One Page Discussion Doctorate of Health Science

Part 3:

The following is an excerpt from “Perfect Vision is Helping and Hurting Navy” (Cloud, 2006):

Colin Carroll, a 21-year-old midshipman from Olney, Md., put anesthetic drops in his eyes and lay down under the laser as Capt. Kerry Hunt, a Navy doctor, and two assistants prepared to begin. "We're locking the laser on now," Captain Hunt told him.

Midshipman Carroll had originally hoped to enter flight school but discovered not only that his eyes were not good enough, but also that he was prone to kidney stones, ruling him out of aviation entirely. He said he was "resigned" to entering the Marine Corps or becoming an officer on a surface ship, neither an assignment requiring perfect vision.

But he decided to get the surgery anyway.

By 10:49, both eyes were done, though extremely bloodshot, and Mr. Carroll walked out wearing sunglasses, declaring he could already see better.

The procedure used by the Navy, photorefractive keratectomy, or PRK, is different from the one used on most civilians. That approach, known as laser-in situ keratomileusis, or Lasik, requires cutting a flap in the surface of the cornea and then using a laser to reshape the cornea. But military doctors worry that the flap could come loose during combat, especially in a supersonic fighter.

So rather than slicing into the cornea covering, Navy doctors grind it away. The approach requires a longer recovery as the covering re-forms but leaves the eye more stable.

The Air Force also limits its pilots to PRK, but nonpilots can get either procedure. Army personnel, including helicopter pilots and other aviators, are allowed to get either procedure.

Use principles such as beneficence/nonmaleficence, and concepts such as the benefit/risk ratio, and the features relevant to Medical Indications (diagnosis, prognosis, treatment options, goals of treatment, indicated and non indicated interventions) to support an ethical answer to the question: Is it ethical to perform corrective LASIK on military personnel?

References

Cloud, D.S. (June 30, 2006). Perfect visions is helping and hurting Navy. The NY Times.

Retrieved from http://www.nytimes.com/2006/06/20/us/20eye.html?_r=0