Righting a wrong comes from the heart

Source: The Sunday Times, Mon, Jan 26, 2009

By Lee Wei Ling

Since young, I have always been upset with myself if I knew something was wrong and I could put it right but didn’t.

Hence, I often find myself on ‘quests’ or ‘missions’, ‘jousting with windmills’. Sometimes, I criticise my friends, saying, perhaps impatiently, ‘you have lost the fire in your belly’.

If there is something wrong that we know of, I believe we should try to set it right whether or not it is our business to do so. Not to do so implies we condone the wrong and hence we would be guilty of committing the wrong too.

The concept of ‘guilty by omission’ is not one that is held commonly here. But it is enshrined in the legal systems of the United States and France.

You can be sued in the US if you do not clear the ice on the sidewalks around your home and as a result, someone slips and fractures a bone. You did not cause the fracture but you would be guilty by virtue of having omitted to clear the ice.

Let me give a concrete example closer to home of the consequences of such omission: A few months ago, a colleague’s mother suffered a heart attack and was rushed by ambulance to Tan Tock Seng Hospital at night.

Horror of horrors, there was no cardiologist there. My friend desperately called one of several private cardiologists she knew personally, being a doctor herself. But what could a layman have done in similar circumstances? Nothing.

Neither Alexandra Hospital nor Tan Tock Seng outside of office hours has the resources to handle acute myocardial infarctions (AMI) or heart attacks.

Thus, they are not in a position to give patients the best chance of surviving heart attacks. Of those who survive, the chance of impaired function of the heart would be higher than for patients treated in hospitals where cardiologists and facilities were available as in the National Heart Centre (NHC) or National University Hospital (NUH).

These problems are beyond my areas of responsibility. But I am a doctor; I know what is wrong; and I know what needs to be done. I would have been guilty by omission if I had not tried to solve this problem.

So I engaged the ambulances which come under the Singapore Civil Defence Force, NHC, NUH and got them all to agree that when their ambulances pick up patients with AMI, they would bypass Alexandra and Tan Tock Seng and go only to NUH or NHC.

I do not believe homo sapiens are necessarily at the top of the evolutionary pyramid. But it is indisputable that we are different from other species in several ways.

Scientists once assured us that we were the only species that possessed language. Then research with gorillas and chimpanzees showed that they too could master sign language. Another distinguishing trait of humans was thought to be our capacity to use tools. But then we learnt otters could smash molluscs with rocks and apes could strip the leaves from twigs to use them to fish for termites.

The one feature that definitely does separate us from other animals is our highly developed sense of morality. We seem to have a primal understanding of good and evil, right and wrong, of what it means to suffer not only our own pain but also the pain of others.

Morality may be a hard concept to grasp, but we acquire it fast. A preschooler, for instance, may learn that it is not all right to eat in class because a teacher says so. If the rule is lifted, the child will happily eat in class. But if the same teacher says it is okay to push another student off a chair, the child would hesitate. He will think: ‘No, the teacher should not say that.’

In both cases, somebody would have taught the child the rules, but the rule against pushing has a stickiness about it. It resists coming unstuck even if someone in authority countenances its breach. That is the difference between a moral imperative and mere social convention. Some psychologists like Michael Schulman believe children can innately intuit the difference.

Of course, the child might on occasion hit some other child and won’t feel particularly bad about it – unless, of course, he is caught. The same is true of people who steal or despots who slaughter their people.

Marc Hauser, professor of psychology at Harvard University, has written: ‘Moral judgment is pretty consistent from person to person – that is, we all know what is right and what is wrong. Moral behaviour, however, is scattered all over the chart.’

The rules we know, even the ones we intuit, are by no means the rules we follow. There are people who have no moral instinct – psychopaths and anti-social people who commit crimes and seem incapable of being reformed. They stand out precisely because their behaviour is so bizarre.

Of the rules that we do follow, it is easier for most people to follow rules that require passively not doing anything wrong. Actively doing something right, especially if that something does not fall within our area of responsibility, is uncommon.

It is good for any country to have an active citizenry. And that is precisely why the concept of ‘guilt by omission’ should be a part of our ethos.

As Singapore climbs the economic ladder, its need for people who would feel guilty if they omitted to do something right – not merely passively do no wrong – will increase.

A rich middle-class society encircled by the material pleasures of life, happily oblivious of social inequities and the suffering of the less fortunate among us, will never become a civil or gracious society.

On the other hand, a country with little financial reserves, a middle class that is not wealthy but is socially active, that tries to lift the lowest common denominator in that society, is one that would be heading in the right direction.

Some things cannot be legislated but must come spontaneously from the heart. The desires to right wrongs and help others are examples.

Singapore is a great place for social experiments to improve both the country and the individual.

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TTSH and MOH give their reply

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