Codification of military medical ethics in the Russian Federation and the USA

This paper provides a theoretical analysis of the phenomenon of war from the perspective of modern ethics. The authors examine four main approaches to assessing the moral aspects of warfare: realism, militarism, pacifism and just war theory. Each of these approaches has its own characteristics and is critically analysed by them. Particular attention is paid to the ethics of military medicine, which faces a number of specific problems in military conflicts. In the article, the authors raise the issue of the need to develop a code of military medical ethics. To this end, the vectors of codification of military medicine ethics at the international level, in particular in the USA, are investigated and possible conceptual foundations for the development of principles of military medical ethics in Russia are discussed. The issues of dual loyalty of military medics, the need for ethical principles in extreme conditions, and the contradictions between military necessity and medical indications are discussed. The authors emphasise that the proposed ethical principles in the code of military medical ethics should be based primarily on the position of moral realism. The results of the study can be considered the ideas of complementarity between the codification of Russian military-medical ethics and strategies for cultivating the moral competence of military medics. Such an approach will prevent the erosion of moral ethos and promote adherence to the ethical principles of military medicine. The authors emphasise the importance of balancing military and medical values, the need for specialised training of medics in ethical conflicts and the development of mechanisms for ethical compliance in combat situations. The authors note that defence of the homeland must include the defence of humanity even in war, as military values serve as a context for medicine's primary goal of preserving life and health, even when this is not possible. The work is of interest to specialists in ethics, military medicine and international relations, as well as to all those interested in morality and war.