Moral “Superheroes” Speaking out Risk Retribution

On April 1, New York Times columnist Nicholas Kristof described how several medical professionals who spoke out about the shortage of personal protective equipment (PPE)—face masks, respirator masks, surgical gowns, and other barriers to infection—during the COVID-19 pandemic lost their jobs. 

As more people with severe, life-threatening symptoms of the novel coronavirus are flooding hospitals in New York City and elsewhere across the country, these “superheroes,” as Kristof calls them, are often improvising their own PPE or even making do without. Many have been diagnosed with COVID-19, as transmission is easier and more virulent due to their close and constant contact with the severely ill. 

As Kristof’s column went to press, one emergency room doctor at New York’s Weill Cornell Medical Center was herself in the ICU struggling to live. Additionally, hundreds of other healthcare workers have become ill due to the virus, and as of this writing, two nurses have died, all because America is sending these warriors fighting for all our lives into battle without the proper armor. 

This is no time for knee-jerk bureaucratic retribution, says Kristof, but that is what is happening to some who speak up to try to help themselves, their staff and colleagues, and the public. 

An emergency room physician in Washington state, Dr. Ming Lin resorted to social media and a newspaper interview to spread his pleas for help to ensure better PPE for both his staff and their patients. He told the Times that he felt a moral duty to speak out. The hospital, where he had worked for more than a decade and a half, fired him. Still, Dr. Lin said, he does not regret what he did. 

Some medical institutions have even ordered their personnel not to wear PPE where patients and families can see them, to avoid frightening the public. Other staff members have received instructions not to bring their own PPE from home. 

A New York healthcare system told its staff that they risk losing their jobs if they speak to the media without prior authorization. In Chicago, a nurse lost her job after her e-mails to colleagues discussing her desire to wear better PPE fell into the hands of administrators.

Media inquiries to some of these hospitals have resulted in tone-deaf and patronizing responses about what is and what is not “appropriate.”

But these courageous and heart-rending pleas are the result of our healthcare workers’ desire to secure the supplies they and their colleagues need to keep alive and continue to help patients. They are also born from the need to give their sacrifices greater meaning by giving their colleagues—and the public—the truth. 

Where are the rights of healthcare workers?

Cardiologist Dr. Sandeep Jauhar’s April 2 New York Times op-ed noted that the almost-200-year-old code of ethics of the American Medical Association requires physicians to treat any patient who needs their assistance. Yet, he goes on to say, the social contract at the heart of a physician’s oath has a counterpart in the duty of society to do whatever it can to protect its physicians. 

The physician’s oath is not necessarily always unconditional. If it were, Dr. Jauhar writes, it would absolve the rest of us of our multiple duties of care to others in society. The orderliness of society, as he describes it, is anchored in “reciprocity.” To ask one group of people to sacrifice everything while others sacrifice nothing makes a lie of this bedrock idea of mutual support. 

Healthcare workers on the front lines of the pandemic are fearful not only of contracting the disease themselves, but of transmitting it to their spouses, children, and elderly parents waiting for them at home. Dr. Jauhar believes that our healthcare workers will continue as they have been, by remaining true to their oaths. But his urgent question is this: Will we be true to them by supplying them with the protective equipment they so desperately need? 

When protecting people means more than a job

Navy Captain Brett Crozier is not a physician, but he has joined a growing number of people who have been dismissed from their duties after trying to alert the public to the true nature of the pandemic we all face. 

Until April 2, Crozier was the commander of the USS Theodore Roosevelt, an aircraft carrier in the Pacific Ocean. The previous week, noting that more and more members of his crew were testing positive for COVID-19, he sought port on the island of Guam. By the time the Roosevelt docked, dozens of crew members were ill with the disease. More than 1,000 were disembarked onto the island and put into isolation.

A few days before he was relieved of command, Crozier had sent a strongly worded message detailing his concerns about the health of his crew to his superiors. He was adamant that more needed to be done to stem the spread of infection, and that the Navy had not done enough. His words leaked out to the media and went viral. 

The Navy decided to relieve him of his command, ostensibly because he transmitted his message over a non-secured e-mail and sent it to a “broad array” of individuals, rather than only to his superiors. 

While Crozier retains his rank and his Navy service can continue, the message from above that he should have kept quiet comes across loud and clear. But as he walked down the gangway of the Roosevelt for the last time, the thousands of his sailors left onboard saw him off with thunderous applause and cheers. He turned and saluted back.

Democracy—and public health—require the freedom to speak out

The common thread in all these stories is that bureaucracies tend to try to suppress “bad news” and present their best face to the public in times of crisis. 

This was certainly the case in China, when Dr. Li Wenliang, an ophthalmologist who was among the first to note the terrifying possibilities inherent in COVID-19, disseminated a warning to his colleagues over social media in December 2019. Before he died of the disease in February, his authoritarian government suppressed his warnings and ordered him to sign a document renouncing his statements. 

People need clear, accurate information about what is really happening in the world to make informed decisions. A swath of experts has pointed to China’s initial suppression of information from Li and his colleagues on COVID-19’s spread as one factor in the disease’s rapid progress through Hubei Province and across China’s borders. As a wounded but still robust democracy, the United States needs to choose a better path.