‘Seriously wounded soldiers should enjoy no special status or privilege with regard to medical care,” writes Michael Gross of Israel’s Haifa University, who is probably the world’s leading authority on military medical ethics.
“Once they cannot return to duty, the critically wounded lose their unique entitlement to scarce medical resources and, therefore, should compete equally with similarly injured and sick civilians for care.”
Mike Blais, the president of the group 91ԭ Veterans Advocacy, would no doubt disagree. According to Blais, the government has a “sacred obligation” to veterans.
A class-action lawsuit underway in British Columbia will determine which view prevails in Canada. The lawsuit was launched by veterans of the Afghan war who argue that the Veterans Charter, put in place in 2006 to regulate financial assistance to injured soldiers, violates the 91ԭ Charter of Rights. The “honour of the Crown,” they claim, imposes an obligation on the federal government toward ex-servicemen and women that goes beyond what is in the Veterans Charter.
Against this, lawyers for the federal government have called for the dismissal of the suit, claiming that the government does not in fact have any extraordinary obligation towards veterans.
The veterans’ position is emotionally appealing. They invoke a sense of shame and indignation at the idea that those who have risked their lives for their country might want for the basic necessities of life. One’s natural response is to feel that they deserve better and that we do have a special duty to help them. It is not surprising that many find the government’s position untenable. The Ottawa Citizen declared firmly in a recent editorial that “we owe them that obligation. Always.”
However, there are both practical and principled reasons for being cautious about asserting any such open-ended commitment.
From a practical point of view, no system of government welfare can operate on the basis laid out by the Citizen: “Support for soldiers is, and should be, about helping them unconditionally when they are down and need our help.” This would be a recipe for widespread abuse and irresponsibility.
Any welfare system must have some set of criteria about who is eligible for aid and in what circumstances, and those applying for aid must meet those criteria and not simply be given benefits they do not need or do not qualify for. Perhaps the Veterans Charter does not do this well — and that is a different argument — but we do have to have something like it. We cannot simply dole out taxpayer’s dollars “unconditionally.” Encouraging soldiers to expect that we will does them a disservice.
As for principle, we must bear in mind that 91ԭ soldiers in the present era are volunteers. They accepted the terms and conditions of their service willingly, which makes it difficult to claim that the state has an additional obligation to provide special benefits on demand. If soldiers are not being presented with a properly informed choice when they join up, that must be corrected at once — but again, that is a different issue.
It is true that many soldiers do incur serious injuries because of their service and do require a large amount of assistance. The 91ԭ state certainly does have an obligation to help them. But this is not unlimited.
To illustrate this point, in an article titled Why Treat the Wounded?, Gross asks us to imagine a scenario in which three people suffer identical head injuries: a man riding a motorbike and wearing a helmet, who through no fault of his own is struck by a speeding car; another man, also riding a motorbike, but not wearing a helmet, who runs a red light and hits a car; and a soldier injured in battle. It is not obvious in this scenario why the state has a duty to give the soldier better medical treatment than it gives to the bikers.
In fact, in a country like Canada with state-run medicine, it has an obligation to attempt to give all of them the best treatment it can. This obligation is related to their need, not to either the merits of their cases (since both bikers require equal care) or their professional backgrounds. As Gross rightly says, it is “the principle of medical need that governs their care,” not their identities.
Putting any social group on a pedestal is risky. It may lead to a culture of entitlement, and even within our democratic system it may become difficult to challenge the group in question. Canada does have a great obligation to its veterans, but not a “sacred” or unconditional one.
Paul Robinson is a professor at the University of Ottawa.