Prohibiting direct medical care by US military personnel in foreign disaster relief: arguments from the Ebola disaster.
Prohibiting direct medical care by US military personnel in foreign disaster relief: arguments from the Ebola disaster.
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DOI：
10.1080/13623699.2016.1185683
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发表时间：
2016-01-01
期刊：
影响因子：
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通讯作者：
Nevin, Remington L
中科院分区：
文献类型：
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作者：
Anderson, Jill N;Nevin, Remington L
近年来，美国军方越来越多地参与在和平时期以外国救灾形式提供公共卫生紧急情况下的医疗援助。虽然法律没有明确授权，但根据美国法典第10篇第404（B）条的解释，国防部（DoD）医务人员传统上在罗斯福任务期间直接向平民提供医疗护理作为“服务”，该条款授权国防部提供“运输、补给、服务，和设备，以便在必要时应对人为或自然灾害，防止生命损失。根据美国国防部的政策，罗斯福特别包括“提供和运输..支持这些活动和其他罗斯福活动的军事资金部分通过海外人道主义、灾难和公民援助拨款提供（国防安全合作局2013）。军方在罗斯福执行任务期间提供的直接医疗服务长期以来一直受到人道主义观察员的批评（Congressional Research Service 2008; Hofmann and哈德逊2009; Minear and Guillot 1996; Schweizer 2004; Wiharta et al. 2008）。根据《奥斯陆指导方针》，联合国人道主义事务协调厅认为，人道主义行动期间的军事支持“应限于基础设施支持和间接援助”，只有在没有民事替代方案的情况下才能提供包括医疗在内的直接援助（即“最后手段”原则）（联合国人道主义事务协调厅，2007年，2014年）。Sidel
In recent years, the United States military has become increasingly involved in providing medical aid during peacetime public health emergencies in the form of foreign disaster relief (FDR). Although not explicitly authorized in law, Department of Defense (DoD) medical personnel traditionally provide medical care directly to civilians as a ‘service’during FDR missions according to an interpretation of Title 10 Section 404 (b) of US Code, which authorizes the DoD to provide ‘transportation, supplies, services, and equipment’in order ‘to respond to manmade or natural disasters when necessary to prevent loss of lives’. According to DoD policy, FDR specifically includes ‘the provision and transportation of… medicines… the furnishing of medical equipment, medical and technical personnel’(US Department of Defense 2012). Military funding to support these and other FDR activities is provided partially through the Overseas Humanitarian, Disaster and Civic Aid appropriation (Defense Security Cooperation Agency 2013).The military’s provision of direct medical care during FDR missions has faced long-standing criticism by humanitarian observers (Congressional Research Service 2008; Hofmann and Hudson 2009; Minear and Guillot 1996; Schweizer 2004; Wiharta et al. 2008). In accordance with the Oslo Guidelines, the UN Office for the Coordination of Humanitarian Affairs contends that military support during humanitarian operations ‘should be limited to infrastructure support and indirect assistance’, with direct assistance including medical care provided only when there is no civilian alternative (ie the principle of ‘last resort’)(United Nations Office for the Coordination of Humanitarian Affairs 2007, 2014). Sidel