First, do no harm
Due to the lessons learned
from the Gulf War, the 1997 Force Health Protection law and the DoD
directive 6490.3 were implemented.
Our Gulf War veterans have
faced a decades long battle to receive medical treatment related to service
The greatest obstacle to
arriving at a conclusion is due to the fact our troops did not have any
baseline data to compare.
Meaning there were no exams
and blood sampling collected before our troops were deployed to the Gulf
Here we have a situation
where there are laws and mandates requiring our troops receive comprehensive
medical and mental exams, including blood sampling pre and post deployment.
Our troops in Iraq did not
receive the mandated evaluations and now we have soldiers who are sick and
On August 5, 2003 the
military sent a six person medical team to Iraq and Germany to evaluate the
reasons for the illness and deaths. There has been no news coverage since
that date related to the status of our troop or the investigation. Why?
There are federal regulations to protect human subjects and these 'rules'
concern Good Clinical Practices (GCP) and the protections of human subjects
under the Health and Human Services (HHS) guidelines.
However, the military subjects are exempt from these protections.
When Representative Shays of Connecticut, on March 25th asked Dr. William
Winkenwerder, Assistant Secretary of Defense for Health Affairs, why the
military did not perform the DoD directive exams and blood sampling pre and
post deployment, Dr. Winkenwerder, said, "the
law called for a medical examination, which is not synonymous with a
The DoD directive 6490.3 -- policy 4.8
specifically states that the exam be 'comprehensive' and consistent.
The following list describes the medical criteria for a 'comprehensive'
exam. The information is from a medical school residency program clinical
competency exam. (see link at bottom of page)
Basic Clinical Skills (Criteria for Assessment)
The competent graduate is:
Capable of eliciting and documenting a medical history appropriate in scope
to the clinical encounter.
Comprehensive physical exam to include:
Vital signs (blood pressure, pulse and respirations)
Mouth and throat
Thorax and lungs
Back and extremities
Mental status exam: using four techniques to evaluate the patient's mental
status - observation, casual conversation, obtaining psychiatric history,
and formal testing - determine the following mental status assessments:
Appearance and attitude
The medical criteria for a comprehensive exam is basic to all fourth year
medical students. Therefore, a practicing physician has no excuse for not
knowing what a comprehensive exam entails.
You do not need a medical degree to be aware that our troops filling out a
questionnaire is NOT by any measure, comparable to a 'comprehensive' exam.
The fact that Dr. Winkenwerder felt he was within the 'letter of the law' to
substitute a questionnaire as comparable to the medical criteria of a
comprehensive exam is cause for concern.
Is it unreasonable to expect that the physician in charge of our troops'
health has the competency and awareness of the criteria expected of a fourth
year medical resident?
Need we ask the good doctor if his oath covers the ethical practice of
medicine or the legalese that results in not only the compromise of quality
of care, but also sloppy science?
How many soldiers have been evaluated with a post deployment questionnaire
and within what time frame? What is the established protocol for consistent
It is imperative to have 'baseline' data on file in order to be able to
establish a correlation with the post treatment/exposure samples.
And, it is essential to collect serum samples and data in a consistent
manner and on a consistent basis at protocol established time intervals.
That is good science.
It's not merely a matter of good science, it's common sense!
of Medical Education and Curricular Affairs, IU School of Medicine
United To Protect OUR Troops
Global Security Newswire
infection kills soldier
Medical Teams to Investigate Overseas Pneumonia Cases
What Happens to Depleted Uranium Inside
The troops in the
Middle East today are our veterans of tomorrow.
tax dollars are going.
Do you want YOUR
tax dollars being used to pay companies to rebuild Iraq at the expense of
our troops and our veterans?
What better method
can we 'Support Our Troops' than by protecting their health?