Healthcare in Danger

Surgeon Rear Admiral Lionel Jarvis CBE QHS FRCR

Challenges for the Defence Medical Services

• • • • • Professional Training Military Training Laws of Armed Conflict Medical Ethics Ethical Dilemmas

Medical Emergency Response Team (MERT)
Contact: casualties sustained
9-Liner sent to Brigade and forwarded to JOC

MERT to HLS Await Apache and clearance to deploy
Fly to EHLS

Loiter if EHLS hot (gnd prep)

Time on ground Return flight HLS to ED

Role 3 Medical Facility BASTION

University Hospital Birmingham Foundation Trust


ISSUES: 1. 21st Century Conflict
• • • • • • • Rapid Electronic Communication Media Interest & Access Asymmetry of War Fighting Multi-National Coalitions Multiplicity of Providers Asymmetric Medical Advances Evolving Medical Audit & Governance

ISSUES: 2. Dilemmas for Medics on Front Line
• • • • • • • • Self Defence Protection of Comrades Protection of Casualties Triage & Prioritization Resources Disposal of Casualties Use of Protective Emblems Support to MEDCAP

ISSUES: 3. Dilemmas in Deployed Hospitals
• • • • • Admissions Discharges Use of Resources Artificial Sustainment of Life Relationship with Other Medical Providers

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