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The use of drugs as weapons

The concerns and responsibilities of healthcare professionals
May 2007

This report has been written because of the widespread interest expressed by governments in the use of drugs as weapons. The ending of the Moscow theatre siege with, purportedly, a fentanyl derivative has brought both reality and urgency to the subject and has raised questions about ‘tactical pharmacology’ of so-called ‘non-lethal’ weapons and their relationship with different aspects of international law. These questions in turn raise a number of difficult ethical considerations for healthcare professionals.

The use of a drug as a method of warfare would constitute a violation of the 1925 Geneva Protocol and the 1993 Chemical Weapons Convention (CWC). Ambiguity in the text of the CWC leaves open the possibility of the use of a drug as a weapon for the purposes of ‘law enforcement including domestic riot control’. There is also a question as to whether some drugs fall within the definition of a biological weapon as defined in the 1972 Biological and Toxin Weapons Convention (BTWC). It is vital that the international community makes every effort to ensure that these weapons conventions remain intact. The development and deployment of drugs as weapons for whatever reason risks undermining the norms these conventions represent.

The primary conclusion of this report is that the use of drugs as weapons is simply not feasible without generating a significant mortality among the target population. Whether this is a consideration of either pharmacology, toxicology or both will depend on the reader’s point of view. The agent whereby people could be incapacitated without risk of death in a tactical situation does not exist and is unlikely to in the foreseeable future. In such a situation, it is and will continue to be almost impossible to deliver the right agent to the right people in the right dose without exposing the wrong people, or delivering the wrong dose. Countermeasures may be easy to apply if such an attack is expected. This brings into question whether drugs can be used for law enforcement or any other tactical situation in which deaths and injuries should be minimised. From this many ethical considerations flow which include:

• the involvement of healthcare professionals in planning and executing an attack using a drug as a weapon
• gathering data about the effects of the weapon in question
• the role of medicine, including medical knowledge, in weapon development
• the dual responsibility of doctors to do no harm on one hand and on the other to support national security
• the role of healthcare professionals in upholding international law.

Ethical considerations aside, the BMA views the interest of governments in the use of drugs as weapons as dangerous for three reasons.

1. The international legal norms which protect humanity from poison and the deliberate spread of disease which have been put in place by decades of negotiation risk being undermined.
2. Widespread but responsible deployment of drugs as weapons would inevitably result in their reaching the hands of state or non-state actors for whom lethality among those targeted is not of concern. This would simply be chemical warfare with a medical label.
3. Using existing drugs as weapons means knowingly moving towards the top of a ‘slippery slope’ at the bottom of which is the spectre of ‘militarization’ of biology; this could include intentional manipulation of peoples' emotions, memories, immune responses or even fertility.

Controlling these future threats might be feasible if healthcare professionals address adequately the use as weapons of currently known drugs such as anaesthetics, sedatives and analgesics, and if they find adequate control methods today.

Healthcare professionals and their associations have a number of responsibilities with regard to the use of drugs as weapons. The most important is to bring their specific knowledge to bear in this domain. This would bring reality to the political, diplomatic, legal, military and law enforcement dialogue about ‘non-lethal’ weapons. From an ethical perspective, healthcare professionals need to begin a deeper examination of their roles in relation to such use of biomedical knowledge and medical expertise for hostile purposes. This is, ultimately, a matter relating to health because the lives and wellbeing of humans are at stake.

Download a copy of the report as a PDF here or by using the link on the right hand side or a hard copy of is available from:
BMA Science and Education Department
British Medical Association
BMA House
Tavistock Square
London
WC1H 9JP
Tel: 020 7383 6164
Email: info.science@bma.org.uk