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CURRENT CONTROVERSIES IN CRITICAL CARE |
September marked the anniversary of our nation’s horrible loss as a result of the attacks on the World Trade Center Towers in New York, on the Pentagon in Washington, DC, and on innocent and heroic airline passengers of United Airlines flight 93 in Pennsylvania. This has been a year of grief, patriotism, and reflection, though a year is not nearly enough time to address the ensuing losses and changes in our world. How can we possibly understand violence that assaults innocent victims with no clear agenda attached other than acting on hatred and enmity? As inadequate as our reflections and "coming to terms" with this event on this anniversary are likely to be, we must continue our collective and individual efforts to come to terms with this event.
I have been moved by the heroic, selfless acts of ordinary citizens, firemen, policemen, rescue workers, physicians, and nurses in response to the September 11 attacks. Compassion becomes even more necessary in the face of violence and injustice. Our nation’s solidarity with and compassion for those who suffered most in the tragic events demonstrate once again that the most basic requirement for human existence and freedom is the ability to care for one another. Violence creates enmity and erodes the human possibilities for freedom and justice.
The tragic events of September 11 highlight the ethical import of what are sometimes called "negative freedoms": freedom from tyranny, freedom from fear, freedom from hunger, and freedom from discrimination based upon race, color, or creed. A pluralistic and open society requires agreements about the worth and dignity of citizens in order for those citizens to be free from coercions and constraints that would prevent their ability to live in sufficient safety and freedom to carve out their own lives and the lives of their families and communities.
As a nurse confronted with tragedies associated with illness, injury, and loss, I have often thought about how justice is almost never sufficient in these everyday tragedies born of our shared human vulnerabilities. In the moments of illness, suffering, and loss, we need mercy and compassion, and acts that go beyond "equal opportunities," beyond the ethics of the market requirements to sell reliable products to "consumers." But the radical injustice and extremity of the terrorist attacks against innocent citizens on September 11 confront me with the necessity of protective, negative freedoms from such violent, unjust acts as basic to the possibility of all the "positive" freedoms (eg, freedom to care, to vote, to assemble, to worship as we choose) in order to pursue a good life. The most basic moral call of human existence lies in how we will respond to other human beings. This moral demand requires the possibilities created by our freedom from coercion, threat, and violence.
I consider comments about the blame or responsibility we as a nation have for the terrorist attacks to be misguided. Such commentaries seem badly misplaced, a case of blaming the victims similar to those heard in cases of domestic violence (eg, if only the spouse or child would have done this and not that, then the violence would not have happened). Violence occurs when the basic freedoms from fear, tyranny, hunger, and discrimination are absent or diminished to the point that the worth of human life is disregarded. Violence calls for a reestablishment of justice and an avoidance of the extension of injustice. As a citizen, I have often exercised the freedom to disagree with government actions and to actively try to change national and international social policies that I consider to be unjust or unwise. This year’s events have shown me just how essential the freedoms to criticize, to differ, and to be heard and seen are. Freedom from coercion, tyranny, fear, and hunger are the conditions of possibility for any of the highly valued positive freedoms to criticize, to attend school, to worship, and to participate in society, as guided by justice and equality of all citizens.
In the coming years, I dare to hope for a just peace, for restoration of freedoms that accord respect for life and dignity of all human beings. I renew my commitment to do this as a healthcare professional dedicated to providing humane and safe care without discrimination. The power of enemies to shape people’s lives has never been more apparent than in the wake of the September 11th terrorist attacks and the retaliatory, irrational hate crimes against those innocent persons assumed to be the enemy terrorists. Enmity focuses anger.
Enmity carries with it a negative self-defining role since "enemies" can become wholly "other" and devalued as human beings. Hating an "enemy" can turn into the annihilation of the "enemy," a rejection and refusal to meet the other on any grounds of common humanity.1 Those who engage in the hatred and intolerance against their enemies justify that hatred and violence by dehumanizing the enemy. Having enemies gives extraordinary permission to depersonalize the other and act aggressively. The power of enmity can grow until it becomes a scapegoat that stands for all that is dangerous and worthy of our attention. We must reject this unwitting, naive form of enmity because many other dangers continue to exist such as hunger, poverty, and threats of ecological disaster.
The injustice and terror of September 11, in the name of a symbolic strike against a whole society defined as the enemy, was an attack on innocent people’s lives. A whole society was demonized in a despicable act of irrational enmity and terror. However paradoxical it may seem in the midst of such terror, it still holds that if we want peace, we have to work for justice. We will have to work to recreate and sustain our freedoms, both negative freedoms from fear, coercion, and violence, and positive freedoms to live our lives with dignity and respect for others.
Appeasement of enemies who continue to have a total passion and commitment for obliterating their defined enemy will not work. But enmity, nurtured and extended beyond the demands of justice, undermines the freedom and dignity of the ones hated and the ones who hate. This perpetuates violence. I believe that healing and caring practices, even in the midst of injustice, are necessary to sustain the fabric of society, even while we work to create just societies and institutions.1 Emmanuel Levinas,2 a professor of philosophy who wrote on the responsibilities between the self and the other and on the atrocities of the Nazi Holocaust, stated: "The justification of the neighbor’s pain is the source of all immorality." Enmity, like friendship, is a recognition practice and therefore has the power to define both the parties. The one who is hated can easily become the one who hates. This leads me to desire freedom from dwelling on enmity while seeking to extend the freedom to care for and about our world.
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