Heavy Burdens

Ethical Issues Faced by Military Nurses During a War

Deborah J. Kenny, PhD, RN, FAAN; Patricia Watts Kelley, PhD, FNP-BC, GNP-BC, FAANP, FAAN


Online J Issues Nurs. 2020;24(3) 

In This Article


It was clear that ethical dilemmas experienced by nurses in this study were unlike anything they had ever encountered in previous assignments. They relayed both negative and positive dilemmas to the research team in a level of detail not tainted by the passage of too much time. Even though many stories will retain their detail for these nurses, some will fade and some details will be forgotten. This is precisely why it was so important to capture these stories as soon as possible after deployment.

The nurses made it evident that despite the dilemmas they faced, they were proud of themselves and how they handled wartime situations. They believed they continued to provide the best care they could for service members, enemies, and civilians alike. They did not hesitate to make what they considered to be the "right decision." However, at the same time, they continued to question the necessity and ethics of war itself. But they knew their purpose and will defend their right to be a part of it and serve the country by doing what their profession and their country required of them.

P8: And so it kept life in perspective, and – I think the only – conflicted part I feel about the whole thing is, I'm more confused than ever, how I feel about the war. I had my opinion set when I went over there, and I just thought I'd focus on my job, to take care of the troops. That's every – all the politics are not my problem. My job is to take care [sic] of the wounded. And the problem is, I still don't know that we're gonna solve anything.

Based on the results of this study, the authors suggest that uniformed nurses going to countries of conflict or on humanitarian missions are provided with open and honest communication about the types of patients they will encounter. Additionally, nurses should be provided more in-depth training of the culture of those countries and how best to handle patients who may be openly hostile to them. Nurses should be given basic in-country patient care language, such as "Where is your pain?", "It is not time yet for more pain medication" or other specific words important to patient care, such as "medicine", "drink", and "urinate", and "blood." Nurses should be informed about types of ethical challenges they may face and offered suggestions and coping tools before deployment. They should be provided with mental healthcare resources during deployment and after return home, so that they can deal with concerns openly and without fear of retribution or loss of promotion opportunities. In summary, nurses should not simply be sent to a war zone, or on a humanitarian mission, with an expectation to handle issues as best they can.