Should Uncle Sam ‘send in the Marines’ after hurricanes?

Julia Brooks, Harvard University and David Polatty, US Naval War College

When humanitarian emergencies flare up, what should prompt the U.S. government to “send in the Marines”?

Disasters like Hurricane Harvey’s floods in Houston and Hurricane Maria’s devastation of Puerto Rico’s roads and power grid can quickly overwhelm civilian authorities and emergency responders. Military support can make a life-or-death difference in those emergencies.

As scholars at the U.S. Naval War College and Harvard Humanitarian Initiative, we have seen that the military can have a profound and positive impact on the immediate response to large-scale disasters such as Hurricanes Harvey, Irma and Maria or the Haiti earthquake in 2010.

But soldiers, sailors, marines and aviators are primarily trained to fight, not feed disaster victims. When they report for humanitarian duties, it typically costs far more than when civilians handle them. Does their muscle actually go to good use?

Why deploy the military

Nonprofits like the Red Cross and government agencies like FEMA simply don’t have the equipment required following disasters like the one unfolding in Puerto Rico – where millions of people may lack power and clean drinking water for months.

Only the military can promptly dispatch the ships and planes required to move people, supplies and fuel. It has the electrical generators, water purifiers, bulldozers and lift equipment for search and rescue operations, debris removal and reconstruction.

At the same time, many military personnel also report that aid missions are good for morale, as countless service members take pride in doing disaster relief.

Having soldiers or sailors airlift people from their flooded homes or distribute hot meals is also great public relations at a time when the U.S. military is engaged in several unpopular and protracted conflicts abroad.

Domestic limits

While military missions can fill critical gaps in response to large-scale natural disasters like Hurricanes Harvey, Irma and Maria, there are also significant limits to the military’s ability to jump in.

For one, there are laws restricting U.S. military operations on U.S. soil. The Posse Comitatus Act of 1878 prohibits active duty military personnel from engaging in civilian law enforcement, although the National Guard may be deployed in some circumstances.

Also, under a law known as the Stafford Act of 1988, the Department of Homeland Security may request military assistance as a last resort in major disasters and emergencies.

These restrictions have loosened up a little since the 9/11 terrorist attacks, granting the military and National Guard more leeway to support domestic counterterrorism operations. These changes made it easier for the military and National Guard to respond to the recent hurricanes.

But there are no such legal restrictions on how the U.S. military may respond to foreign disasters, as long as host governments request help or consent to it.

A common call

According to the Center for Naval Analyses, a federally funded defense research center, the U.S. military diverted units from “routine” operations to conduct humanitarian assistance operations 366 times from 1970 to 2000, compared with 22 times for combat missions.

Since 2000, the U.S. armed forces have conducted many massive humanitarian operations around the globe, such as responding to the 2004 Indian Ocean earthquake and tsunami and the 2015 Nepal earthquake, as well as Superstorm Sandy and Hurricane Katrina at home.

Given how frequently the military undertakes these missions, preparing for them should be a high priority. But that is not the case. With few notable exceptions, soldiers, sailors, marines and aviators spend little if any time training for disaster-response strategies, tactics, policies and procedures.

Concerns

When the same people fight wars and distribute food to people in distress, it can quickly blur the lines, exposing aid workers to attack.

That is why aid workers for nonprofit organizations like Doctors Without Borders and Oxfam have expressed concerns about what they see as a growing “militarization” of humanitarian relief that endangers their own safety and hinders their effectiveness.

There is also the high cost of having boots on the ground doing civilian work.

Consider what happened when the U.S. military responded rapidly after the 2010 earthquake in Haiti that left 220,000 people dead, 300,000 injured and 1,500,000 people displaced. More than a third of the total of US$1.12 billion in U.S. aid – $453.5 million – covered the costs of military transport, personnel and supplies.

According to estimates by Aruna Apte at the Naval Postgraduate School and Keenan Yoho at Rollins College, the U.S. spent more than $17 million just to operate a single aircraft carrier nearby for 17 days – not counting personnel costs.

Aircraft carriers are essentially floating airfields that make it easier to access otherwise impossible-to-reach areas, facilitating evacuations. Although they can dispatch critical food, water and medicine, there are usually better ways to deliver aid after disasters.

For context, that $17 million could have covered the cost of all of the humanitarian organization Save the Children’s health programs in Haiti between 2010 and 2012.

Finding the balance

Despite the big price tag, military involvement in disaster relief is bound to grow. That’s because global humanitarian organizations are already stretched thin by competing needs.
Conflict-driven migration is growing, and severe storms are becoming more common as a result of climate change – along with the higher sea levels scientists say it is causing.

Meanwhile, the Trump administration wants to cut civilian government spending while boosting the Pentagon’s budget.

But we believe it would be a huge mistake for the government to rely primarily on the armed forces in the aftermath of disasters.

The military’s unique capacity can be incredibly useful in the short term. Yet even when its help is most needed, these deployments should be brief and tailored.

The ConversationOther than in the immediate aftermath of the biggest emergencies, the government should activate civilian emergency responders and humanitarian aid groups instead of sending the Marines.

Julia Brooks, Researcher in international law and humanitarian response, Harvard Humanitarian Initiative (HHI), Harvard University and David Polatty, Director, Civilian-Military Humanitarian Response Program, US Naval War College

This article was originally published on The Conversation. Read the original article.

The murky issue of whether the public supports assisted dying

Katherine Sleeman, King’s College London

The High Court has rejected a judicial review challenging the current law which prohibits assisted dying in the UK. Noel Conway, a 67-year-old retired lecturer who was diagnosed with Motor Neurone Disease in 2014, was fighting for the right to have medical assistance to bring about his death. Commenting after the judgement on October 5, his solicitor indicated that permission will now be sought to take the case to the appeal courts.

Campaigners are often quick to highlight the strength of public support in favour of assisted dying, arguing that the current law is undemocratic. But there are reasons to question the results of polls on this sensitive and emotional issue.

There have been numerous surveys and opinion polls on public attitudes towards assisted dying in recent years. The British Social Attitudes (BSA) Survey, which has asked this question sequentially since the 1980s, has shown slowly increasing public support. Asked: “Suppose a person has a painful incurable disease. Do you think that doctors should be allowed by law to end the patient’s life, if the patient requests it?” in 1984, 75% of people surveyed agreed. By 1989, 79% of people agreed with the statement, and in 1994 it had gone up to 82%.

Detail of the question matters

But not surprisingly, the acceptability of assisted dying varies according to the precise context. The 2005 BSA survey asked in more depth about attitudes towards assisted dying and end of life care. While 80% of respondents agreed with the original question, support fell to 45% for assisted dying for illnesses that were incurable and painful but not terminal.

A 2010 ComRes-BBC survey also found that the incurable nature of illness was critical. In this survey, while 74% of respondents supported assisted suicide if an illness was terminal, this fell to 45% if it was not.

Wording counts.
from http://www.shutterstock.com

It may not be surprising that support varies considerably according to the nature of the condition described, but it is important. First, because the neat tick boxes on polls belie the messy reality of determining prognosis for an individual patient. Second, because of the potential for drift in who might be eligible once assisted dying is legalised. This has happened in countries such as Belgium which became the first country to authorise euthanasia for children in 2014, and more recently in Canada where within months of the 2016 legalisation of medical assistance in dying, the possibility of extending the law to those with purely psychological suffering was announced.

It’s not just diagnosis or even prognosis that influences opinion. In the US, Gallup surveys carried out since the 1990s have shown that support for assisted dying hinges on the precise terminology used to describe it. In its 2013 poll, 70% of respondents supported “end the patient’s life by some painless means” whereas only 51% supported “assisting the patient to commit suicide”. This gap shrank considerably in 2015 – possibly as a result of the Brittany Maynard case. Maynard, a high-profile advocate of assisted dying who had terminal cancer, moved from California to Oregon to take advantage of the Oregon Death with Dignity law in 2014.

Even so, campaigning organisations for assisted dying tend to avoid the word “suicide”. Language is emotive, but if we want to truly gauge public opinion, we need to understand this issue, not gloss over it.

Information changes minds

Support for assisted dying is crucially known to drop-off simply when key information is provided. Back in the UK, a ComRes/CARE poll in 2014 showed 73% of people surveyed agreed with legalisation of a bill which enables: “Mentally competent adults in the UK who are terminally ill, and who have declared a clear and settled intention to end their own life, to be provided with assistance to commit suicide by self-administering lethal drugs.” But 42% of these same people subsequently changed their mind when some of the empirical arguments against assisted dying were highlighted to them – such as the risk of people feeling pressured to end their lives so as not to be a burden on loved ones.

This is not just a theoretical phenomenon. In 2012, a question over legalising assisted dying was put on the ballot paper in Massachusetts, one of the most liberal US states. Support for legalisation fell in the weeks prior to vote, as arguments against legalisation were aired, and complexities became apparent. In the end, the Massachusetts proposition was defeated by 51% to 49%. Public opinion polls, in the absence of public debate, may gather responses that are reflexive rather than informed.

The ConversationPolls are powerful tools for democratic change. While opinion polls do show the majority of people support legalisation of assisted dying, the same polls also show that the issue is far from clear. It is murky, and depends on the responder’s awareness of the complexities of assisted dying, the context of the question asked, and its precise language. If we can conclude anything from these polls, it is not the proportion of people who do or don’t support legislation, but how easily people can change their views.

Katherine Sleeman, NIHR Clinician Scientist and Honorary Consultant in Palliative Medicine, King’s College London

This article was originally published on The Conversation. Read the original article.