In this commentary we argue that medical ethics has a key role in discussing the effects of conflicts and other violent human rights abuses. Contemporary medical ethics is an emerging academic discipline without clearly defined boundaries and we have no desire to impose them. We are seeking instead to indicate the kinds of issues that naturally and ordinarily arise within its purview. Recent history has seen a closer relationship and interdependency between medicine and the state. This has led, at times, to tension between professional obligations and state interests. Many would prefer medical ethics to step aside from sectarian politics and focus on the doctor-patient relationship and the objective and neutral medical sciences that underpin it. However, given the role that social inequities play in health outcomes, doctors have been obliged to speak out against such inequities or even against state practices which directly contribute to poor health. For those committed to the impartial practice of medicine, and to the promotion of human wellbeing, silence during times of conflict is seldom an option