifted to London, there is no reason why the Afghan government cannot advocate that their young injured men be treated in Germany or other NATO nations with top notch facilities.
                      "2 crackheads don't become any better or stronger by sharing the same crack pipe." - Greatest PF quote

                      Comment


                      • #12
                        yeah. one has to get ones priorities right. beach front properties overseas, are priority no1, it seems.
                        but the outsiders doing their rip offs, are to blame too.

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