Can I refuse medical attention to a bigot?

Let me also note that the freight of words is affected by who speaks them. Patients – perhaps as a result of delirium associated with sepsis or certain neurological disorders – may not control their speech; People prone to coprolalia related to Tourette’s syndrome should not be denied medical treatment because what they say makes clinicians uncomfortable. And your patient? She had a drug addiction problem and used language that increasingly stigmatizes the user. She had no power over the clinicians who cared for her and whose decisions she was subject to. An indication of his lack of status is that your hospital’s risk managers have obviously decided that the facility can safely eject him without being held responsible for the consequences. Although they did not intend to impose a sentence that could have amounted to a death sentence, the risk managers did put the hospital before the patient.

The duties of health professionals are demanding. In times of war, a doctor may have the responsibility of saving the life of a wounded enemy soldier, even if the soldier has just killed one of that doctor’s friends. Fundamental clinical imperatives — evolved, collectively, over generations — should not be hastily set aside. Clinicians have duties of care to patients, even odious ones. And the more serious the likely consequences of denial of care, the greater the burdens they should be willing to accept.

My elderly mother started talking to a romantic scammer on social media a few months ago. He claims 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 – all her savings. Given the convoluted stories she told me, I have no doubt that this man is scamming her, and she and I fought to keep her talking to him. I love her, and it really upsets me that this man cheated her out of her money! Here’s the thing, though. She talks to him via internet chat twice a day, and it makes her really happy! She’s the happiest I’ve seen her in a long time. She’s had few friends in her life as well as disappointing romantic partners, and he’s someone she really enjoys talking to. Her savings are gone and I think she will continue to use her Social Security and retirement income to pay her bills. In other words, I don’t think she will give this man a lot of money in the future. Should I keep trying to persuade my mother to stop talking to this man, given that I think the “relationship” may end once the flow of money stops, and she may feel very sad about the end? Should I be concerned for her physical safety if she stops giving money to this man? Our fights are really bad, and she definitely prefers that I stop talking about it altogether. Masked name

A lot to been published on romance scams, including by law enforcement, and I don’t see that, in the usual course of things, its victims are in physical danger – scammers often live in another hemisphere, for one thing . (You can 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 sorrow to come for your mother.

You did what you could do. You have repeatedly pointed out the problem; you’ve warned her that her relationship rewards are based on a lie, and you’ve no doubt told her about the proliferation of such scams. She doesn’t want to talk about it anymore. At this point, I don’t see what other choice you have than to leave her alone. As long as your mother remains competent, it’s up to her to manage her relationship with this man. There is the minor reassurance that, as you indicated, the only permanent risk is continued loss of relatively small sums of money, and she has enough to live on. It’s painful to see someone you love being taken advantage of, but you can’t lead your life in their place.

To submit a request: email [email protected]; or mail 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”.