Article Type
Changed
Thu, 12/15/2022 - 09:43

Regular readers of Federal Practitioner may recall that I have had a tradition of dedicating the last column of the year to an ethics rendition of the popular trope of the annual best and worst. This year we will examine the stories of 2 military physicians through the lens of virtue ethics. Aristotle (384-322 bce), arguably the most famous Western philosopher, is the acknowledged founder of virtue ethics.

Virtue ethics is among the oldest of ethical theories, and Aristotle articulates this school of thought in his work Nicomachean Ethics.2 It is a good fit for Federal Practitioner as it has been constructively applied to the moral development of both military3 and medical professionals.4

Here is a Reader’s Digest version of virtue theory with apologizes to all the real philosophers out there. There are different ways to categorize ethical theories. One approach is to distinguish them based on the aspects of primary interest. Consequentialist ethics theories are concerned with the outcomes of actions. Deontologic theories emphasize the intention of the moral agent. In contrast, virtue ethics theories focus on the character of a person. The virtuous individual is one who has practiced the habits of moral excellence and embodies the good life. They are honored as heroes and revered as saints; they are the exemplars we imitate in our aspirations.3

The epigraph sums up one of Aristotle’s central philosophical doctrines: the close relationship of ethics and politics.1 Personal virtue is intelligible only in the context of community and aim, and the goal of virtue is to contribute to human happiness.5 War, whether in ancient Greece or modern Europe, is among the forces most inimical to human flourishing. The current war in Ukraine that has united much of the Western world in opposition to tyranny has divided the 2 physicians in our story along the normative lines of virtue ethics.

The doctor of virtue: Michael Siclari, MD. A 71-year-old US Department of Veterans Affairs physician, Siclari had previously served in the military as a National Guard physician during Operation Enduring Freedom (2001-2014) in Afghanistan. He decided to serve again in Ukraine. Siclari expressed his reasons for going to Ukraine in the language of what Aristotle thought was among the highest virtues: justice. “In retrospect, as I think about why I wanted to go to Ukraine, I think it’s more of a sense that I thought an injustice was happening.”7

Echoing the great Rabbi Hillel, Siclari saw the Russian invasion of Ukraine as a personal call to use his experience and training as a trauma and emergency medicine physician to help the Ukrainian people. “If not me, then who?” Siclari demonstrated another virtue: generosity in taking 10 days of personal leave in August 2022 to make the trip to Ukraine, hoping to work in a combat zone tending to wounded soldiers as he had in Afghanistan. When due to logistics he instead was assigned to care for refugees and assist with evacuations from the battlefield, he humbly and compassionately cared for those in his charge. Even now, back home, he speaks to audiences of health care professionals encouraging them to consider similar acts of altruism.5

Virtue for Aristotle is technically defined as the mean between 2 extremes of disposition or temperament. The virtue of courage is found in the moral middle ground between the deficiency of bravery that is cowardice and the vice of excess of reckless abandon. The former person fears too much and the latter too little and both thus exhibit vicious behavior.

The doctor of vice: James Lee Henry. Henry is a major and internal medicine physician in the United States Army stationed at Fort Bragg, headquarters of the US Army Special Operations Command. Along with his wife Anna Gabrielian, a civilian anesthesiologist, he was charged in September with conspiring to divulge the protected health information of American military and government employees to the Russian government.8 According to the Grand Jury indictment, Henry delivered into the hands of an undercover Federal Bureau of Investigation (FBI) agent, the medical records of a US Army officer, Department of Defense employee, and the spouses of 3 Army veterans, 2 of whom were deceased.9 In a gross twisting of virtue language, Gabrielian explained her motivation for the couple’s espionage in terms of sacrifice and loyalty. In an antipode of Siclari’s service, Henry purportedly wanted to join the Russian army but did not have the requisite combat experience. For his part, Henry’s abysmal defense of his betrayal of his country and his oath speaks for itself, if the United States were to declare war on Russia, Henry told the FBI agent, “at that point, I’ll have some ethical issues I have to work through.”8

We become virtuous people through imitating the example of those who have perfected the habits of moral excellence. During 2022, 2 federal practitioners responded to the challenge of war: one displayed the zenith of virtue, the other exhibited the nadir of vice. Seldom does a single year present us with such clear choices of who and how we want to be in 2023. American culture has so trivialized New Year’s resolutions that they are no longer substantive enough for the weight of the profound question of what constitutes the good life. Rather let us make a commitment in keeping with such morally serious matters. All of us live as mixed creatures, drawn to virtue and prone to vice. May we all strive this coming year to help each other meet the high bar another great man of virtue Abraham Lincoln set in his first inaugural address, to be the “better angels of our natures.”10

References

1. Aristotle. Politics. Book I, 1253.a31.

2. The Ethics of Aristotle. Aristotle. The Nicomachean Ethics. Thompson JAK, trans. Penguin Books; 1953.

3. Schonfeld TL, Hester DM. Brief introduction to ethics and ethical theory. In: Schonfeld TL, Hester DM, eds. Guidance for Healthcare Ethics Committees. 2nd ed. Cambridge University Press; 2022:11-19.

4. Olsthoorn P. Military Ethics and Virtues: An Interdisciplinary Approach for the 21st Century. Routledge; 2010.

5. Pellegrino ED, Thomasma DC. The Virtues in Medical Practice. Oxford University Press; 1993.

6. Edward Clayton. Aristotle Politics. In: Internet Encyclopedia of Philosophy. Accessed November 28, 2022. https://iep.utm.edu/aristotle-politics

7. Tippets R. A VA doctor’s calling to help in Ukraine. VA News. October 23, 2022. Accessed November 28, 2022. https://news.va.gov/109957/a-va-doctors-calling-to-help-in-ukraine

8. Lybrand H. US Army doctor and anesthesiologist charged with conspiring to US military records to the Russian government. CNN Politics, September 29, 2022. Accessed November 28, 2022 https://www.cnn.com/2022/09/29/politics/us-army-doctor-anesthesiologist-russian-government-medical-records

9. United States v Anna Gabrielian and James Lee Henry, (SD Md 2022). Accessed November 28, 2022. https://www.documentcloud.org/documents/23106067-gabrielian-and-henry-indictment

10. Lincoln A. First Inaugural Address of Abraham Lincoln. Accessed November 28, 2022. https://avalon.law.yale.edu/19th_century/lincoln1.asp

Article PDF
Author and Disclosure Information

Cynthia Geppert is Editor-in-Chief; Professor and Director of Ethics Education at the University of New Mexico School of Medicine in Albuquerque.
Correspondence: Cynthia Geppert (fedprac@mdedge.com)

Disclaimer

The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner , Frontline Medical Communications Inc., the US Government, or any of its agencies.

Issue
Federal Practitioner - 39(12)a
Publications
Topics
Page Number
468-469
Sections
Author and Disclosure Information

Cynthia Geppert is Editor-in-Chief; Professor and Director of Ethics Education at the University of New Mexico School of Medicine in Albuquerque.
Correspondence: Cynthia Geppert (fedprac@mdedge.com)

Disclaimer

The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner , Frontline Medical Communications Inc., the US Government, or any of its agencies.

Author and Disclosure Information

Cynthia Geppert is Editor-in-Chief; Professor and Director of Ethics Education at the University of New Mexico School of Medicine in Albuquerque.
Correspondence: Cynthia Geppert (fedprac@mdedge.com)

Disclaimer

The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner , Frontline Medical Communications Inc., the US Government, or any of its agencies.

Article PDF
Article PDF

Regular readers of Federal Practitioner may recall that I have had a tradition of dedicating the last column of the year to an ethics rendition of the popular trope of the annual best and worst. This year we will examine the stories of 2 military physicians through the lens of virtue ethics. Aristotle (384-322 bce), arguably the most famous Western philosopher, is the acknowledged founder of virtue ethics.

Virtue ethics is among the oldest of ethical theories, and Aristotle articulates this school of thought in his work Nicomachean Ethics.2 It is a good fit for Federal Practitioner as it has been constructively applied to the moral development of both military3 and medical professionals.4

Here is a Reader’s Digest version of virtue theory with apologizes to all the real philosophers out there. There are different ways to categorize ethical theories. One approach is to distinguish them based on the aspects of primary interest. Consequentialist ethics theories are concerned with the outcomes of actions. Deontologic theories emphasize the intention of the moral agent. In contrast, virtue ethics theories focus on the character of a person. The virtuous individual is one who has practiced the habits of moral excellence and embodies the good life. They are honored as heroes and revered as saints; they are the exemplars we imitate in our aspirations.3

The epigraph sums up one of Aristotle’s central philosophical doctrines: the close relationship of ethics and politics.1 Personal virtue is intelligible only in the context of community and aim, and the goal of virtue is to contribute to human happiness.5 War, whether in ancient Greece or modern Europe, is among the forces most inimical to human flourishing. The current war in Ukraine that has united much of the Western world in opposition to tyranny has divided the 2 physicians in our story along the normative lines of virtue ethics.

The doctor of virtue: Michael Siclari, MD. A 71-year-old US Department of Veterans Affairs physician, Siclari had previously served in the military as a National Guard physician during Operation Enduring Freedom (2001-2014) in Afghanistan. He decided to serve again in Ukraine. Siclari expressed his reasons for going to Ukraine in the language of what Aristotle thought was among the highest virtues: justice. “In retrospect, as I think about why I wanted to go to Ukraine, I think it’s more of a sense that I thought an injustice was happening.”7

Echoing the great Rabbi Hillel, Siclari saw the Russian invasion of Ukraine as a personal call to use his experience and training as a trauma and emergency medicine physician to help the Ukrainian people. “If not me, then who?” Siclari demonstrated another virtue: generosity in taking 10 days of personal leave in August 2022 to make the trip to Ukraine, hoping to work in a combat zone tending to wounded soldiers as he had in Afghanistan. When due to logistics he instead was assigned to care for refugees and assist with evacuations from the battlefield, he humbly and compassionately cared for those in his charge. Even now, back home, he speaks to audiences of health care professionals encouraging them to consider similar acts of altruism.5

Virtue for Aristotle is technically defined as the mean between 2 extremes of disposition or temperament. The virtue of courage is found in the moral middle ground between the deficiency of bravery that is cowardice and the vice of excess of reckless abandon. The former person fears too much and the latter too little and both thus exhibit vicious behavior.

The doctor of vice: James Lee Henry. Henry is a major and internal medicine physician in the United States Army stationed at Fort Bragg, headquarters of the US Army Special Operations Command. Along with his wife Anna Gabrielian, a civilian anesthesiologist, he was charged in September with conspiring to divulge the protected health information of American military and government employees to the Russian government.8 According to the Grand Jury indictment, Henry delivered into the hands of an undercover Federal Bureau of Investigation (FBI) agent, the medical records of a US Army officer, Department of Defense employee, and the spouses of 3 Army veterans, 2 of whom were deceased.9 In a gross twisting of virtue language, Gabrielian explained her motivation for the couple’s espionage in terms of sacrifice and loyalty. In an antipode of Siclari’s service, Henry purportedly wanted to join the Russian army but did not have the requisite combat experience. For his part, Henry’s abysmal defense of his betrayal of his country and his oath speaks for itself, if the United States were to declare war on Russia, Henry told the FBI agent, “at that point, I’ll have some ethical issues I have to work through.”8

We become virtuous people through imitating the example of those who have perfected the habits of moral excellence. During 2022, 2 federal practitioners responded to the challenge of war: one displayed the zenith of virtue, the other exhibited the nadir of vice. Seldom does a single year present us with such clear choices of who and how we want to be in 2023. American culture has so trivialized New Year’s resolutions that they are no longer substantive enough for the weight of the profound question of what constitutes the good life. Rather let us make a commitment in keeping with such morally serious matters. All of us live as mixed creatures, drawn to virtue and prone to vice. May we all strive this coming year to help each other meet the high bar another great man of virtue Abraham Lincoln set in his first inaugural address, to be the “better angels of our natures.”10

Regular readers of Federal Practitioner may recall that I have had a tradition of dedicating the last column of the year to an ethics rendition of the popular trope of the annual best and worst. This year we will examine the stories of 2 military physicians through the lens of virtue ethics. Aristotle (384-322 bce), arguably the most famous Western philosopher, is the acknowledged founder of virtue ethics.

Virtue ethics is among the oldest of ethical theories, and Aristotle articulates this school of thought in his work Nicomachean Ethics.2 It is a good fit for Federal Practitioner as it has been constructively applied to the moral development of both military3 and medical professionals.4

Here is a Reader’s Digest version of virtue theory with apologizes to all the real philosophers out there. There are different ways to categorize ethical theories. One approach is to distinguish them based on the aspects of primary interest. Consequentialist ethics theories are concerned with the outcomes of actions. Deontologic theories emphasize the intention of the moral agent. In contrast, virtue ethics theories focus on the character of a person. The virtuous individual is one who has practiced the habits of moral excellence and embodies the good life. They are honored as heroes and revered as saints; they are the exemplars we imitate in our aspirations.3

The epigraph sums up one of Aristotle’s central philosophical doctrines: the close relationship of ethics and politics.1 Personal virtue is intelligible only in the context of community and aim, and the goal of virtue is to contribute to human happiness.5 War, whether in ancient Greece or modern Europe, is among the forces most inimical to human flourishing. The current war in Ukraine that has united much of the Western world in opposition to tyranny has divided the 2 physicians in our story along the normative lines of virtue ethics.

The doctor of virtue: Michael Siclari, MD. A 71-year-old US Department of Veterans Affairs physician, Siclari had previously served in the military as a National Guard physician during Operation Enduring Freedom (2001-2014) in Afghanistan. He decided to serve again in Ukraine. Siclari expressed his reasons for going to Ukraine in the language of what Aristotle thought was among the highest virtues: justice. “In retrospect, as I think about why I wanted to go to Ukraine, I think it’s more of a sense that I thought an injustice was happening.”7

Echoing the great Rabbi Hillel, Siclari saw the Russian invasion of Ukraine as a personal call to use his experience and training as a trauma and emergency medicine physician to help the Ukrainian people. “If not me, then who?” Siclari demonstrated another virtue: generosity in taking 10 days of personal leave in August 2022 to make the trip to Ukraine, hoping to work in a combat zone tending to wounded soldiers as he had in Afghanistan. When due to logistics he instead was assigned to care for refugees and assist with evacuations from the battlefield, he humbly and compassionately cared for those in his charge. Even now, back home, he speaks to audiences of health care professionals encouraging them to consider similar acts of altruism.5

Virtue for Aristotle is technically defined as the mean between 2 extremes of disposition or temperament. The virtue of courage is found in the moral middle ground between the deficiency of bravery that is cowardice and the vice of excess of reckless abandon. The former person fears too much and the latter too little and both thus exhibit vicious behavior.

The doctor of vice: James Lee Henry. Henry is a major and internal medicine physician in the United States Army stationed at Fort Bragg, headquarters of the US Army Special Operations Command. Along with his wife Anna Gabrielian, a civilian anesthesiologist, he was charged in September with conspiring to divulge the protected health information of American military and government employees to the Russian government.8 According to the Grand Jury indictment, Henry delivered into the hands of an undercover Federal Bureau of Investigation (FBI) agent, the medical records of a US Army officer, Department of Defense employee, and the spouses of 3 Army veterans, 2 of whom were deceased.9 In a gross twisting of virtue language, Gabrielian explained her motivation for the couple’s espionage in terms of sacrifice and loyalty. In an antipode of Siclari’s service, Henry purportedly wanted to join the Russian army but did not have the requisite combat experience. For his part, Henry’s abysmal defense of his betrayal of his country and his oath speaks for itself, if the United States were to declare war on Russia, Henry told the FBI agent, “at that point, I’ll have some ethical issues I have to work through.”8

We become virtuous people through imitating the example of those who have perfected the habits of moral excellence. During 2022, 2 federal practitioners responded to the challenge of war: one displayed the zenith of virtue, the other exhibited the nadir of vice. Seldom does a single year present us with such clear choices of who and how we want to be in 2023. American culture has so trivialized New Year’s resolutions that they are no longer substantive enough for the weight of the profound question of what constitutes the good life. Rather let us make a commitment in keeping with such morally serious matters. All of us live as mixed creatures, drawn to virtue and prone to vice. May we all strive this coming year to help each other meet the high bar another great man of virtue Abraham Lincoln set in his first inaugural address, to be the “better angels of our natures.”10

References

1. Aristotle. Politics. Book I, 1253.a31.

2. The Ethics of Aristotle. Aristotle. The Nicomachean Ethics. Thompson JAK, trans. Penguin Books; 1953.

3. Schonfeld TL, Hester DM. Brief introduction to ethics and ethical theory. In: Schonfeld TL, Hester DM, eds. Guidance for Healthcare Ethics Committees. 2nd ed. Cambridge University Press; 2022:11-19.

4. Olsthoorn P. Military Ethics and Virtues: An Interdisciplinary Approach for the 21st Century. Routledge; 2010.

5. Pellegrino ED, Thomasma DC. The Virtues in Medical Practice. Oxford University Press; 1993.

6. Edward Clayton. Aristotle Politics. In: Internet Encyclopedia of Philosophy. Accessed November 28, 2022. https://iep.utm.edu/aristotle-politics

7. Tippets R. A VA doctor’s calling to help in Ukraine. VA News. October 23, 2022. Accessed November 28, 2022. https://news.va.gov/109957/a-va-doctors-calling-to-help-in-ukraine

8. Lybrand H. US Army doctor and anesthesiologist charged with conspiring to US military records to the Russian government. CNN Politics, September 29, 2022. Accessed November 28, 2022 https://www.cnn.com/2022/09/29/politics/us-army-doctor-anesthesiologist-russian-government-medical-records

9. United States v Anna Gabrielian and James Lee Henry, (SD Md 2022). Accessed November 28, 2022. https://www.documentcloud.org/documents/23106067-gabrielian-and-henry-indictment

10. Lincoln A. First Inaugural Address of Abraham Lincoln. Accessed November 28, 2022. https://avalon.law.yale.edu/19th_century/lincoln1.asp

References

1. Aristotle. Politics. Book I, 1253.a31.

2. The Ethics of Aristotle. Aristotle. The Nicomachean Ethics. Thompson JAK, trans. Penguin Books; 1953.

3. Schonfeld TL, Hester DM. Brief introduction to ethics and ethical theory. In: Schonfeld TL, Hester DM, eds. Guidance for Healthcare Ethics Committees. 2nd ed. Cambridge University Press; 2022:11-19.

4. Olsthoorn P. Military Ethics and Virtues: An Interdisciplinary Approach for the 21st Century. Routledge; 2010.

5. Pellegrino ED, Thomasma DC. The Virtues in Medical Practice. Oxford University Press; 1993.

6. Edward Clayton. Aristotle Politics. In: Internet Encyclopedia of Philosophy. Accessed November 28, 2022. https://iep.utm.edu/aristotle-politics

7. Tippets R. A VA doctor’s calling to help in Ukraine. VA News. October 23, 2022. Accessed November 28, 2022. https://news.va.gov/109957/a-va-doctors-calling-to-help-in-ukraine

8. Lybrand H. US Army doctor and anesthesiologist charged with conspiring to US military records to the Russian government. CNN Politics, September 29, 2022. Accessed November 28, 2022 https://www.cnn.com/2022/09/29/politics/us-army-doctor-anesthesiologist-russian-government-medical-records

9. United States v Anna Gabrielian and James Lee Henry, (SD Md 2022). Accessed November 28, 2022. https://www.documentcloud.org/documents/23106067-gabrielian-and-henry-indictment

10. Lincoln A. First Inaugural Address of Abraham Lincoln. Accessed November 28, 2022. https://avalon.law.yale.edu/19th_century/lincoln1.asp

Issue
Federal Practitioner - 39(12)a
Issue
Federal Practitioner - 39(12)a
Page Number
468-469
Page Number
468-469
Publications
Publications
Topics
Article Type
Sections
Disallow All Ads
Content Gating
No Gating (article Unlocked/Free)
Alternative CME
Disqus Comments
Default
Use ProPublica
Hide sidebar & use full width
render the right sidebar.
Conference Recap Checkbox
Not Conference Recap
Clinical Edge
Display the Slideshow in this Article
Medscape Article
Display survey writer
Reuters content
Disable Inline Native ads
WebMD Article
Article PDF Media