The sickle cell trait in relation to the training and assignment of duties in the armed forces: IV. Considerations and recommendations.

The main purpose of the military services is the defense of the country and, at time of war, the maintenance of an aggressive, efficient, and effective offense. The prevention of sickness and disability and the preservation of the health and safety of all troops at all times is necessary, not only for the sake of individuals as individuals, but also for the sake of the successful completion of military missions in the best possible manner with minimal chance of failure. Recruits should be selected, trained, and assigned to duties for which they are best qualified and excluded from special operations that, for them, are peculiarly hazardous. Military services cannot afford to take preventable risks. Major consideration should be given to the maximum good of the greatest number of citizens. Policies should be based on scientific facts. Based on facts that are now known, the author believes that individuals with the sickle cell trait (Hb AS) are at greater risk than those without the trait when engaged in military activities that regularly expose them to hypoxic environments or that require maximum stamina and endurance at the time of exhaustive muscular activities.