Clinical Partnering - When Should Host Nation Patients Not be Directed to Coalition Military Hospitals?

This case commentary explores whether and when it is justifiable NOT to direct injured or ill host nation patients to international coalition military hospitals that are better equipped than host nation hospitals to meet patients' health needs in order to ensure sufficient patients for success in clinical partnering. The case discusses Medical Rules of Eligibility as a policy to determine the destination of patients who present for medical care to international military medical services. It also discusses the ethical challenges for international military healthcare workers when working as clinical partners to support capability-building in host national medical facilities. This can be particularly difficult if it involves shared care of patients rather than didactic training. Finally, the case discusses the ethical dimensions of news reporting within medical facilities, especially if this is part of the military effort to share information about the military campaign. The case highlights ethical aspects of higher-level military policy that impact clinical care and the importance of considering if external review of such policies is needed to ensure alignment with legal and professional ethical obligations.