A “comfort contract” is an agreement between patients or their surrogates and health care professionals that designates an expected level of postsurgical overall comfort. It also allows patients to specify chronic discomforts and interventions they use at home for relief. In addition, the contract encourages open dialogue between providers and patients so that expectations can be discussed with the patient before any intervention occurs (Smith et al., 2020). Moreover, this type of agreement promotes collaboration in determining a course of action that aligns with the patient’s values, beliefs, goals, and preferences (Hansen et al., 2019). The contract should include questions related to pain management such as intensity/frequency/duration; interventions used at home; past experiences with pain control; desired outcomes; self-care strategies such as relaxation techniques; coping mechanisms such as distraction or music therapy; cultural practices related to managing pain; and communication strategies including when to call for help (Smith et al., 2020). This multifaceted approach ensures that individualized plans are created based on each patient’s needs and expectations.
First, it is never just to intentionally kill innocent people in wars, supported by Vittola’s first proposition. This is widely accepted as ‘all people have a right not to be killed’ and if a soldier does, they have violated that right and lost their right. This is further supported by “non-combatant immunity” (Frowe (2011), Page 151), which leads to the question of combatant qualification mentioned later in the essay. This is corroborated by the bombing of Nagasaki and Hiroshima, ending the Second World War, where millions were intently killed, just to secure the aim of war. However, sometimes civilians are accidentally killed through wars to achieve their goal of peace and security. This is supported by Vittola, who implies proportionality again to justify action: ‘care must be taken where evil doesn’t outweigh the possible benefits (Begby et al (2006b), Page 325).’ This is further supported by Frowe who explains it is lawful to unintentionally kill, whenever the combatant has full knowledge of his actions and seeks to complete his aim, but it would come at a cost. However, this does not hide the fact the unintended still killed innocent people, showing immorality in their actions. Thus, it depends again on proportionality as Thomson argues (Frowe (2011), Page 141).
This leads to question of what qualifies to be a combatant, and whether it is lawful to kill each other as combatants. Combatants are people who are involved directly or indirectly with the war and it is lawful to kill ‘to shelter the innocent from harm…punish evildoers (Begby et al (2006b), Page 290).However, as mentioned above civilian cannot be harmed, showing combatants as the only legitimate targets, another condition of jus in bello, as ‘we may not use the sword against those who have not harmed us (Begby et al (2006b), Page 314).’ In addition, Frowe suggested combatants must be identified as combatants, to avoid the presence of guerrilla warfare which can end up in a higher death count, for example, the Vietnam War. Moreover, he argued they must be part of the army, bear arms and apply to the rules of jus in bello. (Frowe (2011), Page 101-3). This suggests Frowe seeks a fair, just war between two participants avoiding non-combatant deaths, but wouldn’t this lead to higher death rate for combatants, as both sides have relatively equal chance to win since both use similar tactics? Nevertheless, arguably Frowe will argue that combatant can lawfully kill each other, showing this is just, which is also supported by Vittola, who states: ‘it is lawful to draw the sword and use it against malefactors (Begby et al (2006b), Page 309).’
In addition, Vittola expresses the extent of military tactics used, but never reaches a conclusion whether it’s lawful or not to proceed these actions, as he constantly found a middle ground, where it can be lawful to do such things but never always (Begby et al (2006b), Page 326-31). This is supported by Frowe, who measures the legitimate tactics according to proportionality and military necessity. It depends on the magnitude of how much damage done to one another, in order to judge the actions after a war. For example, one cannot simply nuke the terrorist groups throughout the middle-east, because it is not only proportional, it will damage the whole population, an unintended consequence. More importantly, the soldiers must have the right intention in what they are going to achieve, sacrificing the costs to their actions. For example: if soldiers want to execute all prisoners of war, they must do it for the right intention and for a just cause, proportional to the harm done to them. This is supported by Vittola: ‘not always lawful to execute all combatants…we must take account… scale of the injury inflicted by the enemy.’ This is further supported by Frowe approach, which is a lot more moral than Vittola’s view but implies the same agendas: ‘can’t be punished simply for fighting.’ This means one cannot simply punish another because they have been a combatant. They must be treated as humanely as possible. However, the situation is escalated if killing them can lead to peace and security, within the interests of all parties.
