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Introduction
Since 1969, a total of 1354 British service personnel have been killed on operations as a result of hostile action.1 While it is essential that we strive in every conceivable way to prevent these deaths, we must also recognise that they are often an inevitable consequence of military action. We must ensure that we provide the highest quality care to soldiers at the end of their lives. This article will argue that now—more than ever—is the time to consider strategies for palliative care in the deployed environment.
Current preparation, practice and attitudes relating to deployed palliative care
Glancing at recent history, there may seem little need for end-of-life care on the battlefield. Since 2014, there have been just three deaths from hostile action.2 67.7% of soldiers killed in action on Op HERRICK died within 10 minutes, giving minimal time for anything other than basic palliative intervention.3 Air superiority allowed rapid timelines and excellent survival statistics for those who reached hospital care—trauma cases admitted to UK field hospitals in Afghanistan from 2006 to 2013 had an overall survival rate of 93.2%.4 This excellence has bred an expectation in some spheres that no soldier should die in conflict and efforts to achieve the goal of zero preventable deaths. We have reached a difficult place in our organisational culture, where a fear of death, or ‘thanatophobia’, is ‘implicitly woven into military health policy, training, and organizational culture’.5 Anything more than a cursory consideration of palliative care is not seen as a requirement because we do not want to contemplate the idea that any of our troops are going to die.
This lack of perceived need is reflected in the way we currently prepare our medical personnel. There is minimal teaching on end-of-life care in combat medical technician (CMT) training. Phase 2 training for General Duties Medical Officers has …
Footnotes
Contributors KM conceived and wrote the manuscript. Lt Col Simon Horne provided general advice and supervision.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Disclaimer The opinions expressed in this article are those of the author alone and do not reflect official policy.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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