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Why we need to talk about deployed palliative care
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  • Published on: 21 February 2024
    Palliative Care and Expectant Casualties
    • Thornton L. Ray, Medical Service Corps United States Air Force Reserve
    • Other Contributors:
      • Daniel J. Hurst, Professor

    Regarding deployed palliative care, Kayleigh McMillan has brought up a very important topic that needs more discussion from Western military medical leaders. In U.S. Department of Defense doctrine, the “expectant” casualty triage designation is reserved for “casualties who are so critically injured that only complicated and prolonged treatment can improve life expectancy. This category is to be used only if resources are limited”(1). It also says this designation “includes patients where wounds are so extreme that even if they were the only patient and had all medical resources available, their survival would be unlikely… About 20 percent of casualties will be in this category.” (2) The U.S. is similarly ill-positioned to provide appropriate palliative care to these expectant casualties and needs to undergo a similar transformation in light of the possibility of future peer-to-peer conflict. Our two main concerns in the deployed palliative care discussion are: 1) determining what resources expectant casualties will receive, and 2) integration between medical and other care providers, such as chaplaincy personnel. We have given our general thoughts on these concerns in a response to a paper by Riley on a NATO Article 5 collective defense operation (3).

    In this response, we would like to offer some potential actions to address our concerns that could be added to McMillan’s table 1. Concerning what resources expectant casualties should receive, McMillan has laid out an...

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    Conflict of Interest:
    Both TLR and DJH are United States Air Force Reserve officers. The viewpoints expressed here are their own.