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Danish Perspective: Commentary on “Recommendations for the Ethical Use of Pharmacological Fatigue Countermeasures in the U.S. Military”

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Nielsen JN. Danish perspective: commentary on “recommendations for the ethical use of pharmacological fatigue countermeasures in the U.S. military.” Aviat Space Environ Med 2007; 78:(5, Suppl.):B134–B135.



From the early 1990s and onwards, the Danish military has been increasingly active in the hot spots of the world as part of UN or coalition forces, for example, in the Balkans, Africa, Iraq, and Afghanistan. This has also included deployment of an F-16 unit in relation to the conflicts in Kosovo and Afghanistan, where the pilots had to cope with very long missions in a single seat fighter. It is well known in the fighter community that at least one nation has a policy to issue amphetamines for this use, when missions are foreseen to last more than a set number of hours, etc., and it was necessary to decide whether the Danish military should adopt a similar policy. As a result of this process, the use of caffeine tablets was approved for aircrew on long-duration missions a couple of years ago, and that is still the only substance used as a pharmacological fatigue countermeasure during military air operations. In addition to this, all non-pharmacological measures are pursued as much as possible, such as good sleep and rest planning, proper nutrition, etc. Concerning amphetamines, the conclusion was that their use in any planned military activity (including long-duration single seat F-16 missions over Kosovo and Afghanistan) is not possible under Danish law. The administration of amphetamines for any other use (except clear emergency/survival situations) would be a violation of the legislation concerning illegal drugs. It would also be considered as clearly unethical behavior on the part of the physician.
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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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