Wednesday, November 23, 2005

Human co-responsibility?

I was gone there for a while. You may not have noticed.

But after 12 years of pretty constant advocacy with and on behalf of people with cognitive disability, I took a break. Had a few major surgeries. Went back to school. Read a lot. Discovered a nifty message board. Reconnected with my kids.

Now it's time to get back to business, so to speak. It's kind of a scary place for vulnerable populations of people right now in 21st century America, where I practice what is called (with good humored hopefulness) "care coordination". Dealing with health care disparities all day, every day, is beginning to wear on my soul and make me think about how interconnected we all are, and how vulnerable we all are to, well---to sliding into one of the vulnerable categories ourselves. We are they, and they are we. That's what I think, anyway.

I have been doing a lot of thinking about bioethics, health care, the human animal, and interconnectedness over the last several years, and I've come to the conclusion that it all boils down to two questions:

1) Who am I responsible for?
2) Who is responsible for me?

Here's what I have found for an answer so far: I don't know how to determine who I have a responsibility for outside of defined relationship. For instance, my patients are my responsibility because of ethical professional behavior. My minor children are my responsibility. My child with cognitive disability is my responsibility.

But are the starving babies in Africa my responsibility?

I strongly suspect they are.

Anyway, I was away from internet discussion (beyond email and a message board) for the last three years and look what happened! Everything got blogged. I figure it's time for my blog, for what it's worth among the myriad ramblings out there. I'd very much like to talk about human co-responsibility in any manifestation or wherever that phrase takes your thinking and whatever comes to your mind in hearing it. And that will be the subject of discussion, whenever I get a chance to wax poetic, philosophic, or sophmoric, as the case may be.

If you can answer either of the two questions above, please comment here.

Happy Thanksgiving, America!



Blogger KC said...

Why have you concluded that the first question is "Who am I responsible for?" rather than "Who am I not responsible for?" The first question looks implies that the default position is irresponsibility--those for whom I am responsible can be distinguished from the generality of folks who are not my concern. The second question leaves me responsible for (or, perhaps, to) everyone unless I can excuse myself from this obligation. Wouldn't the second ethical principle provide better "coverage" for those in need of care?

2:22 PM  
Blogger mary said...

Well (oh, my first comment, this is exciting, really kc! thanks): I see your point, as a default requiring me to name those for whom I am NOT responsible leaves me responsible unless I can come up with valid reasons to not be.

However, I already think I am responsible for certain people, as I explained. Those for whom I have a defined responsibility due to my relationship role (mom, for instance, or nurse). So now, I have to ask myself is that the limits of my responsibility? Beyond those relationships, AM I responsible for anyone? If so, who?

They are honestly just questions, though, aiming to devise an ethical principal. They are not disguised ethical principals. They are sincere, in other words.

Could we agree that the answer to the first question is the same as the answer to the second question in so far as the answers to both are either "everyone" or "someone"?

If "everyone" is the answer to both questions, we have no more questions.

If "someone" is the answer to both questions, we are back to me figuring out who those someones are.


3:53 PM  

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