The ethics of war-time data in paediatric trauma: attitudes, angles and impacts

### Summary box War-time data have been pivotal in informing the evidence-based management of trauma in modern medicine.1 The established military-industrial complex that Dwight Eisenhower cautioned of in 1961 has now developed into a vast and established global war economy resulting in over 250 conflicts since World War II.2 The war industry relies on rafts of military spending, requiring frequent and large-scale conflict to sustain it. A further frequently unspoken aspect of war is the wealth of trauma data generated from combat and war victims, whether they be: soldiers, war prisoners and civilians either injured during armed operations or for unclear or unknown reasons.3 4 Civilian casualties have tended to proportionally increase over time: 5% in World War I, 50% in World War II, over 80% in the Vietnam war and around 90% in recent conflicts in the developing world.5 Kendrew Lascelles poem ‘The Box’ encapsulates the unfortunate circumstances of children that are entrenched in a war that is not their own. The current commentary calls into question the ethics of war-time trauma data, with particular reference to children. The example study below helps frame subsequent discussions: