The case is also likely to drive a review of “the process of how to recuse oneself” when a health provider in uniform navigates the “dual loyalty question” of obligation to the nation versus the obligation to the patient. Retired Army Brig Gen. Stephen Xenakis, a psychiatrist who has examined Guantánamo captives, also says a court-martial could end up putting Guantánamo hunger-strike policy on trial.During the 1980s, he notes, military doctors were allowed not only to refuse to perform abortions but also to proclaim their opposition to doing them, “and we didn’t prosecute them.” But something about medical autonomy changed during the war on terror. “The issue is that, with this war, there has been a shift in what has been the professional autonomy of clinicians. They’ve been subordinated to the combat arms, to the war-fighters,” says Xenakis.