A unique accord exists between the limitations war places on the individual human rights of armed forces personnel, and their role in upholding these rights.
Using drugs to enhance performance in sport may be cheating, but war is not a sporting event. Uniquely in military operations, technology and training aim to achieve a competitive advantage, not a fair chance of success. What is more, the nature of warfare involves far higher stakes than a podium position. Performance in war can have life-and-death consequences, not only for the individual soldier, but for those around them, and those on behalf of whom they have been entrusted to fight. The physical survivability and the moral responsibility demanded of soldiers in combat has implications far beyond the individual, as soldiers not only represent society and its values, but are relied on to protect and preserve them, and the civilians who are under the protection of the armed forces tolerate a very different level of ethics (including deceit and self-sacrifice) when the stakes are high. As representatives of the state, soldiers are required to respect both human rights and international humanitarian law (also known as the laws of armed conflict) in the conduct of their actions. This demands a higher standard of behaviour than that expected of those who are not soldiers, and it underpins the state’s moral legitimacy to use armed force.
In accepting the authority of military command, soldiers sacrifice some of their civilian freedoms. They are bound by service law to obey lawful commands, and to preserve service discipline, which means that a soldier’s individual agency can, in the course of their duties, be overridden. A unique accord therefore exists between the limitations war places on the individual human rights of armed forces personnel, and their role in upholding these rights. Furthermore, when soldiers are sent to war, they are required to face danger and risks that are not comparable to those encountered in most other walks of civilian life. This places a liability on commanders to accept responsibility for the duty of care and actions of soldiers who they may ultimately require to take life, or to sacrifice it. It also requires that the governments who send them have a moral obligation to ensure that soldiers are adequately prepared, and necessarily protected. Furthermore, the long-term health of those who have served must be provided for as veterans transition back into civilian life on completion of their service.
The moral and ethical thresholds in war are different from those in peacetime society, but they are not independent from it. Decisions made in conflict reflect the values of the society on whose behalf soldiers fight, and in introducing new technologies, such as the pharmacological enhancement of soldiers, these ethical values must be protected. In addition, any new technology introduced to the military must consider the legal framework under which soldiers operate, including international humanitarian law, human rights law, and relevant domestic laws. In addition, what is seemingly acceptable in one place and time may later be deemed unethical, immoral and illegal.
To assess the implications of the use of pharmacological performance-enhancing drugs by the military, the following chapters evaluate the associated ethical and legal considerations in five areas:
- Would drug use by soldiers dehumanize warfare?
- Would the enhanced soldier be capable of complying with the laws of war? And would that soldier be legally responsible?
- What are the ethically permissible scenarios for enhancement?
- What level of consent would enhancement require?
- What are the implications of military drug use for wider society, notably including veteran care?
As this technology is still emergent, the outcome of this enquiry will be to define a legally and ethically justifiable framework for the research and development of pharmacological technologies in the military setting.
For the purposes of this paper, ‘pharmacology’ relates to drugs that are available only on prescription: it excludes both illicit and over-the-counter (OTC) drugs. It also includes drugs that are yet to be developed but that would be covered by similar regulatory controls. In the UK, these ‘controlled drugs’ are defined and listed under the Misuse of Drugs Act 1971. They are subject to strict legal governance, according to the Controlled Drugs (Supervision of Management and Use) Regulations 2013, which determine how they are prescribed, supplied, stored and destroyed. These drugs are tightly managed because they present a greater risk of abuse, particularly where they have addictive properties, and their misuse can cause harm. However, this paper will not concentrate on the safety risks associated with prescription drugs, and instead assumes that any drugs agreed for use by the military would have already been accepted as safe and approved for use by the relevant body responsible. In the UK, this is the Medicines and Healthcare Products Regulatory Agency (MHRA). Making an assumption about the approved safety standards of drugs for military use will allow the discussion to move beyond the safety concerns, which often cloud such considerations, to explore instead the broader ethical and legal implications raised by their use. Debate on this issue has hitherto been deficient.