Introduction: ethics, national security, and global health

With national security a top priority around the world and righteous indignation among the public and global health communities ignited by the increased use of drones and other airstrikes and the use of a vaccination programme in the covert operation conducted to capture Osama bin Laden, ethical questions concerning the implications for health of security policies and practices demand renewed attention. In a workshop at the Fondation Brocher in Geneva, members of humanitarian aid organizations, a former United States Assistant Secretary of State, health professionals, a legal scholar and a few philosophers gathered to explore some of these questions. Here we offer some of the fruits from our workshop and subsequent discussions and reflections.

In the first essay, Jonathan Marks thoroughly examines steps taken in the wake of torture revelations during the Bush administration, and argues for investing resources in physicians and other health professionals to help prevent future abuses. Lisa Eckenwiler and Matthew Hunt highlight the obligation to consider the health implications of particular policies and operations, and propose a specific set of ethical principles and practices to assist intelligence and other national security officials in decision-making. Finally, Ryoa Chung examines the debate surrounding the securitization of health and whether this discourse linking health to security serves to undermine or advance global health equity.

When we met in Geneva, counter-terror efforts were the focus of growing scrutiny, mostly out of concern for civilian casualties and a perceived lack of transparency. As we submit these essays, the global political landscape has shifted towards greater nationalism, with counter-terrorism efforts only intensifying. Rigorous discussion and the promulgation of principles seems all the more pressing.

Lisa Eckenwiler
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Matthew Hunt