Can I refuse medical care from a bigotry?

I would also like to note that the value of words is influenced by the person who is speaking them. The patient – possibly due to sepsis-related delirium or certain neurological disorders – may be unable to control his or her speech; People with Tourette syndrome-associated coprolalia should not be denied medical treatment because their words upset the clinician. And your patient? She has a problem with substance use and uses increasingly discriminatory language. She has no power over the doctors who have watched her and whose decisions are subject to her. One sign that she’s disqualified is that your hospital’s risk managers have clearly decided that the institute can safely kick her out without being held accountable for the consequences. While they do not intend to implement a penalty that could amount to the death penalty, risk managers have effectively put the hospital in front of the patient.

The duties of medical professionals are demanding. In wartime, a medic may be responsible for saving the life of an injured enemy soldier, even if that soldier has just killed one of the medic’s friends. The basic clinical imperatives – developed, in general, over generations – should not be hasty. Clinicians have a duty to take care of patients, even the ugly ones. And the more severe the consequences of refusing care, the more willing they are to accept the burden.

My mom started talking to a social media scammer a few months ago. He claimed to be building a bridge in South America and asked her for money to support the project. She gave him tens of thousands of dollars – her entire savings. With the complicated stories she told me, I had no doubt this man was scamming her, and she and I fought about her continuing to talk to him. I love her, and I’m really confused that this man has scammed her money! Here’s the thing, though. She talks to him via internet chat twice a day, and it really makes her happy! She is the happiest person I have met her in a long time. She has had few friends in her life as well as disappointing romantic partners, and this is someone she really enjoys talking to. Her savings have run out, and I think she will continue to use Social Security and her 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 convince my mom to stop talking to this man, because I think the “relationship” might end when the money stops and she might feel very sad about the ending? Should I worry about her physical safety if she stops giving this man money? Our arguments were really bad, and she definitely wanted me to stop talking about it altogether. Name withheld

Lots of yes romance scams have been published, including by law enforcement, and I don’t see that, in common sense, its victims are in physical danger – scammers often live in the other hemisphere, for a reason. (You can contact the FBI if you want more guidance.) But the financial and emotional fallout is very real. Once the money stopped, naturally, the scammers continued. There will be heartbreak ahead for your mother.

You did what you could. You have repeatedly pointed out the problem; You warned her that her relationship rewards were predicted based on lies, and you certainly told her about the proliferation of such scams. She didn’t want to keep talking about it. At this point, I don’t see you having a choice but to let her be. As long as your mother remains competent, it is up to her to manage her dealings with this man. There is little consolation that, as you have pointed out, the only risk going on is to continue to lose a relatively small amount of money and she has enough to live on. It hurts to see the person you love being taken advantage of, but you can’t spend your life for her.

To submit a query: Send an email to [email protected]; or write to The Ethicist, The New York Times Magazine, 620 Eighth Avenue, New York, NY 10018. (Include daytime phone numbers.) Kwame Anthony Appiah teaches philosophy at NYU His books include “Cosmopolitanism” , “The Honor Code” and “The Binding Lie: Rethinking Identity.”

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