Healthcare workers in crisis situations are likely to face multiple ethical challenges. At the coalface of emergency response, this will cover triage (the prioritisation of patients for treatment), allocation of scarce medical resources (e.g. time, blood, oxygen, intensive care beds) and 'futility of medical intervention' (providing humane care for patients with unsurvivable injuries). At the organisational level, this will cover the relationship between humanitarian principles and security, provision of non-emergency care (especially for marginalised populations), and training and preparation of personnel to work in this environment. At the policy level, this will cover, clashes between professional principles and organisational priorities (so called 'dual loyalty), consent and confidentiality (especially in medical research and relationships with government agencies), and cultural differences between different traditions of healthcare.

Our programme is based on our work in the fields of military and military medical ethics. The KCL Centre for Military Ethics is hosted within the Defence Studies Department of KCL and is based at the UK Defence Academy at Shrivenham. Since 2015, the team has developed a suite of educational resources to support education in military ethics which have been used to teach members of the armed forces in the UK and multiple international partners such as Jordan, Columbia, Kuwait, Australia, Brunei and Oman. This is delivered through a website, a series of online courses, structured background resources, and a unique collection of teaching scenarios collated into physical and online playing cards to support small group teaching.

Based on this success, a complementary project in military medical ethics (MME) was established in 2018 that focussed on the development of a pack of MME playing cards. The first edition of these cards was very well received by MME educators and has been used in a variety of teaching environments with partners in the United Kingdom (UK), Jordan, Columbia, North Atlantic Treaty Organisation (NATO), International Committee of Military Medicine (ICMM), and the Kofi Annan United National Peacekeeping Training Centre. This experience has demonstrated the value of a parallel theme of MME for the KCME. Version 2 of the cards has been written alongside the creation of a smartphone App to support the delivery of education in MME. These were launched at the end of Nov 20. The next phase of the project will be to evaluate these resources across multiple educational setting through partners and collaborators. We will also explore the translation of these resoruces into humanitarian and civilian settings.

Additional Members

• Dr Daniel Messelken, Center for Military Medical Ethics, the University of Zurich
• Dr Janet Kelly, Senior Lecturer in Midwifery and Healthcare Law and Ethics, University of Hull

Partners

• Zurich Centre for Military Medical Ethics
• NATO Centre of Excellence for Military Medicine