Revisiting the comparison between healthcare strikes and just war

J Med Ethics. 2023 Nov 23;49(12):799-802. doi: 10.1136/jme-2023-108941.

Abstract

In the UK, healthcare workers are again considering whether to strike, and the moral status of strike action is being publicly debated. Mpho Selemogo argued that we can think productively about the ethical status of healthcare strikes by using the ethical framework often applied to armed conflict (2014). On this view, strikes need to be just, proportionate, likely to succeed, a last resort, pursued by a legitimate organisation and publicly communicated. In this article, I argue for a different approach to the just war comparison. Selemogo adopts a traditional, collectivist conception of just war reasoning but this is not the only view. So-called 'individualist' approaches to the morality of war can also be applied to strike action. Taking an individualist perspective complicates the traditional picture of a dispute arising between three well-defined groups of healthcare workers, employers and the innocent subjects of collateral damage: patients and the public. We arrive instead at a more complicated moral picture: some people might be more morally liable to be harmed than others during a strike, or can justly bear increased risks, and some are more obliged to strike than others. I describe this shift of framework before critically examining some of the traditional jus ad bellum conditions as applied to strikes.

Keywords: Ethics; Ethics- Medical; Health Workforce; Philosophy; Policy.

MeSH terms

  • Delivery of Health Care
  • Health Personnel
  • Humans
  • Morals
  • Physicians*
  • Strikes, Employee*