The Principle of Moral Proximity
AAEM PRESIDENT’S MESSAGE
Lisa A. Moreno, MD MS MSCR FAAEM FIFEM — President, AAEM
A
character in a novel I recently read learned that a colleague was making defamatory statements about a senior member of their profession who had not selected the colleague for an important committee. The statements were untrue and were damaging to the senior person’s reputation. Should she, the novel’s protagonist, confront her colleague, who was making these statements? Should she tell the person who was being gossiped about unfairly? What was her moral obligation? Is this her business? After the Allied Forces liberated the Schutzstaffel camps, allied soldiers were assigned to take local citizens on mandatory tours of the camps. The soldiers reported that many of the citizens cried, but some others held their heads high, with defiance in their eyes, and challenged the soldiers to blame or shame them. How, the soldiers wondered, could people have lived with the smell of burning human flesh, in a village where grey ash fell from the sky almost daily, and not have questioned what was going on in these camps? More proximal geographically and temporally, an American court will be considering whether Alex Kueng, Thomas Lane, and Tou Thao had a moral obligation to act to attempt to stop the murder of George Floyd by Derek Chauvin. Even more proximal are the daily questions that we are confronted with as emergency physicians. What is my obligation to treat the patients lingering at the border between Afghanistan and Pakistan, begging to enter Pakistan for necessary medical care? What is my obligation to treat patients in Haiti who have been struck by another earthquake? What is my obligation to act when my colleague has been terminated without due process and escorted out of the hospital by security staff and a Team Health executive? What is my obligation when the admitting team refuses to admit my homeless patient with second degree burns and no access to water, wound care materials, or transportation to the clinic? What is my
obligation to intercede when I hear a patient call a female resident “dumb bitch”? A colleague of mine who worked in a Pakistani refugee camp years ago told the story of a mother of six whose husband had died. She
his confession in this column before. Niemöller was a German Lutheran pastor and theologian born in Germany. In 1892, the Reverend was an anti-communist and so he supported Hitler’s rise to power. But he quickly realized the evil
THANK YOURSELF EACH DAY FOR THE WORK THAT YOU DO,
WITH THE HIGHEST LEVEL OF INTEGRITY, ETHICS, AND AUTHENTICITY, TO SERVE THOSE INDIVIDUALS WHO ARE FRIGHTENED, IN PAIN, AND IN THE MOST NEED OF HELP.”
had lost track of her extended family and his, due to migration during the political turmoil. She had no work skills and she and her children were facing starvation. A 60-year-old widower offered a bride price for the woman’s 12-year-old daughter that would allow her to feed her other five children for at least another three years. She sold her 12-year-old daughter. “How,” my friend asked, “could any mother condemn her little girl to that life? I don’t understand how a mother could do that to her own child.” “Indeed, you don’t understand,” I told her. “And I pray you never have to, but she chose to sacrifice one child to save five.” And then we discussed our moral responsibility to eliminate situations in which mothers are forced to make such decisions. We all know the words of the confession of the Reverend Martin Niemöller, and I have quoted
of Hitler’s plan. After the liberation of Dachau, where Niemöller was imprisoned, he wrote this confession: First, they came for the Communists, and I did not speak out— Because I was not a Communist. Then, they came for the socialists, and I did not speak out— Because I was not a socialist. Then they came for the trade unionists, and I did not speak out— Because I was not a trade unionist. Then they came for the Jews, and I did not speak out— Because I was not a Jew. Then they came for me—and there was no one left to speak for me.
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COMMON SENSE NOVEMBER/DECEMBER 2021
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