“One Who Becomes Compassionate to the Cruel will Ultimately Become Cruel to the Compassionate”: Should Terrorists be given Medical Treatment?
This is the ethical issue that has, as yet, not been fully answered by international law or by consensus ethics. And yet the issue is certainly not hypothetical. If the journal is available to you, you must read the Target Article in the American Journal of Bioethics, October 2009 titled “Medical Care for Terrorists—To Treat or Not to Treat” by Gesundheit, Ash, Blazer and Rivkind. (It is followed by a series of comment articles by other ethicists). In the article, the authors, from Hadassah University Hospital (G, R), Rambaum Medical Center(B) and Israeli Defense Forces (A) present two cases for discussion, both Hamas terrorists, both severely injured and both given immediate and extensive medical and surgical treatment in the Israeli hospitals over 20 days and a year respectively with the costs borne by the hospitals.
The physicians and caregivers provided excellent management despite whatever their own feelings or views were regarding what these terrorists had already done to the public. The ethical principles of autonomy, beneficence and non-maleficence was observed and practiced in the care of these men. An ethical question which might now be raised is whether the fourth principle of justice was observed. In the triage of these critically ill terrorists to provide emergency management, there were other patients, civilians, who needed prompt attention for whom attention to them may have been delayed. Also, in terms of justice, shouldn’t the great financial cost of caring for both terrorists have been used instead to the care of non-terrorist sick civilians? There may be a debate as to the definition of “terrorist” and some may say that they were simply “criminals” but wouldn’t the indiscriminate killing of civilians for no specific purpose but only to terrorize the population be an adequate description. Both terrorists when recovered were handed over to the government, tried and convicted.
So should all the humanistic, professional and ethical standards which physicians take from their Hippocratic Oath and their profession be set aside when it comes to medical care for a terrorist? And should the medical profession bear in mind what was written in the Ecclesiastes Rabba 7:16 “One who becomes compassionate to the cruel will ultimately become cruel to the compassionate”?
What do you think? ..Maurice.
posted by Maurice Bernstein, M.D. @ 4:18:00 PM
3 comments
3 Comments:
Should any of these doctors provide medical care to the Israeli soldiers who fired white phosphorous on schoolkids in Gaza? Should doctors provide medical care to American soldiers who committed war crimes in Iraq?
There is as saying that terrorism is the poor man's war, and war is the rich man's terrorism. The idea that one way of (mass) killing people is morally justified and the other not is specious at best. I am not trying to make a political point here, I am merely trying to illustrate that there is no universal consensus on what constitutes moral or justifiable behavior, particularly when that behavior violates the norms of ordinary human conduct--such as killing people in war.
There is a great danger whenever doctors try to play moral judge and jury over their patient's real or perceived character, behavior and motivations. When doctors can decide on the basis of personal prejudice who to treat and who to let suffer and even die, where is the morality in that? It amounts to extra-judicial punishment where the accused is granted no opportunity to defend himself. Under these circumstances, the doctor is in danger of becoming an executioner, rather than a healer. I would think that a truly ethical physician, who if he is a scientist would of necessity be wary of the limitations of personal prejudice and speculation, would prefer to remain ethically neutral about his patients. I know I would.
Unfortunatley, this is not the case with the way people with chronic pain are treated in the US. Too many doctors seem quite comfortable playing the role of judge of the morals of their patients, and cp'ers who fail to prove themselves somehow "worthy" of pain relief and that they are not some evil malingerer or drug seeker can and will be denied treatment. It is interesting that there is a widespread public debate over the torture of terrorist suspects in the US, as well there should be, but the debate over the abuse of chronic pain patients in anything but mainstream.
This issue of treating a "terrorist" or anyone who is suspected or known to have perpetrated a criminal act currently applies to the alleged Fort Hood military base shooter, Dr. Nidal Malik Hasan. How do the doctors and nurses in the Brooke Army Hospital in Texas feel about their work of preserving the life of Dr. Hasan? ..Maurice.
One of the main values that separates terrorist culture from humanistic culture is the value of human life. Every human life has a value. It's value isn't based upon the behavior of the individual, but upon the intrinsic nature of what it means to be human. Thus, the ethical response is to treat criminals and terrorists regardless of how we feel about them personally. Otherwise, we become more and more like them.
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