Sworn to preserve health and protect life, doctors are the last ones you'd expect to find building weapons for the military. But the growing popularity of nonlethal, "medicalized" weapons is changing such a perception.
Faced with guerilla enemy forces that often intermingle with civilian crowds, the U.S. military is calling on medical professionals to help design weaponry that allows soldiers to subdue crowds and apprehend insurgents without causing undue harm to the civilians in their midst.
Unlike traditional weapons designed to disable targets by causing traumatic injury or death, nonlethal weapons are made to temporarily disable their targets, knocking them out with chemical agents, disorienting them with special lights or otherwise causing temporary physical or neurological distress.
Such weapons are "medicalized" in that they draw on research in pharmacology, physiology and neuroscience, and they require the participation of medical professionals to design and test them.
Although medical organizations such as the World Medical Association take a strong stance against medical involvement in weapons development, Michael Gross, professor of political science and chair of the Division of International Relations at the University of Haifa, Israel, said that "if these weapons prove effective [at preventing undue civilian death], there is an obligation for doctors to get involved."
But many in the medical profession disagree.
"The foundation of medical ethics is the first commitment in the Hippocratic Oath; first, do no harm," said Robert Field, medical ethicist and professor of health management and policy at Drexel University School of Public Health in Philadelphia. "Medical ethics is stood on its head when physicians intentionally create harm."
Still, developing such technology relies on medical expertise and, without it, more civilians may die. So said Gross in a recent report by the Hastings Center, a non-profit bioethics research institute, arguing that this new kind of warfare calls into question the traditional interpretations of a doctor's role in preserving life.
New Kind of Warfare Calls for a New Kind of Weapon
Although blinding laser beams or satellite dishes that make the skin burn from a distance may seem like the work of science fiction, they are some of the potential weapons in the arsenal of "medicalized" weaponry.
The U.S. Department of Defense is integrating the technologies into its toolbox, said Kelley Hughes, spokeswoman for the Pentagon's Joint Non-Lethal Weapons Directorate, which develops the weapons.
This year, she said, "the services employed nonlethal weapons for crowd control, detainee operations, checkpoints, convoy operations and area denial," adding that Air Force, Army, Marine Corps, Navy and Cost Guard are training with nonlethal technology.
One such weapon, called the ADS, which stands for Active Denial System, resembles a large radar dish and sends energy that penetrates the surface of the skin, causing immediate, burning pain.
The idea is to cause civilians to flee the beam of the ADS, while hidden insurgents advance toward their target, making them easier to identify.
The system has proven to involve minimum risk of injury and Hughes herself has personally experienced the ADS three times. "I believe, first-hand, that its effects are temporary and reversible," she said.
Another kind of nonlethal warfare, which has been used in some form in the past, is called a calmative. These chemical agents, often released into the air and absorbed through the lungs, depress the central nervous system and cause unconsciousness or hallucinations.
But while the pain and distress are problematic for medical professionals who vow to ease suffering, the debate is complicated by the accidental injury and death sometimes resulting from the supposedly nonlethal measures.
"'Nonlethal' is a misleading term," said Jonathan Moreno, professor of medical ethics and history and sociology of science at the University of Pennsylvania in Philadelphia.
"Under certain circumstances, these measures can be deadly even if that's not the intent," he added, citing the 2002 incident in Russia in which knockout gas used to subdue insurgents in a theater accidentally killed 129 hostages.
Nonlethal vs. Less-Lethal
Even under the best of circumstances, nonlethal weapons are not completely safe: the Pentagon's Joint Non-Lethal Weapons Directorate has proposed that the weapons be held to a standard that allows it to kill 0.5 percent of those affected and permanently injure another 0.5 percent, the University of Haifa's Gross noted.
The 1 percent window may be a deal-breaker for some medical professionals.
"Nonlethal weapons sound benign on the face of it but there is a slippery slope," Drexel's Field said.
Moreno warned that technology intended solely for nonlethal purposes may open doors to lethal weaponry or help amplify the lethality of other weapons.
"Our experience with novel weapons shows they can lead to escalation and an arms race ? so even if they reduce casualties in the short-run, they can increase casualties through unintended consequences in the long-run."
And while the proper use of the new technology may become a debate for military ethics and even international policy, it belongs outside the realm of concern for medical professionals, Field said.
"There is a broad consensus in the medical community that this is not the role [doctors] signed up for, or that they were trained for," he said.
"Public policy may, at times, require sacrificing a few for the good of many -- this is what waging war is about -- [but] this is not a decision for physicians. We should keep them focused on helping people, one patient at a time."
But the inescapable truth is that physicians are already involved in such military issues, Art Caplan, chairman of the Department of Medical Ethics at the University of Pennsylvania, noted.
"No matter what anyone says, a small number of doctors and scientists are always involved in weapons development, whether in the CIA or NSA [National Security Agency]. ... That doesn't make it right but it is, nonetheless, a reality."
And with the advent of nonlethal weaponry, medical involvement is unlikely to decrease, Gross said.
"Military technology uses more and more medical technology," he said. "There are slippery slopes involved [in this shift] but that should be a cause for concern, [not] a cause to say we're not going to get involved at all."
For Field, "War is war. In the long-run, it will be hell no matter what," he said, and nonlethal weapons "are not likely to change that."