Vietnam War Report

A Vietnam War report a half hour program presented weekly at this time. And our first commander goes on one level because he can go to the officers club and meet the army officers without having seen what he's done. And they've got to keep order in Bonn because people flee otherwise you lose mine. And what are American mine the world of the military seems divorced from all others within its boundaries the morality of the individual must somehow exist. Last Wednesday evening in Boston in the auditorium of the Harvard Medical School library a seminar was held. Its subject medical ethics and their place in the military. There were three speakers Harvard law professor death Lavazza an expert in medical jurisprudence. Colonel James Caskey a doctor and commanding officer of the fort Devons Army Base Hospital and Dr. John they air a lecturer from Harvard School of Public Health. The panel moderator was Dr. Victor Sidel. Both he and Dr. my heir had been defense witnesses at the recent court

martial of Howard Levy. When the doctor was tried for refusing a direct order to train Green Beret. The first speaker was Professor votes he diagrammed on a blackboard the descending levels of military authority and then turned to the nearly filled out of Torah. Here is the unfortunate part about it but as far as the lawyers perspective is concerned. Ethics. I've got Ron on the board. The fact of the matter is that if an order is lawful The trunk's down this training takes precedence over a contrary medical consumption. That doesn't mean that this happens wholesale. There are people as we'll see build around a good many conceptions of law which are contrary to medical ethics in the military I suppose one of the most long established rules which would run counter to what I understand

to be the case in civilian life is that a person in military service may be ordered to take that treatment which the doctor regards as being best suited to returning to duty whether he likes it or not it is a court martial offense. Not if they have to plead your case with respect to the issues about. About the specific orders to teach dermatology to people in military service who are not doctors. Well first of all we have what I suppose from a lawyer's point of view is as authoritative a declaration as is possible of the organized view of the medical profession is that there was none. Nothing unethical or a surprise that the House of Delegates was able to be

unanimous on this point as reported in The Times the comparable body of the legal profession I don't think could be unanimous on anything but I suppose from a legal point of view that tended to settle all the remaining disputes. One of the tragedies of the situation of the military picture. Puts a person in a position where he can be legally compelled to do something which violates his own personal sense of ethics and it's a great tragedy I think a lot of people are responsible for what I suspect without knowing all the facts was an unnecessary conflict on the part of this particular person but the power to regulate the land and naval forces power to somebody is said to conduct war includes the power to conduct it successfully and it overrides a lot of the next to speak was Colonel

James Caskey as both a doctor and an army officer. He himself represented the dichotomy of a man of ethics and a man of the military. As you know now medical lapses and coming on active duty whether a regular army officer or a so-called active draftees take one oath. Of enlistment or commission. This is the same all the infantry ass it takes an engineer takes a social worker takes him we do have them in the army. And then he is expected to abide by the rules and regulations. We have very little formal consideration of any ethics for the most part we assume that a man who has received his degree and internship and has had a national agency or national security Jack and has signed the Oath of

Enlistment down and our allegiance will maintain a high standard of not only and I emphasize but those of a doctor the doctors feel a little bit differently however that particularly the younger group and in most particularly the doctor drafty they figure that they are doctors first and I have to second and this is a general feeling. There is a dichotomy in their feeling. Which is sometimes difficult to manage and control. Now I'm not great really. I have us suspicion that in this case particularly in Levice case that

perhaps the whole thing was mismanaged and got an excessive amount of publicity. From my point of view. And that it probably was not Levi's intent to make an issue or to have his situation yet where it did. Yet in 20 some odd years in the service I have had similar experiences and have refused direct orders to my commanding officer and not been court martialled friends and ultimately have been proven right. We do we have a problem with other doctors in our initial assumption that they are reasonably well trained and they have a standard that are ethical and that as you know like lawyers doctors

sometimes I am not 100 percent accurate. Or 100 percent honest and in a recent We had a recent episode of this at Fort Devon and which I did draft me just Bhan supplied some records. Simple as that. And he was investigated and it turned out that not only did he fall to buy the records at the post he was at but when he initially came into the service and the National Security Agency checked. Not only ponse mind but omitted the fact that he was under suspension from Texas because of misuse of an iconic symbiote you're right and the charges were pending on him in Texas for contributing to the delinquency of minors and sodomy.

Any one of these things were sufficient to court martial law and various articles and ropes. However the best way to handle his particular situation was to give him a choice of resigning. And this was accepted and he has resigned and has been discharged from the service. I think this dichotomy of feeling and our tendency to to trust all doctors by virtue of being doctors and by budget virtue of having completed an internship may get us in a little bit of trouble now and then. But most of the time these things are handled on a local basis without public sitting by press suasion rather.

Or most of us find some other way of of achieving our objective whatever it happens to be following Colonel Caskey was the final speaker. Doctors by air. The moderator Dr. Sidel introduced him. The final speaker on the panel is Professor John Meyer of the Harvard School of Public Health it's perhaps characteristics of him that at the beginning of the proceedings you lean over leaned over and whispered to me make sure you point out that I'm a professor of nutrition and how I backed into this particular kind of problem. And while I'll say it because I promised him that I would. It is. It's modesty which which just does not happen to be true. One story will perhaps give you another side light on this in the court martial testimony. I by the way did not hear this myself I was outside sitting in an empty room because one witness is not allowed to hear the testimony of preceding witnesses.

But this was reported to me by I'm biased observers. Listening at the trial of Professor Meyer was asked about his military background which was with the Free French forces in the Second World War and of the defense lawyer was attempting to get his qualifications out on the record and had to do this by a series of leading questions which are rarely permitted in a court martial procedure and had to finally ask Professor Meyer directly. Did you win any medal from hire. And then we've had to ask him how many. And the answer came back oh 12 or 14. And this is the kind of a man we're doing with a person who has a profound knowledge both of the problems of the military and most important of the history of public health and of medicine. And a lecturer in the history of public health. At the Harvard School of Public Health.

You know as much as I think that I'm here simply because I was a defense witness of the Levy trial and I want to be gamed out because of a great deal of persuasion on the part of the defense of the defense lawyers. I'd like to start out by just making some of his evasions as to what struck me as the main fuse from a comment I think of you point out at that drive. And I may say that. I have had the misfortune of being involved in two court martials. Before both time as an absolute sitting on the court martial at both times during World War Two and it suddenly dawned on me as I was. Sitting here that in both cases I think the reason there was a court martial in the first place was that there were conflicts of ethics that the commanding officer had not known how to handle.

I committed various units rather of the smaller size from a platoon to the end of the small depleted regiment and I can't remember any instance of my at any time even considering having anybody court martialed even though I had the usual. Problems that one has and the conditions but the Clean Water time you know cases there was a perfectly adequate way of dealing with crime and punishment without involving a court martial and I was feeling that perhaps you know it since a court martial is a defeat. Well I am a commanding officer. It means that he has not been able really to deal with the problem and in this case I felt that was going to offend again and I guess he did that day yeah. There were thing was very much mismanaged from the start. The

DME was putting itself in a very difficult position. Probably unnecessarily. And as I speak. Well that's certainly what came out of it. And was not the serious consideration of some of what I thought were the substantive points and which were raised but a sort of denial that there was a need and I think our problem involved here was a captain. Yeah obeyed orders. My. People didn't like very much for a variety of reasons. Who was not the most people thing defendant when I was which is that in those. Civil liberties cases the defendant was a looked and acted like a school field in a man four seasons but it usually doesn't and you know let's dispose of this as though there was no problem. Now to my mind the. Problems were

not that. And Captain Levy had made this or that statement. Against the war in Viet Nam I suspect that a dodgy part of the United States Army could be court martialled at one time or another. As for what they have said either about the war and yet now Marty whether president going there today so that there are sorts of statements of that sort and as long as they were on a one to one basis as the these seem to have been. And there is some question as to whether they were nothing covered by the First Amendment even in the forces the question was not either whether Captain Levy had refused to train the nurses corpsman or to train people into stayed because to my knowledge he had not. And the question was essentially whether he had refused to train Green Berets as in dermatology. And the more one looks

into this problem not in the light of strict military law which but in the light of history the more difficult the problem is. These are not met a girl or a person who was in the narrow sense of the term and this was a very important reason. Which is that they don't report to a physician they report to their normal chain of command to the engine and their captain and so on. To that extent I feel that the question has been raised and which was raised repeatedly during the trial. Don't we need a medical exam. Don't we need medical examiner is particularly in the developed countries is not really pretty but I think the real problem with the Green Berets is not that they are theories but that they are not responsible to physicians. From the point of view of the Story Girl separation.

Of. The military and the physicians in wartime and there is some separation which has already been mentioned for instance the fact that according to Geneva conventions and physicians a retained person there rather than prisoners and should be exchanged as soon as they have been relieved by the physicians of the other side but by the same token to take care of the wounded of both sides and they with their wounded. There is a grave danger that if we employ too many too many people who are not bound by the sort of ethics who cannot stay with the wounded and because they are themselves soldiers and are fighting in terms of battle some of whom have medical status according to their guards and some of whom do not or who do healing on. One day and killing the next that we are going to blow there an edifice of a hundred years of conventions which in the long run have been to the advantage of American

soldiers as well as to the advantage of everybody else. About 100 people listened in on the seminar many of the medical students and interns dressed in white medical gowns after the panelists had each spoken. The floor was open to questions. It soon became clear that the real issue on the listeners minds was how to reconcile their serving in a war. They thought just one student talked of acts in Vietnam that violated international law. Professor votes explain the duty of an officer in such an instance. If a person is given an order by a commanding officer which is a violation of a treaty commitment of the United States or part of international law that we recognize he is not only entitled but he is obligated to refuse to carry out that order. One of the problems is that the very highest level because international law is a very

imperfect mechanism. Our courts have consistently held that if Congress passes a later statute that overrides a treaty at least as far as the United States is concerned that is the treaty that is so long as if if an American pilot were ordered to carry out a mission against a hospital marked as such he is supposed to not do it. Colonel Caskey then explained what action would be taken if an officer did turn in an official objection. These would go back in the form of a critique or an after action report which concludes with a recommendation concerning the operation. I don't know what I always would get out of the theater of combat to reach Washington level language level in this particular war.

All sense decisions I made rarely however does Washington answer an individual. The listeners were not satisfied and wanted to pursue the question. Is there any way a person can refuse an order he considers wrong. First Professor vos answered then Doctor my air. First of all you can always question for example and sometimes that has an effect. When you give it to me in writing for example bomber turned back the first request which apparently came from political sources in the city of Dresden a few days before the end of the war when the city was pulling out of troops but of refugees they were called upon to flatten it and it isn't proceeded to do so now. Military Conduct is such that if you're going to squarely refused you have to be very sure of your ground that there is a higher legality. Of course in most situations

the military vision to if you haven't been in the military you visualize the military as a whole with people but it's not that way people. If you look at the microscope with more resolution you find that they're talking to other people and they're doing all sorts of things that they aren't supposed to and one of them is growing. I'm known of all sorts of cases. I talk to higher ranking officers out of all sorts of things they intended to do and decided after sober reflection I didn't want to do more than a good thing to do. There are a lot more flexibility in the system than the charts would undergo. I think that I think that the forms are very important. If you say no I won't do it. You're obviously in trouble but if you are if you if you stand at attention and show proper deference and that in my experience

every time during the war I got an idea which I thought was a bad audit and made quite clear that I wanted the order in writing because I thought my battery would be unnecessarily wiped out and so on. I did not get the audit this immediately became a matter for discussion you think this is really a bad position so that this doesn't as you know this does not always work but is it's always worked for me. One of the things you have to do is build up so to speak a capital of credit with your superiors. You know most of the time you do what you're told and do it well and then you come in with your shoes shoes shined and your insignia on the right way. And you say I've I don't think we should do this you will you will get a hearing like that not you may may not prevail but you'll be listened to. Once your group objected to the panel's practical maneuvers such legalities he felt only skirted the central issue. Professor votes a great one has of course and this is

somewhat lean in the background of it all do you have the question which you face whether you are. You have come to the conclusion that the whole legal political system of your country to the contrary notwithstanding you are not going to do this is the question which was faced by the officers of Hitler's army in 1944 and I suppose it is clear that at some point when you have taken justice away from the state there's nothing left. Big banditry and you have to hold withhold your allegiance. I think at that point you've sort of stepped outside the legal system. You would have to say to a court martial. From your point of view I have no defense because you and I as an unbridgeable gulf between us and that point comes at some

point in time when a process gets bad enough. That's an individual matter and something in which no lawyer can really help you. It's a matter if you're lucky enough to have a really superb Minister you might be able to help you. But it's a very lonely and very drastic decision. The mood of the audience seemed to solidly against the war in Vietnam and a system that places authority above an individual's conscience. Doctor my error however did not completely agree. I think by and large it's been to everybody's interest to keep the medical. Road from they probably need as much as possible. I have no doubt that this really blurs the role of the physician and it makes him after all. Whether that the minute he's training people who are no longer responsible to physicians he is in fact

a part of a fighting organization rather than a part of a medical organization. Now I must say at the risk of I think being contradicted by many of my friends here that I've always felt that the physicians were in a very poor position to claim a draft exam status and as gunshy and as objective. Because if they are limited to their role as doctors and they gain of both sides impartially and as well as they can then the fact that they do or do not approve of a war is very much less relevant to them than it is to anybody else who may have to actually participate in the war by destroying their lives or property. It was a frustrating seminar that participants seemed unable to resolve any issue that medical students could not understand why they who had been trying to heal should

somehow be forced to conduct a war. Finally a member of the audience rose and called out a statement to the front. Some see him as a role and one which is someone that if you need it he's just make the decision. Questioner this state says you know that the position is important to the military apparatus and that if there were no physicians willing to serve in the military that there could be no war. And I want to comment or go to another question. The panel had no reply. A doctor at a stroke carries a rifle only to protect his patients. But do not those patients recover and return again to kill in battle.

At the end of the evening Dr. Voth said there is a tendency a complicated time such as this where rights and wrongs are hard to decipher for people to say well I'll go back somewhere and research and teach and wash my hands of it and what people do with what I tell them how to do is none of my affair and I feel that anybody who teaches a person how to do something and is aware of the way in which you're going to do with it is implicated in what he's doing. A doctor's years of medical training can promote a deep personal morality. But finally it would seem the military doctor is no different from any other man. Dr. Levy who sits now in a military prison is no different from the 18 year old who sacrifices his youth in the flame of a draft card. Professor votes offered a more compromising course. Well of course there is the military training there is he's not completely sterilised politically

he can write his congressman and Colonel Caskey offered his own solution on the local level but that are all many places delighted to complain about a direct platoon or company or commanding officer. There is always a post station unit inspector general. And there is always the chaplain. The chaplain isn't there. But back to maybe there was a division psychiatrist may well be there for the man of conscience is fragile and the gears of war sometimes overpowered this program was written and produced by James McKenna. We invite you to listen again next week at the same time for another Vietnam War report.