In the modern American political climate, we see echoes of 40 years ago, when Richard Nixon was president. Federal agencies are being used as hatchetmen for the administration, copies of messages mysteriously get lost when subpoenaed by Congress, and if anyone objects to domestic spying, we are told it's to stop terrorism.
Stopping terrorism seems to be an agreeable notion to people, that is why it has become a blanket excuse for all kinds of government conduct.
And it has even become a way to use medical care.
There has been a surge in murders of polio vaccination workers in Pakistan this year, but it wasn't done by liberal elites in California and New York. It's being done by terrorists - because they believe that humanitarian health care workers are secretly working for the military. So there is an issue of moral agency and responsibility. Should humanitarian health workers, military medical personnel, and national security officials and operatives be confused with each other in the name of counterterrorism?
"The militarization of health care" is not new, any more than sending in spies dressed as college students or Canadians is new, but it got new attention from terrorists after the covert operation involving a vaccination program led to the killing of Osama bin Laden.
Now there is fear and distrust among populations in need of health services. An essay in the Hastings Center Report reviews the range of harms to population health traceable to counterterrorism operations.
Counterterrorism-related harms exacerbate global health inequities, say Lisa Eckenwiler, associate professor of philosophy and health administration and policy at George Mason University, and Matthew Hunt, an assistant professor in the School of Physical and Occupational Therapy of McGill University. "Populations in places like Afghanistan, Pakistan, Somalia, and Yemen – already vulnerable by global health standards – are more precariously positioned as a result of the war on terror."
The authors identify profound moral distress and fear among humanitarian and health workers who are professionally committed to neutrality and independence and yet are treated as tools in the war on terror.
"As the global war on terror has evolved – or devolved – the military's effort to 'win hearts and minds' through such strategies as providing medical care to local populations has situated military medical personnel in the midst of ethical controversy," they write. "Deploying health services for the sake of advancing strategic aims seems to violate obligations at the core of health professionals' identity, including the obligations to respect patients as ends in themselves, to avoid treating them as instruments for other purposes, and to serve their particular health interests rather than state interests."
The authors conclude that the most pressing policy issue is how to integrate concern for health in efforts to prevent terrorism: "Identifying threats to global health posed by counterterrorism strategies, analyzing them in relation to anticipated gains, and determining the proper assignment of responsibilities for harms done to health and health systems are morally pressing tasks that existing structures and processes lack the capacity to carry out."