672930

research-article2016
MIL0010.1177/0305829816672930Millennium: Journal of International StudiesHowell

Original Article

Millennium: Journal of

Neuroscience and War:

International Studies
1­–18
© The Author(s) 2016
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Rehabilitation, and the Ethical DOI: 10.1177/0305829816672930
mil.sagepub.com
Limits of Dual-use Frameworks

Alison Howell
Rutgers University – Newark, USA

Abstract
Recent breakthroughs in neuroscience have led to increasing concern about its uses in warfare.
This article challenges the primacy of dual-use frameworks for posing ethical questions concerning
the role of neuroscience in national security. It brings together three fields – critical war studies,
bio-ethics, and the history of medicine – to argue that such frameworks too starkly divide ‘good’
and ‘bad’ military uses of neurotechnology, thus focusing on the degradation of human capacities
without sufficiently accounting for human enhancement and soldier rehabilitation. It illustrates this
through the emergence of diagnoses of Traumatic Brain Injury and Polytrauma in the context of
post-9/11 counterinsurgency wars. The article proposes an alternative approach, highlighting the
historical co-production and homology of modern war and medicine so as to grapple with how
war shapes neuroscience, but also how neuroscience shapes war. The article suggests new routes
for thinking through the connections between war, society, science, and technology, proposing
that we cease analysis that assumes any fundamental separation between military and civilian life.

Keywords
critical war studies, science and technology studies, neuroscience

What could once only be imagined in science fiction is now increasingly coming to
fruition: drones can be flown by thought in human brains; pharmaceuticals can help you
forget traumatic experience, or produce feelings of trust to encourage confession in
interrogation. Research funded by the Defense Advanced Research Projects Agency

Corresponding author:
Alison Howell, Department of Political Science, Rutgers University – Newark, 360 Martin Luther King Blvd,
7th Floor, Hill Hall, Newark, NJ 07102, USA.
Email: [email protected]

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2 Millennium: Journal of International Studies 

(DARPA) is working on brain implants to alleviate the effects of traumatic experience in

war. Invisible energy beams can produce the sensation of burning at a remote distance.
What all these techniques and technologies have in common is that they are recent neu-
roscientific breakthroughs propelled by military research within a broader context of
rapid neuroscientific development. While knowledge of brain chemistry is still largely a
mystery, new computational and imaging technologies, particularly functional Magnetic
Resonance Imaging devices (fMRIs), are driving what is being understood as a revolu-
tion in neuroscience, and in how we understand the human brain. These developments
have raised significant ethical issues concerning the proper role of neuroscience in
national defence.
The most prominent framework for assessing these ethical dilemmas is the dual-use
framework.1 Such an approach draws attention to the ways in which neuroscience may
be put to dual-use: to either help improve human life or to cause harm. The framework
generally places most aspects of the enhancement of human capacities in the former
camp – doing good, or ‘helping’ (even in cases when the enhancement of human capaci-
ties is put to military uses). The dual-use framework thus focuses primarily on how
neuroscience is, or might be, weaponized by military actors to degrade the capacities of
enemies in war.2 What this framework offers is a clear-cut means by which to construct
guidelines about the acceptable and unacceptable uses of neuroscience by national secu-
rity actors. However, the limitation of this clear-cut approach lies precisely in its commit-
ment to a stark division between ‘good’ and ‘bad’. While simple good/bad frameworks
may seem the most immediately (politically) useful, they also come at a cost because
they cannot capture the full ethical terrain of the messy actualities of neuroscientific
practice in warfare or its aftermath.
This article proposes an alternative to the dual-use framework for understanding the
relationship between war and neuroscience. It argues that we must be more historically
minded in order to ascertain how neuroscience is not ‘sullied’ by being put into use for
military purposes, but rather has been inextricably constituted through war. It further
argues that we must be attentive to different modes of warfare since particular military
strategies have shaped medical science and vice-versa. The article offers a novel analysis
of the relationship between neuroscience and war by bringing together several fields of
scholarly inquiry which have otherwise not been considered alongside each other: criti-
cal war studies, bio-ethics, and the history of medicine.

1. Kelly Lowenberg et al., ‘Misuse Made Plain: Evaluating Concerns about Neuroscience in
National Security’, American Journal of Bioethics AJOB Neuroscience 1, no. 2 (2010); The
Royal Society, Brain Waves Module 3: Neuroscience, Conflict and Security (London: The
Royal Society Science Policy Centre, 2012).
2. Jonathan H. Marks, ‘A Neuroskeptic’s Guide to Neuroethics and National Security’, American
Journal of Bioethics AJOB Neuroscience 1, no. 2 (2010); Lowenberg et al., ‘Misuse Made
Plain’; Suparna Choudhury, Ian Gold, and Laurence J. Kirmayer, ‘From Brain Image to the
Bush Doctrine: Critical Neuroscience and the Political Uses of Neurotechnology’, American
Journal of Bioethics AJOB Neuroscience 1, no. 2 (2010): 17–19.

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Howell 3

From critical war studies, we learn that war is not only a destructive force, but also a
productive one.3 Such work has primarily focused on the generative capacities of war in
re-making world orders. The research presented here takes this field in a new direction by
inquiring into the capacity of warfare to generate technological and scientific innovation
in the medical and life sciences, with a focus on neuroscience and neurology. In order to
do so, it not only engages with research on the bio-ethics of neuroscience and war, but also
with the study of the politics of medicine. While significant critical energies in IR have
been directed towards assessments of other areas of technological enhancement in war-
fare, little has been said about neuroscientific developments and their emergence from,
and impact on, warfare. Robotic technologies have tended to garner more attention, espe-
cially concerning the use of drones.4 This oversight is curious, but perhaps not unexpected
given the notable lack of research in IR organised around the role of medical sciences in
producing and propelling war. With few exceptions,5 IR has not systematically under-
taken the study of medicine, despite vast literatures on the topic in History, Anthropology,
and Science and Technology Studies (STS), amongst other disciplines, including as

3. Tarak Barkawi, ‘From War to Security: Security Studies, the Wider Agenda and the Fate
of the Study of War’, Millennium – Journal of International Studies 39, no. 3 (2011):
701–16; Tarak Barkawi, ‘Decolonising War’, European Journal of International Security
1, no. 2 (2016): 199–214; Tarak Barkawi and Shane Brighton, ‘Conclusion: Absent War
Studies? War, Knowledge and Critique’, ed. Hew Strachan and Sybelle Scheipers (Oxford:
Oxford University Press, 2011), 524–42; Tarak Barkawi and Shane Brighton, ‘Powers
of War: Fighting, Knowledge, and Critique’, International Political Sociology 5, no. 2
(2011): 126–43; Astrid H. M. Nordin and Dan Oberg, ‘Targeting the Ontology of War:
From Clausewitz to Baudrillard’, Millennium – Journal of International Studies 43, no. 2
(2015): 392–410.
4. Lauren Wilcox, ‘Drone Warfare and the Making of Bodies Out of Place’, Critical Studies
on Security 3, no. 1 (2015); Kristin Bergtora Sandvik and Kjersti Lohne, ‘The Rise of the
Humanitarian Drone: Giving Content to an Emerging Concept’, Millennium – Journal of
International Studies 43, no. 1 (2014): 145–64; Caroline Holmqvist, ‘Undoing War: War
Ontologies and the Materiality of Drone Warfare’, Millennium – Journal of International
Studies 41, no. 3 (2013): 535–52; Katharine Kindervater, ‘The Emergence of Lethal
Surveillance: Watching and Killing in the History of Drone Technology’, Security Dialogue
47, no. 3 (2016): 223–38; William Walters, ‘Drone Strikes, Dingpolitik and Beyond:
Furthering the Debate on Materiality and Security’, Security Dialogue 45, no. 2 (2014): 101–
18; Thomas Gregory, ‘Drones, Targeted Killings, and the Limitations of International Law’,
International Political Sociology 9, no. 3 (2015): 197–212.
5. Adam Kamradt-Scott, ‘The Politics of Medicine and the Global Governance of Pandemic
Influenza’, International Journal of Health Services 43, no. 1 (2013): 105–21; Elke Schwarz,
‘Prescription Drones: On the Techno-Biopolitical Regimes of Contemporary ‘Ethical
Killing’, Security Dialogue 47, no. 1 (2016): 59–75; Stefan Elbe, Security and Global Health
(Cambridge: Polity, 2010); Alison Howell, ‘The Global Politics of Medicine: Beyond Global
Health, against Securitisation Theory’, Review of International Studies 40, no. 5 (2014): 961–
987; L.H.M. Ling, ‘Border Pathology: Ayurveda and Zhongyi as Therapeutic Strategies’, in
India and China: Rethinking Borders and Security, ed. L.H.M. Ling (Ann Arbor: University
of Michigan Press, 2016).

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4 Millennium: Journal of International Studies 

medicine relates to war.6 At the same time, while multiple studies outside IR have traced
the rise of ‘neuro’ as a way of shaping and governing human life,7 few have examined the
role of military funding or how warfare shapes these new modes of ‘neuro governance’.8
By bringing together critical war studies and the interdisciplinary study of medicine,
we learn that it is not just war that is productive of new medical sciences and technolo-
gies, but that the inverse relation also holds true: that medicine is also productive of war.
Since at least the 19th century, modern Western medicine has so frequently abetted forms
of violence including warfare9 and colonisation10 that these instances cannot rightly be
understood as exceptions. Contrary to these facts, the dual-use framework for assessing
the ethics of neuroscience in war assumes that there is a clear-cut division between help
and harm or the enhancement versus degradation of human capacities, and thus that the
danger neuroscience confronts is in its potential ‘weaponization’. To adopt a framework
of dual-use misapprehends the depth of relations between neuroscience and war, narrow-
ing the potential foci of ethical inquiries concerning their current imbrication.
This article proposes an alternative framework, pivoting on the concepts of co-
production11 and homology.12 Through this framework, other areas of neuroscientific
action in national security are made visible beyond the degradation of human capacities,
such as rehabilitative and diagnostic activities, as well as human enhancement. So, for
example, the article widens ethical inquiry into how the co-production of neuroscience
and contemporary war is fundamentally reshaping notions of trauma, in ways that relate

6. Mark Harrison, The Medical War (Oxford: Oxford University Press, 2010); Joanna Bourke,
‘Suffering and the Healing Profession’, in War and Medicine, Wellcome Trust (London:
Black Dog Publishing & Wellcome Trust, 2008); Zoë H. Wool, After War: The Weight of Life
at Walter Reed (Durham: Duke University Press, 2015).
7. Nikolas Rose and Joelle Abi-Rached, Neuro: The New Brain Sciences and the Management
of the Mind (Princeton: Princeton University Press, 2013); Catherine Malabou, The New
Wounded from Neurosis to Brain Damage, Steven Miller (trans) (Fordham University Press,
2012); Francisco Ortega and Fernando Vidal, Neurocultures: Glimpses into an Expanding
Universe (Bern: Peter Lang, 2011).
8. Jennifer Terry, ‘Significant Injury: War, Medicine, and Empire in Claudia’s Case’, WSQ:
Women’s Studies Quarterly 37, nos. 1 & 2 (2009): 200–25.
9. Bourke, ‘Suffering and the Healing Profession’; Harrison, The Medical War.
10. China Mills, Decolonizing Global Mental Health: The Psychiatrization of the Majority World
(London: Routledge, 2014); Lynette A. Jackson, Surfacing Up: Psychiatry and Social Order
in Colonial Zimbabwe, 1908–1968 (Ithaca: Cornell University Press, 2000); David Arnold,
ed., Imperial Medicine and Indigenous Societies (Manchester: Manchester University Press,
1988); Alison Bashford, Imperial Hygiene: A Critical History of Colonialism, Nationalism
and Public Health (Basingstoke: Palgrave, 2004).
11. Sheila Jasanoff, States of Knowledge: The Co-Production of Science and the Social Order
(London: Routledge, 2004); Antoine Bousquet, ‘War’, in Concepts in World Politics, ed.
Felix Berenskoetter (London: Sage Publications, 2015).
12. Howell, ‘The Global Politics of Medicine’; Patricia Owens, Economy of Force:
Conterinsurgency and the Historical Rise of the Social (Cambridge: Cambridge University
Press, 2015); Cynthia Weber, Queer International Relations: Sovereignty, Sexuality and the
Will to Knowledge (Oxford: Oxford University Press, 2016).

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Howell 5

directly to military strategy. Just as the American Civil War shaped notions of ‘war heart’,
World War I (WWI) led to the creation of the diagnosis of shell shock, and the post-
Vietnam period created the conditions for the introduction of the term Post-Traumatic
Stress Disorder (PTSD), so too are current strategies of war and particular clinical condi-
tions producing the diagnoses of Polytrauma and Traumatic Brain Injury (TBI). None of
these diagnoses are natural facts: rather, they are social and political artefacts that are
shaped by, and shape, the conduct of warfare. War is fundamentally altering how we see
trauma variously as either a physiological, a psychological, or a neurological process, and
in turn, such notions of trauma inform not only the clinical contexts in which soldiers are
rehabilitated, but also the political contexts in which wars are pursued.
The article proceeds in four sections. It begins by examining how the relationship
between war and neuroscience is presently understood primarily as a problem of dual-
use, and focuses on Neuroscience, Conflict and Security, a 2012 report published by the
Royal Society, an independent scientific academy of the UK. The second section sets out
the historical and conceptual basis for the article. It contends that war and medicine must
be viewed as of being co-produced and homologous in order to historicise and contextu-
alise the limits of the dual-use framework. The third and fourth sections each open up
alternative ways of conceptualising the ethics of the relationship between neuroscience
and war. Section three examines how medicine propels warfare through an examination
of rehabilitation activities, which are generally sidelined in dual-use accounts which
assume a stark division between ‘help’ and ‘harm’. The fourth section examines the other
side of the equation by highlighting how war propels medicine, and how war, specifi-
cally counterinsurgency warfare, has shaped neuroscience, including the diagnosis of
TBIs and Polytrauma. By considering the role of military clinical experience, it demon-
strates how warfare is at the crux of new ideas emerging out of military neuroscience
about injury, trauma, memory, and the mind/body relation. The conclusion expands on
the possibilities for thinking beyond the limitations of the dual-use framework, while
also drawing out how the study of science and technology generally, and medical and life
sciences in particular, may open up new avenues of inquiry in IR.

Framing Neuroscience and War as a Problem of Dual-use:

Brain Waves
In the years 2011 to 2012, the Royal Society released a series of reports based on its
‘Brain Waves’ project. The project was aimed at examining developments in neurosci-
ence and their broad implications for society and public policy. The project issued four
reports on the various implications of neuroscientific advancements. The third amongst
these, Brain Waves Module 3: Neuroscience, Conflict and Security,13 focused on the
increased interest and investment amongst military agencies in the enhancement and
degradation of human performance through neurotechnology. There is a growing body of
research on neuroscience and war in the field of bio-ethics.14 This article focuses on the

13. The Royal Society, Brain Waves Module 3’.

14. Marks, ‘A Neuroskeptic’s Guide’; Lowenberg et al., ‘Misuse Made Plain’.

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6 Millennium: Journal of International Studies 

Royal Society’s report not only because it seeks to guide policy, but also because the
quality and carefulness of the report makes it an exceptional exemplar of the dual-use
argument. Far from an ‘easy target’, it is a considered, extensive, and impressive text.
The report is highly nuanced, and yet, as I will show, is constrained by the dual-use
framework that it adopts.
Simply put, the dual-use framework warns that neuroscientific ‘knowledge and tech-
nologies used for beneficial purposes can also be misused for harmful purposes’.15 It
carves out two domains of investigation in studying military applications of neurosci-
ence: those that enhance human performance, and those that degrade it. Brain Waves
Module 3 provides several examples of areas wherein neurotechnologies have been used
or may be developed for both the purposes of enhancing the performance of a country’s
own troops, or degrading the performance of enemy forces.
Performance degradation is figured as the ‘weaponization’ of neuroscience, such as
the use of neuropharmaceuticals against enemy forces. For example, Brain Waves
Module 3 draws attention to the use of opioids by Russia in its response to the Chechen
‘Moscow theatre siege.’ They also address anti-personnel directed energy weapons
which cause a burning sensation that is meant to deter targets (the technology was origi-
nally developed by the company Raytheon for use in the theatre of war, and was later
tested out in a Los Angeles prison for use in law enforcement/prison control).
In terms of performance enhancement in war, neuroscience and neurotechnology
applications include neuropharmacology and drug delivery innovations to sustain and
enhance brain functioning and performance, applications of neuroimaging technology
for enhancing cognition and memory (for example, in military training), and applications
that advance human-machine interfaces for enhancing physical or cognitive perfor-
mance. Military interest in these areas has meant increased funding opportunities in neu-
roscience. For example, DARPA funds neuroscientific research projects on preventing
the effects of sleep deprivation in service members, enabling stress resistance, and devel-
oping neurotechnology for intelligence analysts. Other projects have sought to use neu-
roscience for the purpose of recruit selection: i.e. discerning whether potential recruits
have neurological aptitudes of use to the military – such as ‘fast learning’ or ‘risk-taking’
aptitudes. There is also an interest in harnessing pharmaceuticals that work on neuro-
transmitters in soldiers’ brains. For example, the US Air Force authorised the use of
dextroamphetamine (street name: speed) to enhance alertness. Other neuropharmaceuti-
cals being used, or of interest to militaries, include methylphenidate (brand name:
Ritalin) to improve cognition when a soldier is fatigued, modafinil (Provigil) for the
removal of the need for sleep, as well as caffeine, nicotine, and other drugs.16
Exactly where to draw the line between the ‘good’ and ‘bad’ sides of the dual-use of
neuroscience remains a difficulty for those grappling with this challenge. For example,
Brain Waves Module 3 uses the example of oxytocin, which is a neuropeptide naturally
released during childbirth, lactation, and orgasm, that is thought to encourage ‘prosocial
behaviours’ such as bonding and trust.17 Brain Waves Module 3 warns that oxytocin

15. The Royal Society, Brain Waves Module 3, iv.

16. Ibid.
17. Ibid, 33.

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Howell 7

could be used by interrogators to make subjects more docile and trusting – this, the report
suggests, carries ethical concerns as it infringes on the cognitive liberty of interrogation
subjects. But the report also suggests that oxytocin could be used to foster group cohe-
sion in military units – something that would, according to the report, not pose ethical
concerns if oxytocin was not administered directly through neuropharmaceuticals, but
though ‘indirect’ means such as the tailoring of training programmes. It is with these
sorts of difficulties that a dual-use framework encounters its limits: even a single hor-
mone (oxytocin) defies categorisation because just as it can enhance performance, it can
degrade resistance to interrogation.
Brain Waves Module 3, and other reports and scholarly works that employ the dual-
use framework are admirable in that they engage the possibility that technical guidelines
could be developed to better control military applications of neuroscience and neurotech-
nology. Such guidelines are potentially useful political tools, for example in updating
weapons conventions. But by attempting to categorise some applications as ‘good’ and
others as ‘bad’ through a stark division between enhancement and degradation, this
approach may also constrain a full understanding of the relations between neuroscience,
war, and society. The remaining sections of this article seek to explore some of the limi-
tations of this framework, and propose ways of opening up a more robust discussion of
the relations between neuroscience and military strategy.

War and Medical Science: Thinking through Co-production

and Homology
Dual-use ethical frameworks assume that medical science is something that is ‘mis-used’
or ‘corrupted’ when it is put to violent purposes in war. This is an ahistorical misappre-
hension. From a historical vantage, we can see that when medicine is used for violent
purposes in warfare, this is not an ‘exception’ that can be easily remedied (or, in critical
security studies language ‘desecuritised’ and brought back to the realm of ‘normal poli-
tics’). Rather, we need a new framework to understand the complexities of the ties
between war and medicine. Two concepts are critical for understanding the relationship
between war and medicine: co-production and homology.18
Modern warfare and the medical and life sciences have been co-produced in that each
have propelled and shaped the other in mutually constitutive ways. STS research in IR
has focused on the co-productive and symbiotic relations between science and war.19 Far
less has been said in IR about the specificities of medical science and technology as they
relate to warfare. This silence seems especially odd given that numerous scholars in a
Foucauldian vein have noted that biopolitical war has turned towards securing the ‘health
and wealth’ of the population, yet medicine, which is the central technique of ensuring
‘health’, has largely been overlooked in Foucauldian studies of war.
Several fields of medicine have either been invented or developed in response to war,
and in turn, medicine has shaped the logistics and manning of warfare. This is true for

18. Howell, ‘The Global Politics of Medicine’.

19. Antoine Bousquet, The Scientific Way of Warfare: Order and Chaos on the Battlefields of
Modernity (New York: Columbia University Press, 2009); Bousquet, ‘War’.

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8 Millennium: Journal of International Studies 

such divergent fields as public health, plastic surgery, prosthetics, disaster medicine, psy-
chiatry, amongst numerous other examples, including neurology: a discipline rooted in the
American Civil War, and clinically established through WWI.20 At the same time, these
medical sciences often shaped the practice of warfare, guiding the logistics of battle to
improve the number of soldiers who could return to fighting after injury, or working to
prevent the spread of disease. Consider, for example, the fields of public health and epi-
demiology (the science of measuring and controlling the incidence of disease). Throughout
the 19th century epidemiology emerged out of, and shaped the nature of, two spaces
increasingly dense with bodies: cities and war zones. The Crimean War (1853–6) is a
good example. As an industrialised form of siege warfare, the health of the population of
soldiers was considered critical to military planners in the Crimean War because this form
of warfare involved waiting-out and surviving enemy forces. Public health shaped the war
by giving British and French forces an advantage in the form of curbing the cholera epi-
demic through systems of sanitation and the improvement of war hospitals. At the same
time, the war significantly shaped the science of epidemiology and public health, most
famously through Florence Nightingale’s influential invention of new forms of statistical
models and visualisations (i.e. its scientific method), the professionalisation of nursing, as
well as systems for reforming Victorian London’s workhouses (i.e. social policy). This is
just one example amongst many of how war and medicine are co-produced. Understanding
this history is important if we are going to grapple with the ethics of the uses of medical
sciences in war, because this longer historical view begins to undermine the position that
medicine has only recently been ‘corrupted’ by war through its supposed recent ‘weaponi-
zation’, as the dual-use framework assumes.
To fully examine these dynamics, however, we must push our analysis further. War
and medical science are not only symbiotically co-produced, they are also homologous.
To say that two or more things are homologous means observing that they work through
the same logic21 and inquiring into how this homology emerged. Modern Western medi-
cine and warfare are homologous, I argue, in that they share the logic of strategy in rela-
tion to the population. Through the 19th century, each came to refer not centrally to the
patient or the sovereign, but to the population. Medicine (and in particular epidemiology/
public health) works on the strategic logic of protecting the population from death by the
pathology of disease, while warfare works through the strategic logic of the protection
and of the population from the pathology of, for instance, terrorists and insurgents in
present-day warfare.
Take, for example, the history of emergency medicine. It is true that emergency medi-
cine and war are symbiotic: several techniques of emergency medicine (eg. hemorrhage
control, amputations) emerged from or were significantly developed in warfare.
Emergency medicine also shaped warfare, for example through administrative systems
of managing injured soldiers and maintaining overall troop strength. Furthermore,

20. Stephen T. Casper, ‘A Revisionist History of American Neurology’, Brain: A Journal of

Neurology 133, no. 2 (2010): 638–42.
21. Howell, ‘The Global Politics of Medicine’; Owens, Economy of Force; Weber, Queer
International Relations.

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Howell 9

disaster medicine emerged out of the mass destruction of World War II, and went on to
significantly shape medical humanitarianism. So, we can say that emergency medicine
and warfare have been co-produced. But we must also think through how they are
homologous: how they share the same logic. The emergency medicine technique of tri-
age is key to understanding this.
Triage is a system of emergency medicine aimed at prioritising patients according to
medical need in emergency situations. Several scholars have recently noted that post-
9/11 counterinsurgency strategy (COIN) deploys metaphors of triage.22 Much of this
scholarship treats this as a form of medicalised language, which falsely pitches war as a
form of health intervention. This approach assumes a mis-use of medical language for
propagandist purposes. When it treats triage as a metaphor rather than a technique, it
misses that triage emerged precisely out of war. The appearance of triage as a technique
of war in the COIN manual does not signal its metaphorical misappropriation, but an
expression of the homology of warfare and emergency medicine. The invention of triage
as a technique of emergency medicine was born precisely out of the need to organise the
provision of medical care in war. Triage emerged from the Napoleonic Wars (triage is
from the French word trier), and was developed especially in WWI as an organisational
structure used to manage masses of casualties.
In contemporary COIN warfare triage has taken on a different but parallel role. Unlike
a field of battle populated by a mass of bodies differentiated only by rank (as in trench or
siege warfare), COIN imagines the battlefield in terms of a human terrain requiring the
sorting of people according to their level of threat. In this context, triage becomes a use-
ful technique as a means of strategically sorting people. While other scholars have rec-
ognised that COIN imports the techniques of 1990s humanitarianism,23 they do not
sufficiently account for how the development of humanitarian activity was itself derived
from wartime experience. Many humanitarian techniques are derived precisely from
military techniques, such as systems of administration or logistics including food
delivery (to the front line or the disaster zone), and, of course, public health (sanitation,
hygiene, food aid, disposing of dead bodies, and so on) as well as emergency and disaster
medicine, not least of which triage. It is thus not surprising that COIN warfare and triage
would work through the same techniques. They share a logic of sorting the population
precisely because they emerged and grew together.
This is just one example of the broader shared logic of both modern warfare and
medicine, that is, of protecting and enhancing the population. Highlighting this homol-
ogy is significant because it challenges the common assumption that killing and curing
(war and medicine) are at two opposite ends of the spectrum of human activity – an

22. Colleen Bell, ‘Hybrid Warfare and Its Metaphors’, Humanity: An International Journal of
Human Rights, Humanitarianism, and Development 3, no. 2 (2012): 225–47; M. Kienscherf,
‘A Programme of Global Pacification: US Counterinsurgency Doctrine and the Biopolitics
of Human (In)security’, Security Dialogue 42, no. 6 (2011): 517–35; Derek Gregory, ‘"The
Rush to the Intimate": Counterinsurgency and the Cultural Turn’, Radical Philosophy 150,
no. 8 (2008).
23. Michael Dillon and Julian Reid, The Liberal Way of War: Killing to Make Life Live (London:
Routledge, 2009).

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10 Millennium: Journal of International Studies 

assumption made both by critical scholars of war who assume that the appearance of
medical language in military strategy is a matter of ‘misappropriation’, and by bio-
ethicists who deploy a framework of dual-use, which is based on a stark division
between ‘help’ and ‘harm’. Instead, we must see warfare and medicine as working
towards the same logical purposes via different, but mutually constitutive, means.
Returning to the case of neuroscience, the faulty assumption that sits at the heart of
the dual-use framework is that it sees neuroscience as potentially dangerously ‘cor-
rupted’ by its uses in warfare. It assumes that when neuroscience is used for strategic
purposes, this represents a recent perversion of its natural aim. But neuroscience has
always been strategic. By rejecting this assumption and beginning from the starting point
that war and medical science are symbiotic and homologous, we are able to open up
questions about the multiple and complex relations between neuroscience and war. This
approach, I argue, does not shut down possibilities for ethical thought and action. While
the dual-use framework is alluring because it claims to hold out the possibility that we
may be able to protect neuroscience or medicine from being ‘mis-used’ for nefarious
purposes in war through technical solutions (such as weapons conventions), it also fore-
closes possibilities for more profound treatments of ethics that move beyond a simple
division between ‘good’ and ‘bad’ neuroscience applications.

Beyond the ‘Help’ and ‘Harm’ Binary: Bringing in

Rehabilitation
Conceptualising the role of neuroscience in terms of a ‘dual-use challenge’ presupposes
a stark divide between ‘help’ and ‘harm.’ Because this formulation assumes that actions
that ‘help’ or ‘do good’ cannot also do harm, this approach not only sidelines significant
questions about military applications that enhance human capacities. It also shutters any
questions about the role of neuroscience in rehabilitation activities.
References to rehabilitative neuroscientific research and treatment are scant in Brain
Waves Module 3, the Royal Society’s report. There are some exceptions: it does address
contemporary research on Neural Interface Systems (NIS). Such systems aim to
empower the brain to extend beyond the body through systems that connect the nervous
system to, for example, machinery (such as prosthetics or drones). For example,
Braingate (a private company that conducts research in cooperation with universities,
hospitals, the Veterans Administration, and through funding from DARPA) has success-
fully implanted a small chip onto the surface of the brain that has allowed people expe-
riencing paralysis to control the movement of a prosthetic by simply imagining this
motion. The report suggests that this technology of rehabilitation could be developed so
as to control, for example, robots or unmanned vehicles such as drones,24 a prediction
that has since come true.25

24. The Royal Society, Brain Waves Module 3, 40.

25. Jason Koebler, ‘Researchers Test First Brain-Controlled Drone’, US News and World Report,
June 2013. Available at: http://www.usnews.com/news/articles/2013/06/04/researchers-test-
first-brain-controlled-drone. Last accessed October 3, 2016.

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Howell 11

But in general the report only problematises rehabilitation activities insofar as they
raise ethical issues concerning the use of neuropharmaceuticals. There are two primary
examples of this in the Report. First, it explores the use of methylenedioxymethampheta-
mine (MDMA, street name: Ecstasy) in the treatment of PTSD. MDMA has been used to
induce feelings of euphoria, intimacy, and reduced anxiety in patients as a catalyst for
reportedly more effective therapy sessions. Secondly, the report calls attention to the use
of Beta blockers in preventing the development of PTSD. Beta blockers such as pro-
pranolol have been of interest for military applications because they interrupt the con-
solidation of memories: if a soldier witnesses a traumatic incident s/he could be
administered a beta-blocker so as to reduce the risk of subsequent PTSD. This occurs
within a political economy of veterans services in which attempts to curb costs relating
to massive and growing expenditures on veteran health care26 led to such policies as
denying PTSD diagnoses or creating dubious systems for the ostensible prevention of the
disorder.27 The report briefly states that the use of memory removing or dampening drugs
poses ‘ethical concerns’, but limits its concerns solely to the potential of overmedication.28
Because the dual-use framework operates on the basis of a stark division between ‘help’
and ‘harm’ and categorises ‘harm’ or the ‘weaponization’ of neuroscience as the ‘mis-
use’ of neuroscience, the framework cannot adequately conceptualise the rehabilitative
or preventive aspects of neuroscience as worthy of ethical inquiry.
By dispensing with the stark divide between ‘help’ and ‘harm’, with the framework of
‘weaponization’, and with the idea that neuroscience is neutral until it is ‘mis-used’, it
becomes possible to crack open some more probing questions about the rehabilitative
and treatment-oriented aspects of neuroscience. Guided by the observation that war and
medicine have historically been homologous and symbiotic, it is possible to ask ques-
tions about how neuroscience is propelling contemporary warfare (the reverse dynamic
is explored in the following section of this article).
This comes into stark relief when considering the role of medical science and of doc-
tors and medics in the management and boosting of the ‘manpower’ required to fight
ground wars. One of the primary functions of military doctors is to return soldiers to duty.

26. Joseph Stiglitz and Linda Bilmes, The Three Trillion Dollar War: The True Cost of the Iraq
Conflict (New York: W.W. Norton & Company, 2008).
27. Alison Howell and Zoë H. Wool, ‘The War Comes Home: The Toll of War and the Shifting
Burden of Care’ The Costs of War (Providence: The Watson Institute, 2011); Alison Howell,
Madness in International Relations: Psychology, Security, and the Global Governance of
Mental Health (London: Routledge, 2011); Brianne P. Gallagher, ‘Burdens of Proof: Veteran
Frauds, PTSD Pussies, and the Spectre of the Welfare Queen’, Critical Military Studies 2, no.
3 (2016); Joshua Kors, ‘How Specialist Town Lost His Benefits’, The Nation, March 2007.
Available at: https://www.thenation.com/article/how-specialist-town-lost-his-benefits/. Last
accessed October 3, 2016; Alison Howell, ‘The Demise of PTSD: From Governing through
Trauma to Governing Resilience’, Alternatives: Global, Local, Political 37, no. 3 (2012):
214–26.
28. For a more robust discussion see Michael Henry, Jennifer R. Fishman, and Stuart J. Youngner,
‘Propranolol and the Prevention of Post-Traumatic Stress Disorder: Is It Wrong to Erase the
"Sting" of Bad Memories?’, The American Journal of Bioethics 7, no. 9 (2007).

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12 Millennium: Journal of International Studies 

Sigmund Freud put it this way: War-time doctors ‘had to play a role somewhat like that
of a machine gun behind the front line, that of driving back those who fled.’29 Saving,
enhancing, and rehabilitating the bodies of soldiers is part of a system that re-deploys
soldiers, and therefore participates in the production of violence. In this sense, military
medicine is involved in the manning of wars – in personnel management, or ‘readiness’.
Medicine, then, can both ‘do good’ in the short-term, on the individual level, and in the
clinical setting, while also being implicated in the production of the ‘manpower’ that is
used to do great harm through the waging of war.
This is true of all kinds of medical interventions and specialisations, from emergency
medicine, to public health to psychiatry. Medicine has worked to shore up manpower in
techniques as varied as infection control, sanitation, and the curbing of ‘malingering’.
The shape that such interventions have taken has depended greatly on the state of medi-
cal science. For instance, neurological, psychiatric, and psychological expertise has vari-
ously been deployed to combat ‘nostalgia’, war neurosis, shell shock, battle fatigue,
combat stress, PTSD – and the form that these interventions (and diagnoses) have taken
varies significantly according to the form of warfare in each case. Neurology and neuro-
science have had an especially central role in the 21st century wars in Afghanistan and
Iraq. In addressing the role of medicine in increasing the ‘manpower’ needed for war, it
is important to be specific about how this relates to questions of military strategy.
Two things are of particular note in relation to the wars in Iraq and Afghanistan. First,
these wars have involved lower numbers of allied military fatalities relative to, for
instance, Vietnam, in part because of the use of body armour and robotic technologies
that protect or distance soldiers from mortal harm. However, this lower rate of fatalities
has been coupled with a higher proportion of injuries compared to the rate of fatalities.
These injuries are often brain injuries related to Improvised Explosive Device (IED)
blasts, a point that will be expanded on shortly in the following section on the ways in
which contemporary warfare propels neuroscience.
Secondly, in the post-9/11 wars, military strategy has involved repeated re-deployments
(in part due to a shortage of trained personnel in an era of an ‘all volunteer’30 force). This
fact has made medicine a highly important tool for maintaining overall troop strength. In
the wars in Iraq and Afghanistan, Western militaries, and especially the US military, have
been reliant on neuroscientific knowledge in rehabilitating soldiers – often for the pur-
poses of re-deploying them. Rehabilitation exists within a wider system of personnel
management that is crucial for the waging of ground wars. Help and harm, curing and
killing, medicine and warfare – these are not opposite terms that can be held apart if we
want to grapple with the relations between neuroscience and war. Rather, we must see
medicine and war as symbiotic: medicine propels war and vice-versa.
To be sure, my argument is not that we should stop rehabilitating soldiers. But, we do
need to acknowledge that actions that may ‘help’ or ‘do good’ on the individual level or

29. Quoted in Bourke, ‘Suffering and the Healing Profession’, 112.

30. The term ‘all volunteer force’ is problematic not only because of egregious stop-loss policies,
but also because the context in which people ‘choose’ to ‘volunteer’ for the armed forces is
one of stark social inequality both in terms of class and race.

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Howell 13

in the clinical setting can also be implicated in broader political harm and violence.
Neuroscience has become increasingly central to the production of military manpower
that can be re-deployed. By drawing a stark line between help and harm, the dual-use
framework cuts rehabilitative applications of neuroscience out of ethical questioning.
Instead, by approaching war and medicine as symbiotic, it is possible to see how medi-
cine propels war: it is integral to the management of military manpower and to the fight-
ing of wars. The following section explores the reverse dynamic: how war also propels
medicine in ways not easily captured by conceptual frameworks of dual-use.

TBI, Polytrauma, and Neuroscience in COIN Warfare

Because the dual-use framework focuses primarily on the ‘weaponization’ of neurosci-
ence, it frames ethical concerns about the relationship between neuroscience and war in
only one direction. It assumes that neuroscience is naturally of the civilian domain, and
is only potentially problematic when it gets used against enemies as a weapon of war.
Building on the arguments presented above, this section draws out a second major limita-
tion of the dual-use framework. It argues that the dual-use framework cannot account for
ethical challenges that may be posed by the reverse dynamic: that is, when neuroscience
and neurotechnologies move from the military to the civilian sphere. In order to explore
this point, we need to think about the ways in which the symbiosis between the domains
of war and medicine works in multiple directions: medicine propels war, but war also
propels medicine and the life sciences. This section of the article works to unpack some
of the challenging questions that arise when this dynamic comes into view, opening up
questions about the circulation of medical innovation from the war-front to the home-
front (and back again). It focuses on how post-9/11 COIN warfare has shaped neuro-
scientific ideas concerning trauma through the emergent diagnoses of Traumatic Brain
Injuries and Polytrauma.
Putting these developments into historical context is again important. The role of
warfare and of military funding in the establishment of all academic disciplines, and
particularly the sciences and social sciences, should not be underestimated. US military
funding and the provision of soldiers and colonial subjects as experimental subjects has
been crucial to the establishment of everything from anthropology (as a colonial sci-
ence) to psychology (established as a science in WWI) to physics (particularly in the
Cold War). This is no less true for several branches of medicine, not least neurology,
which, as described above, is rooted in the American Civil War and WWI. We tend to
think of science as a civilian institution, when it is far from such.31 From the perspective
of viewing war as a productive force, we may inquire into the specificities of how war
(re)produces medical and life sciences in new ways, at times precisely as a function of
its destructive powers.
War has been a significant force in propelling the invention of new diagnoses, shaping
medical science in the process. Diagnoses are political artefacts: that is, they emerge out

31. Hugh Gusterson, ‘The University at War’ The Costs of War (Providence: The Watson Institute,
2011).

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14 Millennium: Journal of International Studies 

of particular political constellations (in this case war) and have political effects in the
specificities of their elaboration, and in their circulation. Diagnoses that variously inter-
pret trauma have been particularly tied to the experience of war. Indeed, medical under-
standings of trauma have varied greatly,32 with different forms of warfare giving rise to
new diagnostic categories. For example, the American Civil War gave rise to the diagno-
ses of ‘soldier’s heart’ which focused on the cardiac system (such as quickened pulse),
and of ‘nostalgia’ (what we might now call anxiety). WWI trench warfare and the effects
of aerial bombardment gave rise to the diagnosis of shell shock. The diagnosis of PTSD
emerged out of the American experience in Vietnam, re-constituting battle trauma in
terms solely of a psychological experience (not necessarily involving a physical wound).
PTSD was later expanded to include the witnessing of a traumatic event as sufficient to
cause the disorder. In sum: through the 20th century, trauma increasingly moved out of
the domain of neurologists and cardiologists, to psychiatrists and especially psycholo-
gists, and thus from the body (the heart, the brain) to the psyche.
The course of this diagnostic history was dramatically reversed in the wake of the
post-9/11 wars. Much as WWI gave rise to the diagnosis of shell shock, and PTSD
emerged in the wake of the Vietnam war, so too do the post-9/11 wars have their ‘signa-
ture injury’: Traumatic Brain Injuries (or TBIs).33 From the perspective of medical sci-
ence, this shift is a straightforward fact, attributable to progress in diagnostic technique.
Thus, the 242,000 diagnosed and reported cases of TBIs that have been directly attrib-
uted to the wars in Afghanistan and Iraq34 are considered to be a product of better imag-
ing technology (i.e. fMRIs) and a better understanding of the brain produced in part by
having so many test subjects courtesy of war. But if we treat diagnoses not as simple
evidence of ‘improvement’ in medical technique, but as artifacts that emerge within geo-
political and biopolitical contexts,35 we begin to see that the emergence of the diagnosis
of TBIs must be understood in relation to the particular strategies of counterinsurgency
war that took place in Iraq and Afghanistan. What, we need to ask, are the politics of the
invention and elaboration of neuroscience and neurotechnology associated with military
endeavours? And what might their consequences be?
While the notion of ‘brain injuries’ is long-standing, the attachment of the word
‘trauma’ (as in, Traumatic Brain Injuries) is newer. When, and in what context, did brain
injuries become ‘traumatic’? The earliest references to the term that I have been able to

32. Ruth Leys, Trauma: A Genealogy (Chicago: University of Chicago Press, 2000); Didier
Fassin and Richard Rechtman, The Empire of Trauma: An Inquiry into the Condition of
Victimhood (Princeton: Princeton University Press, 2009); Allan Young, The Harmony of
Illusions: Inventing Post-Traumatic Stress Disorder (Princeton: Princeton University Press,
1995).
33. The term TBIs is used broadly here to also include what are called mTBIs, or mild Traumatic
Brain Injuries. Roughly, mTBIs are a new way of approaching what often used to be called
concussions.
34. The 2012 US Defense Medical Surveillance system reported 253,000 cases of TBIs.
Subtracting a baseline of 11,000 cases, 242,000 diagnosed and reported cases of TBIs have
been attributed to these wars.
35. Terry, ‘Significant Injury’.

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Howell 15

identify in the scientific literature that roughly correspond to current meanings date to the
early 1980s, started to become prevalent through the 1990s, but expanded significantly in
the context of the development of fMRI technology, but also importantly the rise of the
diagnosis of TBIs has occurred in the context of the post-9/11 wars in Iraq and Afghanistan.
The specific form of warfare pursued in Iraq and Afghanistan is of critical impor-
tance. With the turn to COIN warfare from 2006 onwards, and especially with the troop
surges in Iraq in 2007 and in Afghanistan in 2009, these wars became extensive ground
wars that involved high numbers of ‘boots on the ground’. Further, COIN involves
ground troops operating ‘far from the flagpole’ – soldiers have been sent on missions far
from large, fortified bases, in order to circulate in the populations of ‘host nations’. This
military strategy aimed to win the ‘hearts and minds’ of the civilian population by circu-
lating in the ‘human terrain’ so as to improve security and engage in re-building.
But circulating in the ‘human terrain’ also entailed significant and specific risks for
soldiers. In these wars, soldiers have experienced high rates of blast injuries due to expo-
sure to IEDs, commonly known as ‘roadside bombs’. These injuries are multiple, but the
most prevalent amongst them are loss of limbs, abdominal and genital injuries,36 and,
significantly, brain injuries or TBIs.37 Sometimes TBIs involve severe penetrating
wounds (i.e. that pierce the skull), but more often these blast injuries involve the brain
being shaken in the waves of blasts, the result of which is thought to be the disruption of
neural networks.
If the rise of the diagnosis of Traumatic Brain Injury has been significantly propelled
by the post-9/11 wars, then this begins to tell us something about the ways in which the
productive capacities of war (to create new diagnoses) are tied to its destructive forces
(the harm experienced by soldiers is what produces them as experimental subjects). The
bodily injuries frequently entailed in COIN wars have propelled many other innova-
tions in medical technology. These have included, for instance, medical devices meant
to be carried ‘far from the flagpole’ such as hemorrhage control bandages that include
chemicals that clot the blood, mobile ventilator devices, wearable and ingestible health
monitoring devices, and tele-health smartphone devices. Funding has also been directed
to regenerative medicine with the aim of potentially re-growing blasted-off body parts,
and to advances in prosthetic devices (including the brain-prosthetic interfaces dis-
cussed earlier in this article). The high rate of TBI diagnoses is also directly related
COIN warfare, propelling investment in this area of neurology in ways that will shape
civilian applications.
To be clear: I am not arguing that COIN warfare produced Traumatic Brain Injuries as
such. Rather, it provided the productive context, alongside perceived advances in imag-
ing technology, in which higher rates of TBI diagnosis has occurred. This has shaped
notions of trauma away from being mainly understood through the diagnosis of PTSD,

36. Zoë H. Wool, ‘Attachments of Life and Death: Heteronational Masculinity, Genital Injury,
and the Soldier’s Body’, in Living and Dying in the Contemporary World : A Compendium,
ed. Veena Das and Clara Han (Oakland: University of California Press, 2015); Wool, After
War.
37. Terry, ‘Significant Injury’.

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16 Millennium: Journal of International Studies 

which casts trauma as a psychological problem that can be caused at a removed distance
(for example, through witnessing traumatic events), towards a notion of trauma as a
neurological problem occurring in the brain and involving a physical (not just psycho-
logical) injury.
Key to this is the idea of ‘Polytrauma’. Polytrauma was invented out of the clinical
observation in military settings that soldiers diagnosed with TBIs were also likely to be
diagnosed with PTSD symptoms. This observation became the focus of intense interest
and numerous studies have set out to show that symptoms once associated with ‘PTSD’
are a result of damage to the prefrontal cortex associated with TBIs and the disruption of
neural networks involved in the regulation of anxiety. While these studies are highly
speculative, the idea has been on the uptake in military clinical medicine. In the contin-
ued absence of a clear etiology, the notion of ‘Polytrauma’, a term previously used to
describe multiple physical traumas, has come to be used in military contexts to indicate
the frequent combination of diagnoses of chronic pain, PTSD and persistent postconcus-
sive symptoms (PPCS). In this way trauma is increasingly coming under the remit of
neurology: if the disruption of neural networks is assumed to be at the base of the experi-
ence of trauma, then neurology takes for itself psychology’s authority over traumatic
experiences through the encroachment of the TBI diagnosis into the diagnostic terrain
previously occupied by PTSD.
The word trauma has long held within it the possibility of raising the question of
whether a set of experiences that we might call distress are ‘psychological’ or ‘physical’
in nature. TBIs in some ways represent a return to the joining of the physical and psycho-
logical, like the historical diagnosis of shell shock. But unlike shell shock, which was
based on a molar view of the brain, TBIs are based on the molecular: it is not blunt
trauma to the brain that is captured by the diagnosis of TBI, so much as the molecular
level of disrupted neurons. The terms within which we understand and assert authority
over the duality between mind and body are continually constructed through medicine,
and always subject to change. If trauma is reconfigured as a physical (neuronal) process,
what implications might this have?
In the military context, the diagnosis of Polytrauma means that experiences from
memory difficulties, to irritability, mood swings, suspiciousness, and even guilt come to
be understood as ‘neurobehavioral symptoms’. Thus, if a soldier experiences guilt after
a deployment, s/he can simply be understood as exhibiting a ‘symptom’ of a physical
trauma. Like PTSD, then, the TBI diagnosis treats soldiers and veterans as victims,
working alongside resilience models that make soldiers responsible for their mental
states, but not for their actions or inactions. Trauma is being radically reconfigured as a
neurological problem, a brain problem, and more generally as an injury. This is a direct
result of medical responses to the experience of COIN strategy in the Iraq and Afghanistan
wars, but its consequences will likely not be contained to that area. If history is any
guide, these products of the symbiosis between war and medicine will soon circulate into
civilian life sphere, and find unexpected applications there. Finally, we might consider
the role of imaging technology in this state of affairs. Through the TBI diagnosis, and its
potential supplanting of ‘PTSD’, trauma is being reconfigured as something that is not
only physically manifested, but also as something that is visible. What might it mean for
trauma to become ‘visible’ in this way, or, for trauma to be denied in the absence of such
visibility in the brain?

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Howell 17

Conclusions: Beyond Technical Ethics in the Study of War

and Science
If we are going to grapple with the complexity of ethical questions about the contempo-
rary relationship between war and science, medicine, or in particular neuroscience, then
we will need to move beyond frameworks that seek to reduce the applications of neuro-
science in war to a matter of ‘help’ versus ‘harm’. Approaching the application of science
to war through the concept of a ‘dual-use challenge’ provides a means for grappling with
the troubling purposes that technologies, and particularly medical technologies, might be
put to. There is undoubtedly political utility in this approach, and in the language of
‘weaponization’, for informing policy on the appropriate limits to the use of neuroscien-
tific technologies, which are otherwise not appropriately captured under current biologi-
cal or chemical weapons controls. Yet such frameworks in effect reduce ethical questions
to technical matters through simple categorisations of the applications of neuroscience
as either ‘good’ or ‘bad’. As the foregoing analysis has suggested, it is not merely the
destructive, but also the productive facets of (medical) science, and of war, that deserve
ethical scrutiny.
One way to think of this is in terms of the opportunity costs of all of this neuroscien-
tific production. It is notable that wars tend to propel medical innovations that meet
wartime need: militaries do not, in general, invest in infant or maternal health or
Alzheimer’s or cardiovascular disease, for instance, but in medical interventions and
innovations that improve the health of its target population: young males. When the war
effort shapes funding priorities, multiple disciplines including medicine, are shaped by
these military priorities. There are, as such, opportunity costs involved in military-ori-
ented health research, as has been noted in other scientific domains.38
Further, the productive facets of the relationship between war and neuroscience raise
ethical questions concerning memory and responsibility. Numerous IR scholars have
written about the politics of memory in international affairs, including as it relates to
war.39 This research has tended to focus on the cultural production of memory, such as
the role of memorials in shaping public memory. Yet contemporary war-making also
entails neuropharmacological meddling in human memory production. Beta-blockers
which may interrupt the consolidation of traumatic memory pose new ethical questions
about the international relations of memory. If soldierly memory is further encoded as a
medical experience through the diagnosis of Polytrauma, this also raises questions about
the ethical dimensions of responsibility during and after war. If soldiers’ and veterans’

38. Hugh Gusterson, ‘Project Minerva and the Militarization of Anthropology’, Radical Teacher
86, no. 1 (2009): 4–16; Gusterson, ‘The University at War’.
39. Charlotte Heath-Kelly, Death and Security: Bombsites, Memory and Mortality in the Post
9/11 Era (Manchester: Manchester University Press, 2016); Jenny Edkins, Trauma and
the Memory of Politics (Cambridge: Cambridge University Press, 2003); Duncan Bell,
ed., Memory, Trauma and World Politics: Reflections on the Relationship Between Past
and Present (Basingstoke: Palgrave, 2006); Brent J. Steele, ‘Maintaining (US) Collective
Memory: From Hiroshima to a Critical Study of Security History’, Critical Studies on
Security 1, no. 1 (2013): 83–100.

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18 Millennium: Journal of International Studies 

brains are going to be increasingly subjected to new neuropharmaceuticals, new diagnos-

tic categories, and even new cybernetic implants, then are we facing a situation in which
trauma is stripped from any broader social, political, or ethical context? If, with neurosci-
entific advancements produced precisely through war-time imperatives, war becomes no
longer understood or even experienced as ‘traumatic’, does this also raise new questions
about the ethics of war?
Beyond these avenues of ethical inquiry, this research also suggests that the concept
of ‘weaponization’ has some significant limitations. Those espousing the dual-use frame-
work so often invoke the concept of ‘weaponization’ because it conveys a sense that
what is worthy of inquiry is the encroachment of the military on otherwise apparently
‘unweaponized’ sciences or technologies. The concept erroneously signals a (recent)
trespass or encroachment. What if those sciences and technologies that are said to have
been encroached on through a process of ‘militarisation’ have instead been entwined
with, and thoroughly produced by, war in the first place? By illustrating that medical sci-
ences do not conform to this view of the world, we can begin to move in new analytical
and ethical directions. It is not that (medical) science has been encroached on by war, or
‘weaponized’, rather it is that these two things have been producing each other and work-
ing through the same logics (homology) of population health and enhancement for quite
some time. This is likely true of other things which have supposedly been ‘weaponized’
– that they have deeper histories of entanglement with war. Thus, use of the term ‘weap-
onization’ should be judicious, that is, if it is ever a useful means of analysis. This cri-
tique of ‘dual-use’ could be extended to other fields of inquiry to which this framework
is put to use, not least of which nuclear, chemical, and biological science and warfare.
Furthermore, the challenge set out here gives us a sense that war needs to be further
rethought. If, as I have illustrated, it is not that war circulates into what we often term
civilian institutions or practices (such as medical science and technology), then what is
the analytic utility of holding ‘war’ and ‘society’ apart in the first place? Rather, I have
suggested that we may track the movement and development of (neuro)science and
technology in its applications in any given context, and that in doing so we will learn
once again that war is not an exceptional and distant event, but a process that is inter-
twined with what we call ‘civilian’ life.

Acknowledgements
I am grateful to Adam Kamradt-Scott, Stefan Elbe, and colleagues in the Department of Political
Science at Rutgers University – Newark, as well as the peer reviewers and editors of this journal
for their insightful engagement with this work.

Funding
This research received no specific grant from any funding agency in the public, commercial, or
not-for-profit sectors.

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