App Created by USU Helps Medical Providers Tackle Complex Ethical Issues

A military doctor examines a patient

By Ian Neligh

A new smartphone application can now provide medical practitioners with education to help tackle complex ethical issues.

The Uniformed Services University of the Health Sciences (USU) Defense Medical Ethics Center (DMEC), created the Medical Ethics Center Bioethics Mobile Application. The app, which is available on Google Play and the Apple App Store, offers free access to a training course, a guide, a PDF library, an archive of consultancy requests from clinical providers and researchers—and more. 

Starting in 2019, USU was charged with creating a Department of Defense Medical Ethics Program available throughout the Military Health System. “The DMEC was created in response to the ethical dilemmas faced by military medical providers at Guantanamo Bay,” says DMEC deputy director Joshua Girton.

Girton says, as a result, it was determined there should be an entity that military healthcare providers could independently go to and seek counsel on related issues. Their mission then became to work a bioethics curriculum into the Military Health System, create a bioethics training course, and then teach that curriculum.  The app is part of their mission to implement that program.

The idea behind the app is to offer support to those looking for guidance on complex bioethical issues that healthcare providers might encounter state-side or in austere environments.

“The benefit of the phone application is that 90 percent of it is non-internet dependent,” Girton says. “It is like a submarine in the sense that once you surface it downloads all the information. Then it stays resident on your phone so that you’ll have that capability even if you’re far forward deployed, simply to have resources, contacts but also some organic information contained therein.”


Among the bioethical challenges the DMEC team has addressed in the app is a highly-publicized case of a Service Academy student who died, but whose parents wanted to harvest his sperm so that he could father children in the future. DMEC was consulted on the ethical implications, and the case ended up in court, where it was ruled that the family could proceed, based on the consistent evidence of their son having expressed the desire to have a large family one day.

Another recent case included an underage military dependent who wanted to receive a COVID-19 vaccination, based on the public advice of medical experts, but against the wishes of their parents. The question for DMEC was whether the court, the state, or the Military Health System could recognize the minor’s transactional emancipation to make this one decision if it went against the desires of the parents?  In that case, the court determined that the minor could receive the vaccination because what was being requested was what the Department of Defense was advocating for everyone, including the minor and the parents. 

“(The app) basically says, ‘hey, here is essentially the issue, here’s what the law says… “, Girton says. 

DMEC has continuous control over the information in the app and can update it regularly as situations evolve, according to Girton. One of the sections of the app that is frequently updated includes is News.  

“If anything is going on in the bioethics realm, we’ll capture that article and put it in that section and it will be distributed to everyone who has the application on their phone,” Girton says. In addition to the news, “Since 2019, we’ve had more than 100 consultancy requests from clinical providers and researchers contacting us from the field. If we see common trends and questions, we’ll sanitize those consultancy requests and we’ll publish a redacted version and what our counsel was on that.” 

The app is a starting point for DMEC, a tool to help healthcare providers navigate ethical landmines, become better educated to deal with issues as they arise, and prepare them to handle the bioethical questions of tomorrow.