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 to her and to whose decisions she was subject. One indication of her lack of status is that your hospital’s risk managers evidently decided that the institution could safely eject her without being held accountable for the consequences. Though they didn’t intend to mete out a punishment that might have amounted 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 can have the responsibility of saving the life of a wounded enemy soldier, even if the soldier has just killed one of that medic’s friends. The fundamental clinical imperatives — evolved, collectively, over generations — shouldn’t be hastily set aside. Clinicians have duties of care to patients, even odious ones. And the more serious the likely consequences of refusing care, the larger the burdens they should be willing to accept. My elderly mother began 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 her 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 fought about her continuing to talk to him. 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” may end 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 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 F.B.I. if you want further guidance.) But the financial and the 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 do. You have repeatedly pointed out the problem; you’ve warned her that the rewards of her relationship are predicated on a lie, and you no doubt have told her about the proliferation of such scams. She doesn’t want to go on talking about it. At this point, I don’t see what choice you have other than to let her be. As long as your mother remains competent, it’s up to her to manage her dealings with this man. There’s the minor solace that, as you indicate, the only ongoing risk is a continuing loss of relatively small sums of money, and she has 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 [email protected]; or send mail to The Ethicist, The New York Times Magazine, 620 Eighth Avenue, New York, N.Y. 10018. (Include a daytime phone number.) Kwame Anthony Appiah teaches philosophy at N.Y.U. His books include “Cosmopolitanism,” “The Honor Code” and “The Lies That Bind: Rethinking Identity.” Also note that the fare for words is affected by who is speaking. Patients may have uncontrolled speech, probably as a result of delirium or certain neuropathy associated with sepsis. People who are the target of coprolalia associated with Tourette’s Syndrome should not be denied treatment because their words make clinicians uncomfortable. And your patient? She has problems with drug use and language, which is increasingly
stigmatizing users. She accompanied her and had no power over the clinician she had decided on. One symptom of her lack of status is that the risk manager at your hospital has clearly determined that the facility can safely discharge her without being held accountable for her consequences. They did not intend to defeat the punishment that might correspond to the death penalty, but risk managers effectively placed the hospital in front of the patient. The duty of medical professionals is
strict. During the war, doctors can take responsibility for saving the lives of injured enemy soldiers, even if the soldier just killed one of his doctor’s friends. Basic clinical obligations that have evolved over generations should not be set aside in a hurry. Clinicians have a duty of care to patients, even nasty patients. And the more serious the possible consequences of refusing care, the greater the burden they are willing to accept. My older mother started talking to romance scammers on social media a few months ago. He claimed to be building a bridge in South America and demanded her money to support her project. She gave him tens of thousands of dollars — her overall savings. Given the complex story she told me, I’m sure this guy is scamming her, and she and I fought about her continuing to talk to him. I love her, and it really upsets me that this guy cheated her money! However, this is a problem. She talks to him in internet chat twice a day, and it really makes her happy! She is the happiest I have met her for a long time. She had few friends in her lifetime and was disappointed by her romantic partner. This is the one she really enjoys talking to. Her savings are gone and she will continue to pay her invoices using her social security and her pension income. So I don’t think she will give this guy a lot of money in the future. Should I continue to convince her mother to stop talking to this guy, as I think the “relationship” ends when the flow of money stops and she may be very sad at the end? Should I worry about her physical safety if she stops giving money to this guy? Our argument is really bad, and she definitely likes to stop talking about it altogether. Tax withholding name We have a lot Although publicly disclosed about romance scams, including law enforcement agencies, I don’t think the victim is at physical risk in the normal course of the process. For example, scammers often live in different hemispheres. (If you need further guidance, you can contact the FBI.) However, financial and emotional accusations are very realistic. When the money stops, of course, the scammers go on. Your mother has a broken heart. You have done what you can. You have repeatedly pointed out the problem. You warned her that the rewards for her relationship were based on her lies, and you definitely told her about the spread of such scams. She doesn’t want to keep talking about it. At this point, she doesn’t know what options she has other than leaving it to her. As long as your mom is competent, it’s up to you to manage the deal with this man. As you show, the only ongoing risk is the continued loss of a relatively small amount of money, with the minor comfort that she is sufficient to survive. It’s hard to see someone you love being exploited, but you can’t live her life for her. To send a query: Send an email to [email protected] Alternatively, send an email to The Ethicist, The New York Times Magazine, 620 Eighth Avenue, New York, NY 10018. Kwame Anthony Appiah (including daytime phone numbers) teaches philosophy at NYU. And “Binding Lies: Rethinking Identity”. Source link |
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