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Legal aspects relating to the response of Defence Medical Services to a mass casualty event
  1. Felix Wood1,2,
  2. R H James1,2 and
  3. S T Horne1,2
  1. 1Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine, Birmingham B15 2WB, UK
  2. 2Emergency Department, Derriford Hospital, Plymouth, UK
  1. Correspondence to Dr Felix Wood, Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine, Birmingham, UK; felix.wood{at}

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During a mass casualty (MasCal) event, medical treatment facilities are overwhelmed despite all additional efforts and resources. By definition, affected facilities are unable to continue business as usual. The 2020 explosion at the Port of Beirut created thousands of casualties in an instant, completely overwhelming local capacity. During a peer-on-peer conflict, Defence Medical Services (DMS) should be prepared for an event of similar scale. We have considered the legal matters arising from a number of options which could be considered to assist the DMS in fulfilling its ethical imperative to provide the greatest good for the greatest number of casualties. We hope that sharing these findings will advance discussion of these issues among …

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  • Contributors All authors contributed to the conception and writing of this letter. FW will act as the guarantor.

  • 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.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.