Can I Withhold Medical Care From a Bigot?

Let me note, too, that the freight of words is affected by who’s speaking them. Patients – perhaps as a result of sepsis-associated delirium or certain neurological disorders – may not be in control of their speech; People who are subject to Tourette-syndrome-related coprolalia should not be denied medical treatment because their words make clinicians uncomfortable. And your patient? She had a problem with substance use and employed language that is, increasingly, stigmatizing of the user. She had no power over the clinicians who attended her and to whose decisions she was subject. One indication of his or her status is that your hospital’s risk managers apparently decided that the institution could safely be ejected without being accountable for the consequences. Although they did not intend to provide a punishment that may amount to a death sentence, the risk managers effectively put the hospital ahead of the patient.

The duties of medical professionals are demanding. In wartime, a medic may have the responsibility of saving the life of an injured enemy soldier, even if the soldier has just killed one of that medic’s friends. The fundamental clinical imperatives – evolved, collectively, over generations – should not be set aside. Clinicians have duties to care for patients, even odious ones. And the more serious the consequences of refusing care, the larger the burdens they should be willing to accept.

My elderly mother started talking to a romance scammer on social media a few months ago. He claims to be building a bridge in South America and has asked him for money to support the project. She has given him tens of thousands of dollars – her entire savings. Given the convoluted stories she has told me, I have no doubt this man is scamming her, and she and I have continued to talk to her about it. I love her, and it really upsets me that this man defrauded her of her money! Here is the thing, though. She talks to him via internet chat twice a day, and it genuinely makes her happy! She is the happiest I’ve seen her in a long time. She has had few friends over her life as well as disappointing romantic partners, and this is someone she actually enjoys talking to. Her savings are gone, and I think she will continue to use her Social Security and pension income to pay her bills. That is, I don’t think she will give this man much money in the future. Should I keep trying to persuade my mom to stop talking to this man, given that I think the “relationship” might end up once the money flow stops, and she may feel very sad about the ending? Should I be worried about her physical safety if she stops giving this man money? Our arguments are really bad, and she definitely prefers I stop talking about it altogether. Name Withheld

A lot has There have been published about romance scams, including by law enforcement, and I don’t see that in the usual course of things, its victims are in physical danger – the scammers often live in another hemisphere, for one thing. (You could contact the FBI if you want further guidance.) But the financial and emotional depredations are very real. Once the money stops, naturally, the scammers move on. There will be heartbreak ahead for your mother.

You ‘ve done what you can. You have repeatedly pointed out the problem; You have warned her that the rewards of her relationship are predicated on a lie, and you have no doubt told her about the proliferation of such scams. She doesn’t want to go on talking about it. At this point, I do not see what choice you have other than her. As long as your mother is currently competent, it will up her to manage her dealings with this man. There is a slight solace that, as you travel, the only ongoing risk is the continued loss of small sums of money, and that is enough to live on. It’s painful to watch someone you love being exploited, but you can’t lead her life for her.


To submit a query: Send an email to ethicist@nytimes.com; Or send mail to The Ethicist, The New York Times Magazine, 620 Eighth Avenue, New York, NY 10018. (Include a daytime phone number.) Kwame Anthony Appiah teaches philosophy at NYU His books include “Cosmopolitanism,” “The Honor Code” and “The Lies That Bind: Rethinking Identity.”

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