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.
courageous specialists at Beth Israel Deaconess Medical Center kept a suspected
terrorist alive because it was the right thing to do.
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
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.
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.
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.
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
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
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.