“Then they came for me—and there was no one left to speak for me.” [1]
A Certified Public Accountant (CPA) a Bioethicist, and a Doctor sat around talking about the current state of health care issues. The CPA discussed his view on the proposed reforms to the Affordable Care Act (ACA) while the Doctor discussed her concerns on the impact reforms would have on her patients’ ability to access healthcare. They turned to the Bioethicist and asked why I was silent. I paused before answering, and then asked where each of their associations stood on the proposed reforms. The CPA replied the American Institute of CPA’s (AICPA) had not released a statement or a position because it does not affect them. The mission of the AICPA is to develop standards for audits, provide education, develop and grade the CPA exam and monitor the technical and ethical standards. The Doctor acknowledged the CPA’s response with a nod and responded the American Medical Association (AMA) announced it rejects the current proposal to replace the ACA.
I took a moment, processed their words and began to talk. I am a member of various associations, two of which have taken a stance against the current administration’s proposed laws. I am also a member of the American Society for Bioethics and Humanities (ASBH). The ASBH upholds the right to academic freedom but is silent on where, as a professional society, we stand concerning the proposed legislation renewing torture, the pipeline access, degradation of women’s and LGBQT rights, as well as the travel ban. Craig Klugman, Ph.D. wrote a blog for the American Journal of Bioethics (AJOB) [2] asking, can the ASBH remain neutral? My immediate answer is no.
As laws and leaks roll out of this administration, I am reminded of Reverend Martin Niemoller’s quote entitled “First They Came For The Socialists.” Reverend Niemoller spent the last seven years of Nazi regime in concentration camps. Afterward, when he spoke about his resistance to the Nazis and his subsequent imprisonment in said concentration camps, he spoke with regret about not protecting the Jews. His role, as a Reverend, was to love unconditionally and to protect those who cannot protect themselves.
The ASBH, by its title, is responsible for safeguarding bioethics and humanities. As a member, it is my duty to protect those who cannot protect themselves and be a voice for those who may not be able to access the channels necessary to be heard. I am charged with the care of others. We can protect academic freedom but to exercise such freedom is to wield power we cannot ignore or vacate. To refuse to remain neutral while others are being disenfranchised ensures that we will not be alone when our intellectual freedom to uphold the right to access healthcare is threatened. Once a society lacks access to all of the basic human rights established by the United Nations and the World Health Organization, including the right to health, we will have failed in our duty to ensure beneficence, autonomy, justice, and non-maleficence as bioethicists.
Bioethics is based on the belief of encompassing all religions, cultures, and orientations. To fully understand a patient is to understand their ethics and morals while advocating in their best interest. It is not our job to judge or imbricate our morals on another. Our duty is to listen and provide guidance. It is also our obligation to act as surrogates for those whose voices are being snuffed.
Whether it’s through grassroots campaigns, overt refusal to carry out an order which betrays the rights of another, or speaking and writing about wrongs that are occurring, we have a duty to protect. As one of many, I believe it is my task to uphold the Four Principles of Bioethics set forth by Beauchamp and Childress. It would be irresponsible and inhumane to sit by and allow injustices to occur. Now, is the time to let our voices be heard and stand with those who stand to lose the most due to legislation limiting or removing their rights to access health, education, and financial opportunities.
References
1. Niemoller, Martin. “First They Came For The Socialists.” Accessed March 7, 2017, https://www.ushmm.org/wlc/en/article.php?ModuleId=10007392.
2. Klugman, Craig, Ph.D., “ Bioethics and the Problem of Silent Neutrality in the Age of Trump,” Bioethics.net, (blog), January 30, 2017, http://www.bioethics.net/2017/01/bioethics-and-the-problem-of-silent-neutrality-in-the-age-of-trump/