Ukraine Bioethics News, 2022
October 4, 2022
On February 24, 2022, Russian forces invaded Ukraine. In the months following, the Russian military has been accused of violating international humanitarian laws, including the Geneva Conventions, the Hague Regulations of 1907, and international human rights laws.[1] The media,[2] the United Nations,[3] non-governmental organizations,[4] specific countries, including the United States,[5] and the international community[6] have been documenting potential war crimes by Russian forces against Ukraine. In March, the U.S. Department of State formally accused Russian forces of war crimes.
Ukraine is contending with a disaster scenario, which has seen the breakdown of its medical infrastructure in some parts of the country. Ethics in disaster situations is a unique category of bioethics because it constitutes a large influx of patients in a very short amount of time, sometimes in a setting where normal infrastructures are precarious, limited, or unavailable. This situation creates an acute shortage of medical workers and medical supplies. Over the last two-and-a-half years, the world has encountered a global disaster from the Covid-19 pandemic. However, disaster situations can also occur because of war.
Below is a selection of headlines from bioethics.com that demonstrate the range of bioethical issues encountered in Ukraine following the invasion from Russia.
February 24: “Russia Presses Invasion to Outskirts of Ukrainian Capital” by Yuras Karmanau, Jim Heintz, Vladimir Isachenkov and Dasha Litvinova, Associated Press
Russia launched a full-scale invasion of Ukraine on Thursday, unleashing airstrikes on cities and military bases and sending in troops and tanks from three sides in an attack that could rewrite the global post-Cold War security order.
March 1: “Ukraine’s Surrogacy Industry Has Put Women in Impossible Positions” The Atlantic
Should a surrogate be tucked away somewhere safe, to protect the child she’s growing for someone else? Or should she be with her own family, or in her hometown, or even out on the streets defending her nation?
March 1: “’We Don’t Know How to Survive Here’: A Cancer Ward for Ukrainian Children Under Siege” by Emma Graham-Harrison, The Guardian
On the oncology ward at Chernihiv children’s hospital, patients are battling cancer, their city is surrounded by Russian forces, and now they are running out of painkillers and stockpiling food.
March 2: “Ukrainian Maternity Ward Moves to Basement for Shelter” by Mstyslav Chernov, Associated Press
The basement of the maternity hospital in Ukraine’s coastal city of Mariupol transformed into a bomb shelter and nursery as Russian forces escalated their attacks on crowded urban areas Tuesday [March 1].
March 3: “Disabled Orphans Fleeing Kyiv Received by Poles, Hungarians” by Justin Spike, Associated Press
On Wednesday [March 2], a train pulled into the station in Zahony, Hungary carrying about 200 people with severe physical and mental disabilities — residents of two orphanages for the disabled in Ukraine’s capital of Kyiv that were evacuated as Russian forces battered the city.
March 7: “Food and Medicine Shortages in Ukraine Prompt Global Relief Effort” by Saabira Chaudhuri and Denise Roland, Wall Street Journal
With food and medicine supplies threatened across Ukraine, domestic and international food manufacturers, distributors and aid workers are mobilizing to keep grocery stores and pharmacies open and shelves stocked.
March 8: “W.H.O. Condemns Attacks on Health Care Services in Ukraine and Calls for Safe Passage for Medical Supplies” by Isabella Kwai, New York Times
With the health care system in Ukraine facing urgent supply shortages, the head of the World Health Organization’s European region on Tuesday [March 8] condemned attacks on health services and underscored the need for a humanitarian passage to deliver equipment and medicine to the hardest-hit regions.
March 9: “Airstrike Hits Ukraine Maternity Hospital, 17 Reported Hurt” by Evgenity Maloletka, Associated Press
A Russian airstrike devastated a maternity hospital Wednesday in the besieged port city of Mariupol amid growing warnings from the West that Moscow’s invasion is about to take a more brutal and indiscriminate turn.
March 11: “WHO Condemns Russia for Mounting Attacks on Ukraine Health Facilities” by Oriana Gonzalez, Axios
The World Health Organization confirmed there have been at least 26 attacks on Ukrainian health facilities since the start of Russia’s unprovoked invasion.
March 14: “The War Puts Ukraine’s Clinical Trials—and Patients—in Jeopardy” by Grace Browne, Wired
According to the US Food and Drug Administration’s clinical trials database, there are over 250 active trials with research sites in Ukraine. Of those, 117 involve interventions related to cancer. Others are for conditions like multiple sclerosis, schizophrenia, and Covid-19 infection. Now the war threatens to cut off the supply of medications and scatter the participants, making their health records harder or impossible to track.
March 15: “Exclusive: Ukraine Has Started Using Clearview AI’s Facial Recognition During War” by Paresh Dave and Jeffrey Dastin, Reuters
Ukraine’s defense ministry on Saturday began using Clearview AI’s facial recognition technology, the company’s chief executive told Reuters, after the U.S. startup offered to uncover Russian assailants, combat misinformation and identify the dead.
March 16: “’They Draw Bombs, Tanks and Wishes for Peace’: Ukraine’s Child Mental Health Crisis” by Lorenzo Tondo, The Guardian
Mental health workers and doctors in Lviv report that thousands of Ukrainian refugee children displaced by the war are showing severe symptoms of trauma.
March 16: “The War in Ukraine Is a Reproductive Health Crisis for Millions” by Max G. Levy, Wired
The war in Ukraine is becoming a crisis of reproductive health. Over the next three months, more than 80,000 Ukrainian people are expected to give birth, according to the United Nations Population Fund (UNFPA).
March 18: “Young Ukrainian Cancer Patients Get Medical Help in Poland” by Vanessa Gera and Pawel Kuczynski, Associated Press
The World Health Organization said Friday that cancer is one of the major health challenges resulting from the war. It said it was supporting the effort by the organizations that ‘are working against the clock to reconnect pediatric cancer patients with their treatments.’
March 18: “Big Pharma Faces an Ethical Dilemma: Should They Keep Selling to Russia?” by Grace Browne, Wired
The pharmaceutical industry is in a tricky ethical spot. To withdraw from Russia would not result in citizens simply losing access to frappuccinos or designer goods. It could mean that cancer patients go without chemotherapy or diabetics without insulin. That is a moral line that so far most drug companies have not been willing to breach.
March 22: “Russia’s War with Ukraine Is Devastating for Ukraine’s War on TB” by Ari Daniel, NPR
According to the World Health Organization, the country has the fourth highest incidence of the disease in Europe. And it has one of the highest rates of multidrug resistant TB anywhere in the world.
April 4: “In Ukraine, New Reports of War Crimes Emerge as Russians Retreat from Kyiv Area” by Brett Forrest, Wall Street Journal
More than 100 civilians lay buried in mass graves in this suburb of Kyiv after Russian troops withdrew last week, one of several regions in which Ukrainian officials and independent rights watchdogs say they are uncovering evidence of war crimes perpetrated by occupation forces.
April 8: “Horrors of Ukraine’s Bucha Laid Bare on Yablunska Street” by Brett Forrest and James Marson, Wall Street Journal
The shootings on Yablunska were part of what residents and Ukrainian officials say was a spree of killing, raping and looting that marked Russia’s monthlong occupation of Bucha, a well-heeled town on the northwestern outskirts of Kyiv.
April 8: “Doctors, Crater Disprove Russia’s Hospital Airstrike Misinfo” by Lori Hinnant and Mstyslav Chernov, Associated Press
[Three doctors’] testimony, along with AP reporting, AP footage from the scene and interviews with munitions experts who analyzed the size of the shell crater, directly contradicts Russian claims that there was no airstrike. Russian officials have repeatedly tried to sow doubt about atrocities in Mariupol, the shattered city in eastern Ukraine that is a key Russian military objective.
April 11: “The Race to Archive Social Posts That May Prove Russian War Crimes” by Tom Simonite, Wired
In early April, as Ukraine started to regain control of Bucha and other small towns northwest of Kyiv, appalling imagery began to spread on Telegram and other social networks.
April 11: “Mariupol Mayor Says Siege Has Killed More Than 10K Civilians” by Yuras Karmanau, Adam Schreck and Cara Anna, Associated Press
The mayor of the Ukrainian port city of Mariupol said Monday that more than 10,000 civilians have died in the Russian siege of his city, and that the death toll could surpass 20,000, with corpses that were ‘carpeted through the streets.’
April 20: “Aid Groups Fight to Deliver Lifesaving Supplies Despite Losing Lives to Russian Shelling” by Apoorva Mandavilli, New York Times
On a bracingly cold day in March, four people set out from Ukraine’s capital, Kyiv, to deliver lifesaving medicines, heating devices and food to the besieged residents of Chernihiv, in the northeast. Only one survived.
April 22: “UN: Human Rights ‘Horror Story’ Is Unfolding in Ukraine” by Laurin-Whitney Gottbrath, Axios
The United Nations is seeing growing evidence of war crimes in Ukraine as a ‘horror story’ of human rights violations unfolds, UN human rights chief Michelle Bachelet said Friday [April 22].
April 25: “Satellite Images Reveal Another Mass Grave Site Near Mariupol” by Shawna Chen, Axios
New satellite images show the construction of another mass grave site in Vynohradne, Ukraine near Mariupol, which remains under siege, Maxar Technologies said Friday. The big picture: The discovery follows previous satellite imagery showing the construction of mass grave sites in Bucha and Manhush.
May 11: “At Least 3000 Have Died in Ukraine for Want of Disease Treatment: WHO” by Emma Farge Reuters, re-posted on Medscape
The World Health Organization’s European chief said on Tuesday that at least 3,000 people had died in Ukraine because they had been unable to access treatments for chronic diseases.
May 19: “Captive Medic’s Bodycam Shows Firsthand Horror of Mariupol” by Vasilisa Stepanenko and Lori Hinnant, Associated Press
A celebrated Ukrainian medic recorded her time in Mariupol on a data card no bigger than a thumbnail, smuggled out to the world in a tampon. Now she is in Russian hands, at a time when Mariupol itself is on the verge of falling.
May 27: “War Crimes Watch: Russia’s Onslaught on Ukrainian Hospitals” by Michael Biesecker, Erika Kinetz and Beatrice Dupuy, Associated Press
For a month now, Russian forces have repeatedly attacked Ukrainian medical facilities, striking at hospitals, ambulances, medics, patients and even newborns — with at least 34 assaults independently documented by The Associated Press. With every new attack, the public outcry for war crimes prosecutions against Russian President Vladimir Putin, his generals and top Kremlin advisers grows louder.
May 31: “A ‘Terrible Nightmare’: Treating Ukraine’s Wounded Civilians” by Elena Becatoros, Associated Press
Run by the aid organization Medecins Sans Frontieres (Doctors Without Borders), the train is a lifeline for the overwhelmed hospitals in cities and towns near Ukraine’s front lines that are struggling to cope with an influx of war wounded on top of their usual flow of sick patients.
References
[1] “War and International Humanitarian Law,” International Committee of the Red Cross, October 29, 2010, https://www.icrc.org/en/doc/war-and-law/overview-war-and-law.htm.
[2] “War Crimes Watch Ukraine,” Associated Press, accessed August 29, 2022, https://apnews.com/hub/war-crimes-watch-ukraine.
[3] “Norweigian Judge Appointed Chair of the Commission of Inquiry on Ukraine,” United Nations, March 31, 2022, https://unric.org/en/norwegian-judge-appointed-chair-of-the-commission-of-inquiry-on-ukraine/.
[4] “Ukraine: Torture, Disappearances in Occupied South” Human Rights Watch, July 22, 2022, https://www.hrw.org/news/2022/07/22/ukraine-torture-disappearances-occupied-south.
[5] Press statement by Antony J. Blinken, Secretary of State, “War Crimes by Russia’s Forces in Ukraine,” U.S. Department of State, March 23, 2022, https://www.state.gov/war-crimes-by-russias-forces-in-ukraine/.
[6] “Statement of the ICC Prosecutor, Karim A.A. Khan QC, on the Situation in Ukraine: ‘I have decided to proceed with opening an investigation,” International Criminal Court, February 28, 2022, https://www.icc-cpi.int/news/statement-icc-prosecutor-karim-aa-khan-qc-situation-ukraine-i-have-decided-proceed-opening.
