Déjà Vu: In D.C., It’s The Brooklyn EMTs All Over Again. How Can This Happen Even Once?

"Hey, I'm ready! Just go through the proper channels, and I'm On it! You can count on me!"

“Hey, I’m ready! Just go through the proper channels, and I’m On it! You can count on me!”

I guess it’s a sign of longevity that some ethics stories are recurring so exactly that I can handle them with previous posts. I never wanted to see this one repeat, however.

In 2004, two EMT’s let a pregnant woman die in front of them without offering aid, because they were on a break and wouldn’t abandon their coffee and bagels to save a mother and her unborn child. (They were suspended and yet kept their jobs.) Over the weekend, in Washington, D.C., a 77-year-old man, Medric Cecil Mills, collapsed across the street from a fire station. The man’s daughter ran across the street to seek help, and the firefighter she spoke to explained that he couldn’t respond until being dispatched and instructed her to call 911. The man died.

[A black humor note: when 911 was called and a rescue vehicle dispatched, it went to the wrong address.]

As in Brooklyn four years ago, there are the usual condemnations from city officials, and apologies from the mayor, and promises of investigations and system changes. The fact is, however, that a man is dead who might not be if another human being’s ethics alarms even twitched. Pedro Ribeiro, the D.C.mayor’s spokesman noted that if there is some rescue protocol requiring dispatch before help can rendered be rendered by a qualified rescuer on the scene, “then protocol be damned.” Of course. Why didn’t that occur to the firefighter in question? Why don’t the ethics alarms go off?

So here is what I wrote in the wake of the Brooklyn EMT’s betrayal, and it applies with equal force, indeed exactly, now. I can’t think of anything to add. It doesn’t take an ethicist to figure out that what happened to Mr. Mills should never happen at all in an ethical society. The point of inquiry has to be how it can happen at all:

The astounding indifference to both human life and their duties displayed by the EMTs in yesterday’s incident in Brooklyn relates directly to the title of this blog. Why…why…didn’t their ethics alarms go off when they knew that a young, pregnant woman was fighting for her life a few yards away? What could have dulled their senses of duty and humanity, disabled them, to this extent? 

This isn’t like the Mount Everest incident in 2006, when dozens of mountain climbers passed by a still-living companion who had collapsed in the snow, allowing him to die. The factors that interfered with their ethical instincts were clearly identifiable after the fact. They rationalized that he couldn’t be saved. Saving the man would have involved personal risk. Each climber thought another might step in; no one had any more responsibility than anyone else. And each had paid over $60,000 to reach Mount Everest’s peak, a prime achievement for their “bucket list.” I understand why this happened, even though it shouldn’t have.

The EMTs, however, are mystifying.

Or maybe not.

I was involved in an epiphanal  incident several years ago, as I was getting breakfast at a local MacDonald’s notable mostly for its four-year streak of never getting a single one of my family’s orders right.  Sunday mornings like this one  typically attract a great many Virginians of all sizes, ages, nationalities and socio-economic categories who are seeking a breakfast that is cheap, or fast, or both.

I had been dispatched to this dreaded McDonald’s by my wife, to pick up breakfast for my son and his sleep-over guest. I was standing in a long and excruciatingly slow line (as usual, the crack employee taking orders was as unfamiliar with her employers’ menu as she was with the language being used to reference it…but never mind) when I noticed that a senior citizen, holding a full tray of food, was in distress. He was having great difficulty proceeding to the drink area, as he could barely walk. The man evidently needed a cane to move but couldn’t use it (it was hanging on his arm) because his hands were full. He was shuffling very shakily and slowly toward his destination, and seemed to be on the verge of taking a bad fall and spilling everything.  Dozens of people swept past him on all sides, sometimes coming close to knocking him over. It was  obvious that he was frightened, but nobody stopped to help him or asked if he needed help. Nobody even seemed to see him, though he was a large man and presented a very painful spectacle.

I wasn’t the most likely candidate to assist him. He was quite a distance away from me with many other customers moving between us; not only that, but I was finally about to be served, and stepping out of line ensured another long wait. But after a minute or so of watching the poor man, I realized that nobody else was going to do anything, at least in time to prevent a messy and even serious accident. I stepped out of line, walked over to him and asked if I could carry his tray to his table. “Oh, thank you so much!” he said with obvious relief. Sweat was pouring down his face. I told him I would get some cream and sugar for his coffee and take it to him so he could sit down.

Why didn’t anyone else help him before I did? The question bothered me then, and still bothers me.  The McDonald’s was filled with kids, teenagers, Democrats, Republicans, local home-owners, at least one policeman, blacks, Hispanics, Asians, and many other elderly citizens. Surely the vast majority of them are basically good people, as most people are. Almost all of them have opinions concerning the “right thing to do” about abortion, health care, gay marriage, tax policy, illegal immigration and dozens of other subjects. Nevertheless, when they saw a fellow human being struggling and in need of assistance, it never occurred to any of them to take responsibility and help him. It is not as if I jumped to his assistance immediately; far from it. I assumed that it would be only a matter of a few seconds before several people were vying to come to his rescue, and was stunned that nobody did. I almost waited too long, in fact. He looked as if he was about to drop his tray by the time I broke out of line.

The incident at McDonald’s is distinguishable from the Brooklyn incident. Nobody’s life was in immediate peril, and nobody asked for help. Still, the EMTs had the ability to help a pregnant woman having a heart attack, and every single person in that McDonald’s had the ability to help an old man who was in peril, yet nobody did anything. The ethics alarms didn’t ring. I agree that the situation is more obviously outrageous when those refusing to help are in a profession dedicated to assisting others, but think about it: don’t all of us have just as clear a duty to help our fellow human beings when they need us? Nobody wanted to help the desperate senior because they wanted to have breakfast….just like the EMTs.  The customers in that McDonald’s refused to do their duty…just like the EMT’s.

Why did I act? My ethics alarms went off, that’s all. One reason they went off was that I was in the middle of writing an article about ethics.  I had an advantage the other MacDonald’s customers didn’t. I teach ethics every day, and this keeps my alarms  in unusually good working order; I have to use them all the time, not just in my life, but in my work. I have no idea what my response to the elderly man’s plight would have been if I was simply practicing law, or running a conventional business. I have to admit to myself that it is possible I would have ignored him too.

We can condemn the EMTs, and we should. At the same time, their conduct is not as extreme and inexplicable as it seems. It is amazing how badly any of us can act when, for whatever reasons, our ethics alarms break down.

I will add: amazing, and frightening.

_____________________________

Pointer: Sam Anthony

Facts: Washington Post

12 thoughts on “Déjà Vu: In D.C., It’s The Brooklyn EMTs All Over Again. How Can This Happen Even Once?

  1. Contrast to the lifeguard who saved a drowning person and got fired for leaving his assigned area. (http://www.csmonitor.com/USA/2012/0705/Lifeguard-fired-for-saving-man-outside-his-zone.-Outsourcing-gone-wrong-video)

    If we don’t have laws enshrining duty to rescue, can we at least have laws that protect rescuers from retaliation?

    Imagining myself in the firefighter’s place, I can’t guarantee that I would have risked putting my family out on the street with no health insurance in order to treat a stranger a few minutes sooner.

  2. The only possible thing I can think of – and this has happened to my sister (a family doctor) is that they have had hammered into them that they are not covered by (malpractice) insurance if they’re not on the job.

    I know there have been incidents where doctors who stop to help at accidents have been sued (and have also been sued when they haven’t stopped!) The legal system for these sort of cases sometimes seems so arbitrary that it scares people (at least I know physicians who it terrifies – whether justified or not)..

    • Having said that, you’d still think all sorts of ethics antennae would be going off and making it difficult for them to sleep at night (and not stuffing their mouths with bagels). Although at least in this case, the firefighter seemed to be ready and willing …

    • Ooh. Even if DC has a Good Samaritan protection law, it might not cover people who are getting paid.

      If liability law is really the underlying cause here then liability law needs to change.

  3. Jack,

    How much do rigid SOPs, the religion of bureaucracy, and otherwise being viewed as a cog in a machine ultimately combines to slowly degrade the individual’s ability to think when they are not officially in their functional role?

    Far from being an excuse for their inaction, how much of their inaction could have been caused by the initiative draining force of onerous bureaucratic rules and Cover Your Ass policies and fear of liabilities?

  4. A few years ago I went ahead and became an EMT, not as a means to make a living but as a way to insure those I am in charge of had the best chance of living if something catastrophic happened. I had already had a lot of medical training and experience so that part was not very difficult but the regulations and laws are daunting in regards to providing such care. The state in which I reside has Good Samaritan law, in fact I would be comfortable in rendering aid in almost any situation, but those who choose it as a career path may not. The reason is they are part of the system, they have strict protocols they have to follow and hierarchy they are responsible to. In fact the area where I reside has one of the highest levels of hospital and response coverage in the nation, in such areas decisions are made at a much higher level then you see in rural areas. There are advantages to this as it is common for EMTs and Paramedics to be in direct consultation with a doctor while treating a patient on scene. Where the down side comes in is that although this state has a Good Samaritan law, a well written one, it does not remove regulations and protocols that emergency response personnel must adhere to while on the job. They would be covered by the Good Samaritan law, even if they caused damage to the patient; however they would be in trouble with the employing agency, state, county or city. As a representative of such agency they have to follow the rules.
    With that said during my internship for my EMT I was working on one of the city fire department crews when an accident occurred at the intersection near the station. An off going paramedic (off duty) provided initial aid and called 911; we responded and took it from there. The off duty paramedic was covered under the Good Samaritan and was not operating under the requirements and protocols that he would if he was on duty. Interestingly enough a few years ago he would have been screwed as the “off duty” status as it pertains to Good Samaritan was not recognized until he returned to his residence; there are legit reasons for this duty status that I won’t go into other than to identify that only Good Samaritan law now applies during their transit to and from work.
    The last thing I will add is that while on duty and the emergency arises in view of the EMT/Paramedics, they see the injury happen or witness the person going into duress then they can respond, at least where I reside.
    Where all this leads me is there are good reasons that there is a process in place for them to be dispatched from keeping the crew out of harm in the case that there is an active crime/threat ongoing, that the emergency is within the scope of capabilities/practice and resource management. Yes some bad outcomes and decisions can result but I don’t know enough about what protocols they were operating under to make an ethics call on the crew.

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