Doping soldiers so they fight better – is it ethical?

The military is constantly using technology to build better ships, warplanes, guns and armor. Shouldn’t it also use drugs to build better soldiers?

Soldiers have long taken drugs to help them fight. Amphetamines like Dexedrine were distributed widely to American, German, British and other forces during World War II and to U.S. service members in Korea, Vietnam, Kuwait, Iraq and Afghanistan. In 1991, the Air Force chief-of-staff stopped the practice because, in his words, “Jedi knights don’t need them.” But the ban lasted only five years. DARPA, an agency that does cutting-edge research for the U.S. Department of Defense, is trying to make soldiers “kill-proof” by developing super-nutrition pills and substances to make them smarter and stronger. New drugs that reduce the need for sleep, such as modafinil, are being tested. Researchers are even looking into modifying soldiers’ genes.

As a professor of health law and bioethics, I began studying the use of drugs to enhance performance in sports, and I soon became interested in the use of performance-enhancing drugs in the military. Most people think doping in sports is harmful cheating; shouldn’t that be how doping in combat is viewed? The answer, I decided, was no: Doping in sports doesn’t produce any meaningful social benefit, but using drugs to improve performance in the military could save lives and make it easier to complete missions.

But the military still needs rules for how performance enhancements should be used.

Mandatory use

Can soldiers be ordered to take enhancement drugs? What if the drugs have dangerous side effects? What if there hasn’t been a lot of research on their long-term effects? It’s also important to realize that the risks from performance-enhancing drugs are not only to the soldiers who use them; in 2004, pilots in Afghanistan who accidentally dropped a bomb that killed four Canadian soldiers blamed their mistake on being hopped up on amphetamines.

Soldiers generally have to follow orders, so it’s important for their commanders to carefully think through whether use of these drugs should be mandatory or voluntary. Applying a set of principles that I developed to guide bioethical decision-making in the military, superiors should force troops to use enhancement drugs only when the advantages that the drugs provide and the importance of the mission outweigh the risks to the user. Soldiers in the Gulf War were required to take drugs that hadn’t been approved for the purpose for which they were given, which was to try to provide some protection in case Saddam Hussein’s forces resorted to chemical or biological warfare. Congress stepped in and said that troops could be ordered to take drugs for such “off-label” purposes only if the president authorized it directly or declared a national emergency.

Opponents of doping in sports maintain that athletes who win races by doping should not be rewarded. Should we adopt the same policy in the military? Should soldiers who act bravely or shoot straighter with the help of drugs get promotions or medals? If the soldiers are ordered to use the drugs by their commanders, I suggest the answer should be yes, since it doesn’t seem fair to punish them for doing something about which they had no choice, especially if the drugs they were ordered to use could have serious side effects.