The instructor began the class with a question, “Let’s say you just got done with a long shift as an EMT. You’re tired so you stop at a Dunkin Doughnuts for a coffee and a muffin. A women sitting in a corner eats her munchkins too quickly and starts to choke. People look to you because you are wearing your EMT uniform. Do you have a duty to act?” The conversation that insured was the most fascinating conversation on ethics that this philosophy major has witnessed.

During the debate I kept my mouth shut, at first out of that certain arrogance that comes along with knowing names like Kant, Hume, and Leibniz, but then out of fear. I was quite hesitant to utter a sentence as I was not sure there was an original thought on the matter in my head. Sure I could have said, “this dead white guy would say blah and this other dead white guy would respond with blah” but such utterances seemed out of place in this context. The distinction between morals, values, virtues, ends, and means all became meaningless in this discussion because all that was left was action. “Do you have a duty to act?”

A second scenario further muddied the water, “You enter a home an old women is lying on the floor gasping for air. Before she passes out she yells out to you, ‘Save Me’. After she passes out you notice a bracelet on his wrist with the letters D.N.R. The old women at some point signed a legal document  asking not to be resuscitated should she lose consciousness. Her husband sits on the sofa screaming for you to help her. Do you have a duty to act?” Life and law are placed into direct conflict here. One’s sense of duty is compromised by legality. The force behind this conflict is basic self-preservation. To resuscitate someone who has made it know that they do not wish it is punishable by fines, potential jail time, loss of job and certification. Yet, despite all that is at risk watching the women die is simply counter to the nature of your existence both as an EMT but also as a human being. “Do you have a duty to act?”

The hierarchy of safety is taught as safety of self, safety of partner, safety of patient. Such logic is similar to the airplane emergency instruction to put your face mask on before you assist others. I always thought that it was beautiful that such an announcement had to be made. The force of pronouncement is necessary to counter the innate, though sometimes ill-informed, compulsion to help our fellows. The Duty to Act flows from the self in both cases and to the self in both cases.

The answer the instructor provided for the first case was a simple and resolute no. His answer was met with much aggression in the room, once again our basic compulsion got the best of us. He explained that it the women who has choking had a DNR or if she was injured during the rescue attempt the person the off-duty EMT could be held personally liable. Such a precaution was also applied to the situation where someone asked an on or off-duty EMT for medical advice.

Ultimately the instructor told us that the easiest way to avoid the issues that might arise when it comes to duty is threefold 1) Stay within our Scope of Practice 2) Adhere to the Standard of Care expected within the scope’s context and 3) Do not where a uniform when off duty. It may be implied from this that the question of duty necessarily arises from the self. “Do you have a duty to act?” It seems to depend on who, where, and when you are. Of course there is nothing particularly profound or new here except my very real contemplation of its implications as it relates to the mundane medical duty to save lives.

Already five minutes late to my first EMT class, I race down Comm Ave. toward the Boston College campus, I did not realize how large it was. Staring at the small map on my phone I desperately try to orient myself. In my rapid movement my phone drops down on the pavement and splits open. I stop to look around. I had not noticed how beautiful the place was; to my left the sun reflects off the Chestnut Hill Reservoir, to my right Gothic towers and sprawling greens.  In that moment I just knew I had time so I sat down to roll a cigarette (I know) and contemplate my surroundings. I inhale. I exhale. The world is calm. A young women appears before me and asks for a smoke.  She explains that she is late for her first EMT class but she needs to calm her nerves. We bond.

As we enter the classroom we are confronted by a line of students waiting to register and receive books. We speak more about our personal lives. She explains that she just moved from a small town in upstate New York to Dorchester to live with her boyfriend and that they were struggling to make it. The young man in front of us chimes in to agree. He is a Marine Corps veteran who has just come back home, trying to become a firefighter in his small MA town. Later that night I met a first generation Chinese-American student from central MA hoping to be the first doctor in her family, and a Latino from Chelsea  who just graduated from high school and was looking for a fast track into nursing.

This class ended with no real content discussed, just an explanation of the course schedule and basic housekeeping. But even so I sensed something different about this course, something that both invigorated and put me at ease. It struck me as I walked with one of my classmates to the Chestnut Hill train station after class. Our whole walk was filled with alternating admiration and ridicule of the rather affluent area we were travelling through, I had not had such an authentic conversation in a while. Later in the night it dawned on me that this was the first time  in five years I had been in a course where the majority of students were working class. In the wealthy enclave of Chestnut Hill and Boston College my first lesson was economic. To be continued...

I have struggled a great deal while I have been a philosophy student at Boston University. While basic arguments regarding socioeconomic position, motivation, or a basic indictment of academia may be leveled here, I believe my major issue during my time at BU has been the rather abstract nature of my education. In each and every one of my classes the question always arises, “Why does this matter, really?” I have now spent years engaging the basic arguments as to the importance of understanding the ideas which lay at the foundation of societies, and particularly their importance in relation to my personal growth. Nothing concrete, however, has surfaced from this engagement; I have yet to discover something which I can take back to my community in Atlanta, Ga. to help the people who suffer significant crises every single day. I have come to understand that my primary concern has always been, “How will my education enable me to help people?”  This concern has translated itself into deep and sometimes antagonistic engagement with my courses, professors, and a range of ethical and political theories I have encountered at BU.

Recently, I had a breakthrough while working on a paper in which I bring into conversation Rousseau’s Social Contract Theory and Howard Thurman’s Theory of Common Ground. Thurman’s The Search for Common Ground details the inner workings of the human circulatory system in order to argue that harmony (“community” in his language) is the telos characteristic of all life. While such thought is not new, it did represent a methodology which I had not previously considered. After I learned of this fellowship, I heard the words of Gilgamesh echoing from freshmen year, “Study the brickwork,” I wish to take this opportunity to study the very foundations of the human body and then learn how it must be cared for in times of crisis. My hope is that such exploration will synthesize with the philosophical foundations I have acquired at BU to produce a deep understanding of how I may better serve the larger body of my community which finds itself in crisis.

More specifically, my proposal may be broken down into three sections: 1) I wish to enroll in an intensive Emergency Medical Technician Course for two months during the summer 2) I wish to take the EMT certification test in MA and 3) for the remaining month and a half of the summer I wish to serve as a volunteer EMT in Boston with the Boston Medical Reserve Corps.  The intensive two month course will be 4-6 hours, six days a week and will include 12 hours of ER observations and ambulance ride-alongs. The course will cover the following topics: Medical, Legal, and Ethical Issues in EMS, Anatomy & Physiology, Pharmacology for the EMT-B Respiratory Emergencies, Cardiac Emergencies Endocrine Emergencies, Environmental Emergencies, Neurological Emergencies, OB/GYN Emergencies, Medical Emergencies, Traumatic Emergencies, Ambulance Operations, and Pediatric & Geriatric Emergencies.

This course represents a significantly more concrete set of skills to learn which will allow me to adjudicate internal epistemological disputes in a way my courses have not done, particularly as the course content is directly related to the care of others. Further, the content provides a rich opportunity for engagement with basic questions of ethics and ontology.  The certification examination, which is not required, but is preferred for the volunteer program, provides me with the opportunity to attain a concrete representation of my ability to attend to a subject (in a Murdochian sense). This both allows me to solve deep personal issues surrounding epistemology and self-worth, and also provides me with a potential occupational direction after I am done with my two-year post-grad internship.  Finally, the volunteering opportunity will provide me with hands-on experience helping people in crisis, potentially leading to significant revelations as to how to restore the broken harmony I identify both in my own community (racial, geographic, economic) and in the larger American community, as underlined by my political philosophy interests.