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A Glance at the Tip of a Big Iceberg: Commentary on “Recommendations for the Ethical Use of Pharmacological Fatigue Countermeasures in the U.S. Military”

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Jaeger HF. A glance at the tip of a big iceberg: commentary on “recommendations for the ethical use of pharmacological fatigue countermeasures in the U.S. military. Aviat Space Environ Med 2007; 78:(5, Suppl.):B128–B130.

It is normal for military authorities to seek performance advantages over their adversaries. When the search for such advantages posits the use of pharmacologic means to improve human performance, medical officers may be asked to provide advice, or even pressured to prescribe a particular drug. Dr. Russo has examined the ethical aspects of this intervention in the specific case of combating the degrading effects of fatigue, and has developed a four-question framework to assist medical personnel in judging the ethical acceptability of such intervention. This commentary congratulates Dr. Russo for bringing an important question into the open, and for the practicality of his approach, but argues for physicians to exercise great caution in carrying out this function. There are biases that will predictably affect relative risk perception and decision making in this area; medical officers must be prepared to counteract these biases through education and through challenging assumptions. Military medical leaders must be prepared to guide their junior medical officers, and to intervene with line commanders when command decisions cause ethical discomfort.
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Keywords: Bioethics; cogniceuticals; cognitive enhancement; countermeasures; fatigue; military; neuroethics

Document Type: Research Article

Publication date: May 1, 2007

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