Friends from France have written a detailed paper on the question – read it <a href="https://mouvement-communiste.com/documents/MC/Booklets/BR6_Sant%C3%A9%20_EN_vF%20Site.pdf">here</a>.
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Debate on the current character of hospitals and their restructuring

We have previously featured a <a href="https://www.vitalsignsmag.org/posts/the-assisted-dying-bill-contribution-to-the-debate-1">guest contribution</a> that looked more closely at the details of the Bill. The following thoughts from Vital Signs group are of a more general nature. As health workers and concerned working class people we have to discuss together when the state introduces fundamental changes in the health sector &#8211; changes that decide how we work and how we relate to patients.
The following points for debate are written from two angles. The first angle relates to a historical and structural view of the current social system. Crisis in capitalism means that the grip on working class lives tightens and that more pressure is piled on to ‘costs’, such as wages, pensions or benefits. The second angle relates to our concrete experiences of caring for seriously ill or dying patients on the wards.
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1) The Bill is a drastic change in the trajectory of health work
It is not enough to primarily discuss the technicalities of this bill. Even if the bill itself is not ‘far-reaching’, it is nevertheless an important shift: so far the health system was supposed to sustain health and life, now it also becomes responsible for actively ending life. As our health system is hierarchical, we on the ‘frontline’ might be asked to assist with dying without having much knowledge about the wider circumstances &#8211; only the doctors and the judge will know more and have a say in the case. This would put us in a very alienated position. 
In wider social terms the Bill changes the discourse. Since it has been passed, <a href="https://www.theguardian.com/society/2025/jan/28/expand-assisted-dying-bill-to-help-those-with-parkinsons-and-dementia-mps-to-hear">groups have lobbied</a> to expand its reach and include patients with dementia or Parkinsons. Currently the public debate circles around the question of ‘who has the right to die’, which opens up the question of ‘what kind of life is worth living?’, and potentially to ‘what kind of life is worth sustaining?’.
2) In capitalism the focus on ‘individual choice or freedom’ often disguises underlying material forces that curb both choice and freedom
Why should it be a problem that individuals have the freedom to choose to end their lives and ask for assistance if they cannot do so themselves? Seen from an individual point of rights there is no problem. The problem arises once we see the wider reality, the social context within which individuals ‘choose’ to do something. An individual might ‘choose’ to join the army, because there are no other jobs around. An individual might ‘choose’ to take drugs, because of previous abuse and lack of hope for a good future. Similarly, an individual might ‘choose’ to end their lives, because there is no adequate palliative care, because they feel isolated or a ‘burden’ on family and society.
3) Working class people have less material scope ‘to choose’ than middle class people
We assume that the people who mobilised for the assisted dying bill are people who tend to feel in control of their lives in general and now want more control over how to end it &#8211; we assume that a middle or upper class background facilitates this wish for wanting more choice. Our concern is that a lot of people, in particular working class people, don’t feel that they have much control over their lives. We often end up in jobs where we don’t have much of a say and cannot control our environment. Accordingly, many working class patients tend to develop a certain fatalism towards life and death. There have been many sociological studies that showed that working class patients with substance abuse issues have a much smaller chance to overcome their addiction than middle or upper class patients &#8211; because in the end they are all too aware that there is less chance that a good life is waiting for them in recovery. 
There is also the fact that working class patients often feel that they cannot interact with consultants and medical professionals in an equal way, which expresses itself in mistrust or by becoming passive and handing over of responsibility. Taking all this into account we can assume that while middle-class people fight for their ‘right to choose to end their lives’, for working class people this ‘individual choice’ is much more vulnerable to outside structural pressures and open to manipulations. 
4) Many working class patients are made to feel that they are a burden on family and society
From our experience of caring for very ill working class patients on hospital wards we know that many feel like a burden, both to the ‘health system’ and to their families. Facing situations of understaffing and lack of beds and resources, they are made to feel apologetic. We are also often confronted with safeguarding issues, where situations of social isolation and poverty lead to relatives trying to take advantage of patients, e.g. by getting access to their money, property or making decisions over their heads. Given the work stress and the under-funded community care we actually know very little about the vulnerable conditions of working class patients beyond the hospital. Again, all these pressures work on the ill individual and their ‘choice’. It is not far-fetched to think that under these conditions, terminally ill patients might feel forced to ‘alleviate’ the perceived burden.
5) The ‘wish to die’ is influenced by the degree of social loneliness and the quality of palliative care
Caring for dying patients we know that in particular patients who feel alone express the wish to die. To see a patient die alone or with only a few, not too warm relationships around them is a devastatingly sad thing to witness. To see a close group of family and friends saying goodbye is both sad and beautiful &#8211; and our hospitals lack space and time to enable this. Crisis and austerity undermine family ties, friendships and adequate palliative care. Unless we can give a warm and collective environment for our dying, we should question our wish to die quicker. 
6) The main organisations that lobby for the Assisted Dying Bill are not grassroots organisations, but have problematic links to the Labour Party and the private sector
On the surface it looks like the main organisations that have been lobbying for the Bill, such as ‘Dignity in Dying’, are grassroots organisations of concerned patients and family members or people with a liberal humanist outlook. Actually, ‘Dignity in Dying’ seems to be based in the neoliberal swamp that exists around<a href="https://www.thecanary.co/uk/analysis/2024/10/24/assisted-dying-labour/"> Labour Party</a> politicians and their activities in the private commercial sector. A few examples:
<ul>
<li style="font-weight: 400;" aria-level="1">In Scotland, ‘Dignity in Dying’ gave <a href="https://www.dailyrecord.co.uk/news/scottish-news/msp-behind-scotlands-assisted-dying-34270770">Lib Dem MP Liam McArthur</a> thousands of pounds to fund a member of staff to work on his right-to-die bill. ‘Dignity in Dying’s sister charity ‘Compassion in Dying’ in turn received £300,000 from Church Street Trustees, a tax haven company. US Securities Exchange Commission filings show that Church Street Trustees is linked to a number of senior business figures and American big pharma interests including NovoCure and Channel Islands firm Volati.</li>
<li style="font-weight: 400;" aria-level="1">Days after the Starmer government took power, ‘Dignity in Dying’ appointed Paul Blomfield as director and chair of the board. Blomfield has been working closely with Starmer as the Labour shadow Brexit minister between 2016 and 2020.</li>
<li style="font-weight: 400;" aria-level="1">Jo Gibbons has been a trustee for ‘Compassion in Dying’ since 2016, and was previously a board member for ‘Dignity in Dying’ between 2015 and 2021. Her ‘Compassion in Dying’ bio says that she worked as a senior adviser for Tony Blair in Downing Street. For a year from 2004, she was a general election coordinator for former health secretary Alan Milburn, who is currently lead non-executive director of the Department of Health and Social Care (DHSC).</li>
<li style="font-weight: 400;" aria-level="1">Alan Milburn joined the neoliberal think tank Demos in 2010, at the time when Demos hosted the launch for the lord Falconer-led Commission on Assisted Dying. The think tank was heavily funded by the Bernard Lewis Family Trust, owned by textile industrialists.</li>
<li style="font-weight: 400;" aria-level="1">Various Labour Party staffers, amongst them Jo Gibbons, launched private advisory and media companies, such as Blackstock Communications and Story Network. One of the clients of these enterprises is ‘Dignity in Dying’.</li>
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The Labour Party has been one of the major forces that combined their party network with NGOs, think tanks and consulting firms in order to drive the process of privatisation, e.g. through ‘private public partnerships’ in health or housing. When it comes to the passing of the Assisted Dying Bill the Labour Party has mobilised the same neoliberal forces to push it through.
7) Historically, times of crisis and austerity meant that the state has to create an atmosphere where working class lives seem dispensable (‘wars’) or an unnecessary cost
The guest article is right in saying that the bill will not save money, but rather cost the health system more. Our concern is that with the global economic and political crisis there is a mounting pressure to ‘save money’ and to ‘get the economy going again’. In this sense the Bill is a potentially slippery slope, a first acceptance of a moral shift that, under mounting financial pressure, can take on a different dynamic. The first ‘victim of austerity’ within the Assisted Dying Bill are the High Court Judges, who were supposed to decide on assisted dying cases. As there are not enough of them and cases in family courts are piling up, MPs plan to issue an amendment that will replace them with a cheaper and more available ‘expert panel’, that has to include a ‘senior lawyer’.
Historically deep crises such as the one we are facing today produced situations where states put more and more pressure on those sections of the working class that they deem as ‘unproductive’: the unemployed, the foreign, the sick, the elderly. The current discourse of ‘individual choice to die’ takes place within a much louder debate about ‘demographic time bombs’ and the ‘financial costs’ that sick and old people inflict on society. The media is full of propaganda, telling us that our societies are ‘getting too old’ and that we cannot afford this. At the same time the state is looking for external enemies again and wants people to get ‘war ready’. ‘Life’ becomes cheap again, both ‘at home’ and at the various frontlines. As long as this absurd system, which puts money above humans, prevails, we have to defend lives at all costs. Let’s show our elderly or terminally sick patients that we have their back and fight with them for the best and most dignified conditions possible.
In relation to the actual scope of the current Bill our concerns might seem over the top &#8211; but we think that both the historic cases of mass euthanasia and the current ‘calculated’ and somehow accepted early deaths of elderly people (underfunded health system, cut in winter fuel allowance for pensioners) should ring our alarm bells. Under the brutal conditions of this system, ‘individual freedom’ for some (‘the land of the free’ etc.) has often been mobilised against the anonymous masses of the poor.  
We are not in favour of criminalising anyone who wants to end their lives and seeks help for that &#8211; but we want to focus our fight on better care, more time and space for meaningful relationships and dignified deaths.
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The Assisted Dying Bill – Contribution to the debate (2)

A fellow health worker sent us this guest contribution about the Assisted Dying Bill. As health workers and concerned working class people we find the debate about the Bill very important. As Vital Signs group we think the article below touches upon many significant issues, such as the tragic division between primary and secondary care, but we find that a more fundamental criticism of the Bill and its context is needed. We will publish a wider critique in the coming weeks. Please feel free to get involved in the discussion &#8211; we will announce a series of local public discussion events soonish, watch this space.
The recent play about the life and work of Aneurin Bevan is framed by the tragic and painful death of his father, without access to dignified palliative care, compared with Nye himself, dying peacefully in an NHS bed, with his best friend and wife by his side. The NHS, according to Nye, exists not just to care for people throughout their life, but to provide people a dignified and comfortable end. 
Sadly, the NHS isn’t always able to meet this need. Often the care that would make someone’s last days comfortable isn’t available in time and, even when the best palliative care is available, the drugs don’t work for everyone. 
The bill about to be discussed in parliament would make assisted dying available only to people with a prognosis of 6 months, who have a consistent wish to die, confirmed by two doctors and a judge. This process takes at least 28 days, except in cases where the prognosis is shorter than this. This is one of the most restrictive assistive dying laws around. It would not make assisted dying available to people with long term impairments, nor to people with progressive diseases that can expect to live more than six months.
Most of the discussion on the left concerns assisted dying broadly, which is an essential discussion. However, little discussion has been had about this legislation specifically. What does a class analysis of this legalisation make us consider?
<h3>Communication across classes</h3>
We should consider the power dynamics in the patient, doctor relationship and whether the particularities of this bill do enough to mitigate the risks in this dynamic. Consultants are upper middle class workers, with very different lives to most of their patients. This makes communication difficult (as illustrated so well in the previous issue of Vital Signs). This is even more of a problem when the patient is from a racialised or other marginalised community.  Imagine a doctor says to you “You can consider assisted dying”. Even said as sensitively and neutrally as this, if a doctor is saying it, wouldn’t you hear that your next 6 months might not be bearable? Patients might feel that applying for assisted dying is the recommended option, even if their doctor only means to give them all the facts. 
The restrictions in this UK bill are designed to mitigate this risk. Two doctors must countersign the patient’s declaration that  they have a consistent wish to die and both of these must have independently examined the patient and agree that they are terminally ill and have a consistent wish to die. If there is any doubt in the patient’s capacity to make this decision they must be assessed by a specialist. Once a declaration is made an application can be made to a high court judge who will confirm that the proper process has been followed. This judge can question the patient if they feel it is appropriate. 
This process makes accessing assisted dying feel like a big deal, and a faff. Things that are a big deal and a faff are less likely to be thought of as a recommended option by patients. Say your doctor says to you “You can consider assisted dying” and you think “shit, ok, they’re saying I’m better off calling it quits asap” and then they’re like “ok we’ll have to get you to sign this declaration, and then another doctor, and then we’ll book in a court appearance with a judge”, you’re likely to then think “woah, that’s a lot”. To be motivated to go through all that you would have to truly believe that this is better than the palliative care on offer. It’s thus unlikely that anyone would make this decision lightly, or because of misinterpreting the intensity of a doctor’s recommendation. 
It is, however, still to be determined what the experience of the process of applying for assisted dying is like. What looks like extended and expensive faff, including a wait of at least 28 days, might be streamlined for the comfort of the patients applying. It’s not required that the patients themselves appear in court, and the judge will largely be confirming that the process has been followed, rather than that the wishes of the dying are being met. 
To add to this, the opinion of two doctors might not mean two separate opinions. The opinion of the second doctor is likely to be influenced not just by the wishes of the patient, but also the opinion of the first doctor. It’s bad etiquette to disagree with a colleague, so only practiced when it will benefit the disagreeing doctor, usually because the first doctor was so clearly wrong that the second might be implicated in some incident. The stakes, for the second doctor, will not always be that high, not least because the patient won’t live to complain about mis-prognosis.
<h3>Doctors and the medical model</h3>
The power dynamics between patient and doctor could complicate the authenticity of this process in other ways. The medical model positions the doctor, the gatekeeper of medical intervention, as the most powerful person in the system of support for a patient. So, doctor’s are generally invested in a medical model of illness where bodies are machine-like and can be fixed, or otherwise, with medical interventions. When someone can’t be made pain free with medicine a doctor may believe they can’t be made pain free at all, and thus support their wish to die based on their belief that they’ll otherwise be in pain.
However, this might not be the case. Pain is more mysterious and multifaceted than a machine experiencing a mechanical problem. Stress has a huge impact on our experience of pain. If we feel relaxed and in control of our bodies and our environment, we feel a lot less pain. Someone who has the support to die at home is likely to have a much more pleasant end than someone in hospital. So, if the decision to apply for assisted dying is made while the patient is in hospital, they might not have fully considered how good home could feel. If you’re a doctor who’s been working in a hospital for years and believe wholly in the value of hospital based medical care you might find it hard to imagine what care could feel like at home, or how much better a patient might feel in a calmer, more comfortable environment. 
<h3>Money</h3>
A class analysis of this bill must consider money. What is the impact of this bill on the already stretched NHS. Of course most people’s big concern is that even one person might be persuaded to die as a cost saving measure! Obviously this is the opposite of what any socialist could want. Thankfully this is not what will happen with this bill. Ths cost of providing this new process is so high that <a href="https://www.theguardian.com/politics/2024/nov/13/assisted-dying-law-nhs-cuts-wes-streeting">Wes Streeting has said he will vote against it because he fears the cuts that will have to be made in other areas in order to provide it. </a>
That it’ll cost money to provide is a pretty thin concern. I’m sure most of us would agree there’s a few CEOs that could be cut, and I reckon the cost of gatekeeping gender affirmative care for trans people could be cut to save a fair portion. Providing healthcare costs money but it’s something we should invest in because it’s right and good and come the fuck on Wes. If you believe assisted dying is a legitimate treatment in some cases, and you believe healthcare should be free at the point of need, then you have to believe the NHS should fund it. 
Though the NHS does a good job of providing care free at the point of need, the same cannot be said for social care. To be eligible for free care at home or in a care home your needs have to be primarily medical, not social. Social care is means tested, so you might have to pay for it. Whether your needs are primarily health or social needs is decided by medical professionals and the local authority through the CHC scheme. If you have free care on the basis of a primarily health care need and your needs change, you can be reassessed as having primarily a social need. This reassessment happens after the first 3 months and then every 12 months after that. So, if you live too long or get a bit too much better you might have to start paying. 
If you’re eligible to apply for assisted dying with a six month prognosis, but would be reassessed for means tested social care after three months, you might save money by dying before 3 months is up, and avoid the risk that you’ll be reassessed as being stable enough to have a primarily social need. Put another way, if you decide to live out your days at home with NHS care then you’ll have three months to enjoy that unbothered. After three months you’ll be reassessed and if you’ve got a bit better, you might have to pay for the rest of your care. Even though this very specific circumstance is unlikely, people with six months to live generally don’t get much better, you might be afraid enough of the risk that you’ll make sure you save the money by shuffling off before reassessment. 
<h3>Equality of access</h3>
The third consideration is that assisted dying might not be available to every patient who would want it. Assuming you believe it&#8217;s a legitimate form of care, then you will believe it ought to be provided equally well to everyone who requires it. However, with doctors being able to opt out of engaging with assisted dying, it may not be available across the board. 
<a href="https://www.bma.org.uk/advice-and-support/ethics/end-of-life/physician-assisted-dying/physician-assisted-dying-survey">A 2020 BMA survey </a>found that 45% of doctors would not engage in any way in the process of providing assisted dying if it were to become legal. This means it’s not unlikely that the doctor you see will not help you access this treatment. This could mean that another postcode lottery comes into existence where some people can access support to end their life and others cannot. This, along with all disparities in care, is unjust. 
It’s a truth that must be reckoned with, that it’s not possible for everyone to be given a dignified and comfortable end of life. Even with the best care available whenever it’s needed, and it isn’t, there are still some people who would choose assisted dying. The provision of this is complicated by the power even the most sensitive and class conscious doctors have over patients. It’s also complicated by the costs some patients end up having to pay for their care, when it’s considered primarily a social need. There is much about this bill that will need resolving as it becomes law. 
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The Assisted Dying Bill – Contribution to the debate (1)

We translated this important interview on the militarisation of the health sector by a friend in Germany. In the coming weeks we will publish our own article about how the UK state is attempting to increase military intervention into and control over the NHS. We will also feature an interview on the history of the <a href="https://www.vdaeae.de/">Association of Democratic Doctors</a> (vdää*), the organisation in Germany to which the interviewee belongs.
The Telegraph recently published an article on the cooperation between UK and Ukraine military medical corps. The article quoted Dr Hettiaratchy, the lead trauma surgeon at Imperial College Healthcare, who trains Ukrainian military surgeons. He suggested the NHS would have to be all but shut down in order to deal with war casualties if Britain was to be dragged into a full-scale conflict. Since the war started in Ukraine, 400,000 soldiers have been wounded, out of which 50,000 lost limbs. The military strategists complain about a low ‘return rate’ &#8211; that only around 50% of wounded soldiers could be patched up well and quick enough to be sent back to the frontline.
The current global capitalist system is in crisis and drives us towards war &#8211; <a href="https://www.vitalsignsmag.org/posts/issue-no-1-against-the-global-trauma-ward-against-the-bosses-wars">we have written about it in Vital Signs</a> before. As health workers who struggle for a new human society we repeat:
Not one man, woman, penny, or paramedic for the bosses’ wars!
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‘The Bundeswehr wants control over employees in the civilian health sector’
The quiet militarisation of medicine.<a href="https://www.telepolis.de/features/Es-geht-der-Bundeswehr-um-den-Zugriff-auf-die-Beschaeftigten-im-zivilen-Gesundheitssektor-10246258.html"> Interview with doctor Bernhard Winter</a> about the military turning point in healthcare.
17 January 2025, Interview by Matthias Becker
“We have to be ready for war by 2029,” said German Defence Minister Boris Pistorius, in disturbingly specific terms, in the Bundestag last year. Karl Lauterbach, the Minister of Health, followed suit less than a week later. “We also have to be better prepared for major disasters and possible military conflicts,” said Lauterbach, calling for “clear responsibilities, for example for the distribution of a large number of injured people among hospitals in Germany”. In Bundeswehr (German army) and NATO war games, the German health system has always played an important role. Now the preparations for war are becoming more concrete.
The interviewee, Bernhard Winter, has been a board member of the Association of Democratic Doctors (vdää*) for many years and has been dealing with the militarisation of the health system for a long time.
The prevailing scenario &#8211; What would a war mean for the health system?
Bernhard Winter: The prevailing scenario assumes that NATO&#8217;s eastern flank is attacked by Russia. Germany would then serve as a hub for moving around 750,000 soldiers to the front. On the other hand, about a thousand wounded soldiers would have to be brought back and medically treated per day, 300 of them in need of artificial respiration. These figures were allegedly derived from experiences in the war in Ukraine. It is difficult to say whether they are realistic.
Ten thousand acute care beds needed
At the last surgery congress in Leipzig, it was stated that in this scenario many bullet and blast injuries are to be expected. These wounded would have to be treated primarily in civilian hospitals because the military hospitals have only 1,850 beds available. Dietmar Pennig, Secretary General of the German Society for Orthopedics and Trauma Surgery (DGOU), believes that this capacity would be exhausted within 48 hours.
Bernhard Winter: That is quite possible. In the scenario mentioned, ten thousand acute care beds would be needed. Two thousand are available in the hospitals of the professional associations, which have been working closely with the military for a long time. They have comprehensive cooperation agreements which also include practical war-related training. The Bundeswehr expects that a further two thousand beds can be provided by the university hospitals. That still leaves four thousand wounded who would have to be accommodated in normal hospitals. Because the crisis in inpatient care is unmistakable, representatives of the Bundeswehr are also turning against the commercialisation and profit orientation of hospitals. They should serve the public good, they argue. However, the Bundeswehr also wants to have a say in hospital requirement planning. Hospital beds should be located near train stations that can be reached quickly, so that they can be reached quickly from the front.
A changed mindset
What do healthcare workers think about this?
Bernhard Winter: Military publications often talk about the sceptical or even hostile attitude of large sections of the population towards the military. Civil and military actors are therefore calling for a change in the mindset of healthcare workers in particular. After 75 years of peace, people would have to get used to the idea that military action was necessary and normal. Cynically, war is presented as the norm and the desire for peace is denounced as a luxury attitude. That is, so to speak, the ideological front line. In the 1980s, there were fierce disputes about a law that, among other things, provided for compulsory further training in war medicine. For example, medical professionals were to practice triage, meaning, the prioritisation according to the severity of injuries and prospects of successful treatment. The peace movement and many health care workers protested against it. At the time, our slogan ‘We won&#8217;t be able to help you!’ was very effective in making it clear to the population that effective protection in the event of a nuclear war is impossible. At the time, there was a risk that the government would have access to health care workers in order to deploy them from a military point of view. However, this health security law failed.
Shaping opinions in the medical profession
At the beginning of January, Michael Giss, the commander of the Baden-Württemberg federal state military command, said in a newspaper interview that the population had to be prepared for the fact that in hospitals ‘the seriously wounded soldier will be treated first, the appendectomy patient later’.
Bernhard Winter: The Bundeswehr is currently making increased efforts to influence how opinions are formed in the medical profession and among medical personnel in general, including public events and symposia and cooperation with state medical associations, professional associations or emergency services. Behind the scenes, the aim is once again to gain access to employees in the civilian health sector. The last NATO manoeuvres have shown that logistical experts are necessary for the operating base that deploys military towards the east. The military cannot carry out the transports alone. Therefore, the military wants it to become possible for employees in the transport sector to be conscripted into the army service. The operating base that organises the return must transport injured soldiers, but also fleeing civilians. Health Minister Lauterbach had actually announced a new Health Security Act in preparation for disasters and military conflicts, which would have included corresponding rules for war. The collapse of the coalition government of SPD, Green Party and Liberals has put an end to that for the time being.
Blurred boundaries
Will the next federal government try this again?
Bernhard Winter: Definitely, regardless of which parties form the government! But the line between the civil health system and the military is also being blurred beyond this federal law. As early as 2008, the Red Cross was placed under the command of the Bundeswehr medical corps in the event of war. I doubt whether many nurses at the DRK are aware that they are subordinate to military structures in the event of war. The leadership of the Maltese and the Johanniter health service are pushing to be integrated in the same way because they expect material benefits from it. Since 2023, there has been a national security strategy with an ‘integrated security approach’. The following events are listed in it: ‘environmental and natural disasters, chemical and nuclear accidents, epidemics and pandemics, terrorism and military conflicts’.
Is the Association of Democratic Doctors against preparing for such events? After all, it is not unrealistic to assume that they will occur.
Bernhard Winter: Of course, after the experiences with Covid-19, the healthcare system must prepare for future pandemics, there&#8217;s no question about that, as well as for environmental disasters and attacks. We have nothing against institutions practising how to react in such situations. However, medicine in war is something completely different. In medicine, the guiding question is: What will do the patient the most good right now? War medicine has a different focus. Its purpose is to get wounded soldiers back in fighting form as quickly as possible and send them back to the front. This applies especially to the armies of rich countries with large medical capacities and highly qualified military personnel.
Criticism of the cooperation between civilian and military institutions
Your association criticises the increased cooperation between civilian and military institutions – why?
Bernhard Winter: Under international law, attacking a hospital is always considered a war crime. The reality is different: medical facilities are increasingly becoming military targets. If we mix civilian and military, it is hardly possible for a military opponent to distinguish between the two either.
In the 1980s, the peace movement succeeded in pushing back the military&#8217;s influence on medicine. The political situation has changed a lot since then. Will there be resistance if the next government passes a new Health Security Act that puts medical personnel under the command of the Bundeswehr in the event of war?
Bernhard Winter: There will certainly be clashes and protests, although perhaps not as strong as they were back then. Our association is receiving an increasing number of enquiries on this topic. After all, the situation is not the same after Russia&#8217;s attack on Ukraine. Young people were overwhelmed by the threat of war. Now they are gradually beginning to have to deal with it, to overcome their passivity and also to talk about their fears.
The question that is suppressed
The 2023 ‘Framework Directive on Overall Defence’ also mentions ‘temporary treatment facilities’ in the event of the use of chemical, biological, radiological or nuclear weapons.
Bernhard Winter: That seems to be an important point. In the 1980s, the threat of nuclear war played an important, mobilising role. This threat still exists, but it no longer plays any role in the debate. But who says that the war on the so-called eastern flank will only be waged with tanks against tanks? At the moment, the government and the military are managing to suppress this question&#8230;

Debate on the current character of hospitals and their restructuring

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