Hospitals must treat terrorists, too

Specialists at Beth Israel Deaconess Medical Center kept Boston bombing suspect alive "because it was the right thing to do."

By AVRAHAM RIVKIND, MARCIE NATAN
Boston bombing victim wheelchair 370 (photo credit: REUTERS)
Boston bombing victim wheelchair 370
(photo credit: REUTERS)
When Dzhokhar Tsarnaev was captured in Watertown, Massachusetts, the world watched with relief as the second suspected Boston Marathon bomber was at last brought into custody. Just a few moments later, that collective feeling of relief transformed into intense curiosity.
There were so many questions to which we wanted quick answers: Was he so seriously injured we wouldn’t get the chance to hear from him? Was he going to live to tell his tale of terror? What were his motives? Where would he be taken to be treated? And what doctors assigned to the task? How will he be tried in court? While some hoped for the worst for Tsarnaev, the medical staff at Beth Israel Deaconess Medical Center in Boston, the hospital he was rushed to after being captured, never wavered in their ethical obligation to treat the wounded, nor should they have. The rare and divisive times when the perpetrators of violence require urgent, lifesaving care as well as for their human rights to be protected provide an opportunity to reflect on the bioethical commitments of medical professionals. But, when an ambulance pulls up to Hadassah’s emergency room, one must brace oneself for fear that it might be carrying your own child or someone you love.
The courageous specialists at Beth Israel Deaconess Medical Center kept a suspected terrorist alive because it was the right thing to do.
When aspiring physicians declare, “I solemnly pledge to consecrate my life to the service of humanity,” they do so without any qualification of their future patients’ nationality, ethnicity, religion, financial status – or even terrorist background. All human beings deserve medical attention so long as they do not pose any imminent danger to their surroundings or those treating them. For instance, if the suspect had an explosive device still strapped to his torso, we would not expect doctors to treat him before it was safely removed. But it is the duty of trained medical staff to provide full and unbiased medical care.
When Tamerlan Tsarnaev was brought into Beth Israel for urgent treatment in the early morning with serious injuries, chairman of emergency medicine Dr. Richard Wolfe explained, “You have to put their interest first during that period.
It doesn’t matter if it’s a perpetrator or the president.... You work equally hard to save everyone.”
The same doctors and surgeons who treat the victims of terror often end up treating the alleged terrorists themselves, as Dr. Maura Kennedy added, “We take care of any person who walks in off the street.” Despite the sentiments of some individuals, this is, and always will be, the philosophy of emergency care units.
At Hadassah Medical Center in Jerusalem, we have faced these difficult situations time and time again; on occasion, we have even had to give medical priority to terrorists over the victims of their terror due to the severity of the perpetrator’s injuries, or absorb the costs of the terrorists’ medical treatment because they cannot afford to pay.
In May 1996, when we treated Hassan Salameh, a high-priority terrorist who was suspected of orchestrating three out of the four devastating suicide bombings in Israel that year, we did so knowing that he was responsible for the deaths of our friends and loved ones.
In our tiny country, where our own existence faces the constant threat of terror, we too must comply with the bio-ethical obligations underlying the standards of the medical profession. It’s certainly not our call to give better or preferential treatment to a Jew over an Arab, or an Arab over a Jew, or even a terrorist over a victim. We operate in a conflict zone which can escalate at any moment, and our job is to treat as best as we can. Hadassah Medical Center takes great pride, in fact, in our commitment to treating fairly and equally all who come through the emergency room doors, regardless of who they are, why they ended up under our care, or the extent of the treatment required.
Now that Dzhokhar Tsarnaev has been transferred to a federal medical detention center, the American public wants to see him tried, and if convicted, punished. The fact that he did not die from his injuries will likely allow for a more fruitful investigation into the motives behind his Boston Marathon attack. If the doctors could have successfully resuscitated Tamerlan Tsarnaev, perhaps we would be able to learn even more about this tragedy.
But the treatment of a suspect by medical staff does not go hand in hand with criminal investigations – it exists as its own call to action guarded from moral judgment. Any political or legal consequences of Tsarnaev’s actions are irrelevant in terms of medical treatment administered.
It is not a hospital’s job to render a judicial verdict or withhold treatment based on prior knowledge of a patient. In our hearts, this is sometimes a path that is not easy to take, but in medical practice there is no debate to be had here. Doctors did not choose to give medical attention to the Tsarnaev brothers, they were just fulfilling their ethical obligations.Dr. Avraham Rivkind is the director of the trauma unit at Jerusalem’s Hadassah Medical Center and has published extensively on trauma care, including a 2009 piece, “Medical Care for Terrorists – To Treat or Not to Treat?” in The American Journal of Bioethics. Marcie Natan is national president of Hadassah, the Women’s Zionist Organization of America, and lives in New York City.