Should ambulance paramedics save drink-driver accident victims?
A friend of mine recently became an ambulance paramedic. He’s a devout Muslim and very involved in interfaith work here. I asked him if his experiences as a paramedic influenced his religious thinking and views of life in general. What he shared was very beautiful.
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Drink-drivers who meet with accidents gave him the most moral-emotional struggles. To him, drink-driving is one of the most stupid and irresponsible things a person can do. When an accident happens, the drink-driver almost always is the cause of it, and is responsible for his own sorry plight.
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Yet, as an ambulance paramedic, he does his very best to help and treat and save the drink-driver accident “victim”.
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These experiences, he says, has changed his mindset and taught him that what a person does and deserves, can and often should be separated from how we treat him. Just because the person did something really wrong, and landed himself in huge trouble, doesn’t mean that we should let him suffer and die.
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It is the plight of the accident victim that determines how the ambulance paramedic should behave, not what the ambulance paramedic thinks of the victim’s actions and responsibilities
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I thought that was so beautiful.
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Society has little compassion for conditions like HIV. Why should we subsidise their treatments when they got infected through their promiscuity? Through irresponsible behavior? These are common responses.
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Or when a teenager becomes the victim of sexual abuse because she put herself at risk or was careless, how many people have been unsympathetic, saying that she deserved it?
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How would you feel if you were in an accident and the ambulance paramedic didn’t help you because he thought you put yourself at risk by jaywalking?
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How would you feel if you had a heart attack and the hospitals didn’t treat you or took away the 80% Class C subsidy, because you were a huge char kway teow or laksa fan?
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Why do we continue to subsidise people who smoke and people who don’ t exercise?
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Because who are we to judge? Who are we to pronounce the death sentence on someone? Like the ambulance paramedic, it is not our place to judge and to punish. We help because we can, because we ought to, because they need it. At least I think, that’s our role as human beings.
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Very beautiful indeed. It knocked some sense into me.
That’s a good and unselfish thought. That should ideally govern how we as human beings think and behave.
But unfortunately our leaders seems to be more concerned that they themselves be treated as more deserving to be paid adequately (or obscenely) as opposed to treating those unfortunate fellow Singaporeans as very much less deserving than themselves.
That is how hypocritical we as human beings can behave.
I hope your paramedic friend does not have such doubts, else he should quit
Forget what I said: I misread the post. with the proper light I understand what you are saying…
But to me this is so obvious: I wonder why anyone would ask themselves this… and of course I do not understand what religion has to do with this.
i put in the religious angle because most of the objections/condemnations of “immoral people” who land themselves into trouble these days seem to come from a religious/moral angle.
Sometimes it’s easy to see how the religious people are saying it out of deep prejudices eg. Haiti deserves the earthquake because of voodoo practices (some fundies claim)
At other times, the religious/up-righteous moralist have claimed that gays and people who had casual sex or visited prostitutes should not get help for their STI/HIV treatments. In a sense they are right —- many of these patients/victims could have prevented themselves from being in those positions by not engaging in risky behavior. Yet, does that mean we should deny them of help and treatment later?
It’s the whole “sin, therefore suffering as a punishment, therefore you shouldn’t be helped” philosophy that seems to be very common amongst a lot of “staunch” religious /moralistic people. And I’m hoping to offer another perspective to these people. Hmmmm i think i’ve to improve on my writing skills……….. = )
Hmmm actually i asked my friend that question about how being a paramedic influenced his religious/life views for 2 reasons:
1. we were at an inter-faith dialogue event
2. working so closely to the boundaries of life and death often affected people’s religious/life views in some ways
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Mathia Lee,
I agree with you completely. Just that there are people ahead of HIV patients – e.g. kidney patients who are means tested and squeezed for the last cent, children with congenital defects, special needs children…even old folks in need of nursing homes families are means tested and some have to pay 30-40% of their family income on nursing homes.
Who comes first, who come second? The govt has to spend money to buy military equipment to keep us safe so there isn’t enough for all.
Joe Lee
I think the “money not enough” is a myth. If Sg as one of the top GDP per cap in the world can’t afford it, then who else can?
Bear in mind Thailand with significantly lower GDP per cap and much much more HIV+ people can subsidise to $100-200 a month, plus can subsidise the S’poreans who go there to get the drugs too! Can you imagine? S’poreans have to be subsidised by the Thais?
It’s like you kenna knock down, and the S’pore ambulance will not help you cos you jaywalked, and you have to wait for the JB ambulance to come instead!
National Shame!
Mathia Lee,
The situation like this. The Thais said heck with big pharma years ago because they couldn’t afford those AIDS medicine which they knew could be made for $1 but sold for $300 – the Americans need to recoup the money which the spent on research even if it means squeezing a 3rd world country. So the Thais went ahead to manufacture generics that violated patents and so on. A Thai life is worth something…
In Singapore the situation is different, we export billions in pharma manufactured in Singapore, The govt cannot afford to offend them otherwise they will run off with their FDI to somewhere else.
Singaporeans should be thankful that we have the Thais as neighbors. I heard some Singaporeans go to JB for dental treatment because it is cheaper. ..and our health minister said parking our old in JB nursing homes is a viable solution.
I think the problem with Singapore is Singaporeans can’t afford to live in their own country especially the sick, old and disadvantaged.
There is a big picture to your little story and on National Day when the roll out those new F15 fighters bought with billions in tax payers money – you will know where the tradeoff have been made.
You know what i find really disgusting and shameful about the whole situation?
We don’t even have to start talking about defense budget where some people say we need to keep our country safe.
When you walk down orchard road, you can find an LV store every 100 meters, in almost every shopping center next to each other.
A country where LV stores are as common as MacDonalds and 7-Elevens cannot afford to finance HIV treatments?!?!?!
Mathia Lee,
LVs? Merc, Lexus and every luxury – thanks to our income gap and laissez-faire low tax every man for himself – get rich quick society. How do western govts take care of the less fortunate – they tax the rich surely they can afford to buy one LV bag less, ….
In our system the govt is as allegic to taxing the rich as it is to helping the poor & sick. But even without asking the rich to spend less on LV, there is enough money collected to routinlely lose billions here and there investing in high risk companies. The interest earned on our reserves is enough to save lives.
The govt has to learn that they cannot lose when they are helping Singaporeans.
What is going to bring about change in this country? To right the wrongs?
Mathia Lee, are you willing to wait forever for change?
sigh, Joe Lee, everyday i ask myself the same question ” What is going to bring about change in this country? ” and how can i contribute to this change……
Mathia, you said “how can i contribute to this change……”
I thought you recently attended a conference on liberal democracy. Does that model offer any hope for us? Or is our authoritarian capitalism going to take us to greater heights of human progress? There is nothing new in Singapore about letting the poor & sick fend for themselves….our economic progress seem to have vindicated our model as western govts fell into the potholes of welfarism.
Joe Lee,
I do think that the liberal democracy would enhance the justice and equality here, and consequently bring about more happiness, prosperity and progress for our nation.
Unfortunately, the large majority of the electorate doesn’t know/want such a system, and it would be against all the ideals of liberal democracy to force such a system on an unwilling electorate
I think if Singaporeans spent a little less time on getting their examinations As, and spent a little more time reading publications from outside of Singapore, perhaps mindsets would change
I really have no idea how to bring about all this change….
“as western govts fell into the potholes of welfarism.”
I have to disagree with this. I think the “failure” of welfarism is a myth perpetuated by those who disagree with such a model for various reasons. If you look at world GDP, health status, crime rates etc indicators of success, you will find that the best performing nations all have some form of welfare system and the opposite is true for those performing poorly.
To a large extent, Singapore’s success has been built on this sort of “Welfarism” too, even if it is not explicitly state.
In the early days of independance, our govt built schools and made them very affordable so that everyone has an equal chance — that’s one of the characteristics of welfarism. Over the years, private tuition became popular, and that was only available to the rich. In this way, the playing field is no longer level.
In the early days, housing was deliberately made affordable so that people can move from kampungs to proper housing. These days, the “affordable housing” has become corporatised and benchmarked to private property prices. Of course people will have to move back to “kampungs” along the beach.
In the early days, health care was very cheap and affordable , and we managed to wipe out alot of diseases. These days, many doctors have come out to private practice, and the quality of care between cheap and private healthcare seems to be perceptibly different. Look at all the other STIs that we’ve been treating ovet the last few decades —- they are all treated very very cheaply at our DSC clinic. But HIV that came to Sg in the mid 80s was given a different treatment.
These are only some obvious examples of how we have slowly made the playing field uneven and more advantages to those born more privilleged. The disadvantaged people grow more disadvantaged through the years.
In the West, IMO, welfarist states are facing difficulties, NOT because of their welfarist idealogies, but because of their cut-off points. Meaning, from which point onwards of poverty level do you start subsidising, and from which point onwards of wealth do you start taxing?
For eg. In the past, when life expectency was 70 yrs old, you can give welfare to everyone above 60. Now that people are living until 90, and fit and healthy into their 70s and 80s, perhaps it is time to raise the welfare bar to 75yrs and above. Keeping the cut-off at 60 will not be financially sustainable anymore. I think the welfarist states are at the point where they need to relook these cut-off points.
One might think it sounds cruel to only start welfare at 75yrs. But bear in mind, everyone has almost equal access to healthcare and medication that can keep them alert, agile and healthy even at 70++ when in the past, it wasn’t possible. Preventive medicine is very accessible —- many health screening programmes there are free. Alot of them can afford to detect and treat illnesses at the earliest stage when it is easy to be cured. In Singapore, by contrast, most old folks have the notion that they should see the doctor only when the pain is unbearable so that they don’t spend money excessively at the doctors’. Unfortunately, by the time the pain is unbearable, it is the advanced stage of the disease, and very difficult to treat. And so our 70++ year olds are less healthy and require more help than those in welfarist states.
I was just contemplating on the decline of equal opportunities in Singapore. I think a fair number of people have also noticed that and have also mentioned the reason, which i quite agree with and will describe here:
In the early days of independance, most of Singaporeans were not well educated and poor. Most would have seen the effects of an unequal society when the colonial masters were here.
When these S’poreans from humble backgrounds became policy makers, they understood the need for leveling the playing field, and they gave people chances. My dad’s case actually is one of the many examples. He got hired despite not having the certificates, because the company decided to have a mass abilities-testing exercise, rather than simply looking at grades, which is unthinkable today. The rationale then , was that basing the hiring on grades would miss a lot of talent who did not have the certs because they did not have the opportunities.
Later on, these changed. Scholarships were given based on grades. Grades often depended on how good your tuition teacher was. And the richer you were, the more and better tuition teachers you could afford. Streaming in schools also limited the students’ exposure to other kinds of students. Those at the top never knew how had the situation was at the bottom, and these were the ones who made the policies. Policies are therefore made on misleading views and assumptions of society. As a result, policies were made to benefit the people at the top, because they didn’t even know what it was like to be at the bottom.
On the other hand those at the bottom only knew the ways and lives of the people at the bottom, and had no chance to learn from the successful ones. Over generations, this effect would only amplify itself. If there was one policy i’ll really like to see changed, it’s the streaming policy.
I know some of the so-called elite would be reading this and vehemently protesting that they care.
I have no-doubt that some of this elite care. Given the opportunities and privilleges that i’ve been given in life, I would probably be labelled thus too, and I’ll like to think I care.
But sometimes, caring is not enough, because we will never know what it really feels like without walking in those shoes. Doing voluntary work and believing that you know something is really very different from actually being there. And i don’t think I really know at all too………….
“because these schools tend to cultivate liberal attitudes, they leave their students in the paradoxical position of wanting to advocate on behalf of the working class while being unable to hold a simple conversation with anyone in it”
—http://http://www.theamericanscholar.org/the-disadvantages-of-an-elite-education/
:::I know some of the so-called elite would be reading this and vehemently protesting that they care:::
There is a difference between having elites in our society and elitism. Some as intelligent as yourself, phd material and all that will stand out as an elite and naturally we will have some people who are born stronger and smarter than others and by definition become the elites in our society. Elitism is another thing altogether. It is the believe that only the elites matter in our society and because they believe they are all that matter , they deserve disproportionate rewards.
For elitism we don’t have to look further than the so-called leaders who rule this little island. While they rewarded themselves with million$ salaries, they refuse (recently) $30 for women to get mammograms. Subsidies for AIDS patients. They debated at length about a $30 increase for people on Public Assistance saying it might discourage them from working when in fact most of them cannot work. We have elderly who have to sell tissue paper to survive or work as cleaners. But the elites in govt actually have free medical care, old age pension and other privileges. They believe they deserve it….it is elitism when they believe the rest of us deserve no safety net when sick, unemployed or have children with special needs.
Yeh i think that’s a good point & reminder….. there is a difference between having elites and elitism……
Although i think everyone is an elite in one way or another. Just looking at my own FB friends, if I rank base on grades, I get one list. If i rank based on looks, i get another list. If I rank based on EQ, the list again is different. 90% of my FB friends is an elite in his/her own special way, and the 10% left is because those are strangers i don’t reallly know…………
It’s very sad and ridiculous to say that increasing public asssitance would discourage people from working, when so many people don’t even have anymore free hours to convert into working hours!
I think this word “reward” actually needs to be used more carefully by our society. THere’s a difference between “reward” and “development funds”.
I agree, if you are paying your employees bonus, you should reward based on merit, and give it to the top performers.
But imagine a company who considers training opportunities as “Reward”, and give training “rewards” to the top performers???? The company will end up having the top performers get better and better (or maybe not, if they are so good that the training is useless), and the poor performers will always be lousy and never improve, because they are not being trained!!!! It’s very common sense and intuitive to give extra training to the poor performers, and less to the top, even tho’ bonuses are given the other way around!
Yet when we look at our education system, we see this very illogical “reward” system happening.
The top performers (i’m not even talking about tertiary education) are given the best resources. Compare the school facilities in RI, RGS, with any neighbourhood school with Normal Tech stream.
When I used to give science workshops to secondary schools, I noticed that in the “elite schools” , the labs are air-conned, with microphone. All the students can concentrate and pay attention.
In the “neighbour hood schools”, the labs are large but not-airconned so it is hot and sweaty. The noise level outside distracts everyone. THere is no microphone so I have to yell, and even then, the back row cannot hear properly, so they stop paying attention. Everyone is in a lousy mood , and the teacher teaches the bare minimum.
Notice also, that the elite schools get overseas programmes, all kinds of creative classes and opportunities. THe neighbourhood schools don’t. Why? Because we have this cultural mindset where, if you can’t even pass your exams, you shouldn’t waste time on all this other extra activities. Only those who can cope very well and will be tomorrows leaders have the time and is worth spending the extra money on, to do all this extra activities.
So if you compare 2 students, one poor one rich, with equal intelligence. The rich one gets tuition, and so scores better, and gets into the elite school. In the elite school, the learning environment is more condusive and he improves even further. Then he gets all the extra enrichment classes which makes him way way ahead of his poor counterpart.
How much talent in Singapore are we wasting, because we’ve decided that the top performers need more and better training than the poor performers???
Two differences between the assistance provided by a paramedic and HIV – the duration where treatment is required, and the cost of treatment.
When a paramedic provides assistance, it is in an emergency, and over a short period of time. He does not bear any concern over the cost of immediate treatment or long-term treatment, as that is not his responsibility. His responsibility is in the professionalism of the service provided to alleviate the emergency condition. If the emergency condition becomes chronic, the family and other supporting structures (insurance, etc) fall into place to fund the treatments.
HIV differs in the chronic and non-emergency identification of the condition. If there are emergency conditions associated with the patient (pneumonia, heart failure, etc), emergency services and treatment are in place to care for the physical condition. Service providers in this realm need only perform their duties with professionalism. The chronic nature of HIV and drug cocktails are more similar in nature to organ failure cases (eg. renal failure), where not-for-profits assist cases by collecting community funds (through charity).
Where there are cut-off points in society, the role of individual responsibility is set-off against penalties borne by the community. I feel no need for public funds to be expended on the consequences of promiscuity that is willfully entered into by irresponsible individuals. If anything, financial counselling and personal responsibility for each person’s life comes foremost.
HIV not-for-profits are free to collect charity funds from supporters in the public, and to finance overseas treatment (if cheaper) rather than ruin Singapore’s interest in the global marketplace by infringing intellectual property rights. HIV not-for-profits are also fully able to fund and develop generic treatments for HIV patients, rather than rely on pharma corporations to develop the drugs.
Hey Dog,
Just curious: Do you think that the subsidies currently offered to other chronic conditions should be removed? I am specifically referring to conditions where a person’s behavior and choices has a large influence eg. stroke, heart failure, smoking-related cancers. If so , why; if not, why also?
The drunk driver will receive punishment by the law, HIV patients doesn’t, that’s the difference.
It is not shocking or specially touching when a medical worker gave his best to treat a injured drink-driver. His profession is to save lives, it will be horrendous if the work of a medical professional is interfered by the thought to evaluate if the victim is attracting the illness/injury to himself.
I expect a medical professional to be free from any mental struggle when he attend to drink-driver, a HIV patient, a hooker with STD, etc.
Debbie,
THat’s a very interesting concept you’re implying here: that there is a difference between the way a medical professional should treat a patient vs how society should treat a patient (sorry and correct me if i misundersttod please)
A medical professional should not be taking into consideration the moral dimension of the person’s responsibility in bringing about his/her condition, and treat strictly based on severity of the medical condition.
Society on the other hand, should make this distinction, and punish errant behavior (THat brings up another question : Drunk drivers are punished regardless of whether they cause accidents or not ; should promiscuous people be punished even if they do not contract/pass on STIs, and if so, would there be different degrees of punishment for different degrees of promiscuity?)
Have I understood your rationale thus far?
So then my question:
If I were a qualified medical professional, I would be professionally obligated to treat the HIV patient to the best of my ability and the best of treatment options medically available.
If my patient cannot afford it, am I obliged to waive my fees? Am I obliged to help him find financial help? Very importantly, am I obliged to campaign for State-subsidised treatments if most of the HIV-deaths under my care were premature due to financial unaffordability?
It’s not surprise then, that HIV -medical-specialists are at the forefront of the campaign for HIV-subsidises here.
What if I were a medical professional who does not see patients, but is instead a health-policy maker?
Am I , and should I , be under that Hippocratic Oath too?
If I am under that Hippocratic Oath, am I obliged to make policies for State-subsidies, and ensure zero pre-mature HIV-deaths due to unaffordable medication?
If health-policy makers are NOT under the Hippocratic Oath, am I free to cloud my policy-making with my own private moral prejudices, religious beliefs etc? Am I free to make judgements on patients that doctors and ambulance paramedics are not allowed to judge upon?
What is the difference between dispensing life-saving medicine, and life-saving money?
Finally, following this line of argument, is it appropriate to have Health Cabinet Ministers who are not under the Hippocratic Oath because they are not medically trained or qualified?
Mathia
The medical professional on duty should do this best to save lives.
When he is off duty, he is part of the society, what he think and feel about drink drivers or HIV patients is very much subjective, he can form any kind of opinion based on his precept.