IV. Aiding the Sick and the Injured

OHAPTER IV. AIDING THE SICK AND THE INJURED. § 441. Part of the subject-matter of the preceding three chapters is included under the title of this chapter; for rnal'ital beneficence, parental beneficence, and filial benefi cence, severally dictate solicitous care of any member of the family who is suffering from illness or from accident. In the natural order of things the house becomes at need a hospital and its inmates nurses. Whether or not in respect of those outside the family group, beneficence requires that the sick and the hurt shall be succoured, even at the risk of self-injury, it certainly requires that this shall be done inside the family-group. If, as we see, the. protecting of wife by husband is demanded as ancillary to continuance of species (since if the mother is unprotected the species must suffer), then, for the same reason, the care of wife when she is in any way prostrated is dernanded. In like manner a reciprocal care of the bread-winner is called for as a condition to maintenance of the family. Still more obviously requisite is a diligent attendance on children who are ill: the obligationto nurse them being included in the general obligation to use all Ineans of rearing them to maturity. Only in the case of affiicted parents having grown-up children, are ,ve debarred from saying that the welfare of the species dictates the suc couring of thenl. Here the fact that direct increase of hap61 . (355) 356 THE ETHICS OF SOCIAL LIFE.

piness results from rendering the needful assistance, gives rise to the obligation. As happens in the case of infectious diseases, obligations of this class have to be discharged, even at the risk of suffer ing and sometimes of death. Nature at large teaches us this lesson. Beyond the fact that among inn umerable kinds of lower creatures, parental life is wholly sacrificed for the • benefit of offspring, ",'e see that aUlong higher creatures the instincts are such as prompt, especially on the part of a mother, the facing of any danger for protection of the young: survival of the fittest has established this reck lessness of evil. Hence it must be held that the risking of infection is ethically enjoined on a human mother: the only important check being the consideration that loss of life involves loss of ability to discharge obligations to the surviving members of the farnily. .A.nd there seems no reason why an equal obligation to meet the risk should not devolve on the father; unless it be that he has to provide the necessaries of life alike for the household at large and for its suffering member, and that his incapacity may bring starvation on all.

Are there any other checks to the self-sacrifices entailed on some of the family by the illness of another or others belonging to it? There are such other checks. A wise and duly proportioned beneficence does not countenance loss of the relatively worthy for preservation of the reIa tively worthless. Everyone can name persons wrecked in body and luind by cherishing invalid relatives-relati yes who often thanklessly receive the sacrifices made for them. I-Iere is a ,,,ife ,vhose sole occupation for a deceniunl has been that of nursing a gouty husband; and who, as a result, dies of a worn-out physique before he does. Here is a daughter who, after many years' attendance on an invalid mother, is shortly after required to give siInilar attendance to an invalid aunt; and "",·ho, now that she has lived through these long periods of daily abnegations and wearisome AIDING THE SICK AND THE INJURED. 35'7 duties, is becolning mentally unhinged. And here is a husband whose latter days are lnade miserable by the task of safeguarding, in .bis own bouse, an insane ,vife. Though in such cases (all of them occurring within my own small circle) beneficence demands great self-sacrifice, yet its dic tates should be so far qualified as not to require that the lives of the healthy shall be lost in making the lives of the diseased lllore tolerable. Sotne cOlnpromise has to be made by which there Inay be achieved partial relief from the heavy burdens.

Especially is it proper that domestic invalids who make undue demands should receive a not-unlimited attention. Often a whole household is snbordinated to the exactions of a sickly menlber; and instead of gratitude there comes grumbling. This tyranny of the ,veak ought to be resisted. For the checking of their own egoism, as well as for the wel fare of those around, the unreasonable sacrifices they con tinually ask should be refused. Such invalids are not onl.r physically sick, but are nlorally sick also; and their moral sickness requires treatment· as well as their physical sickness. Husbands in the decline of life who have married young wives, and presently make them little else than nurses-objecting even to have other nurses to share the labours with them-require awakening to a due sense not of others' duties to them but of their own duties to others. A man is not absolved from the obligations of beneficence because he is ill; and if he rightly feels these obligations he will insist that others shall not injure thelnsel ves for his benefit.

§ 442.. Concerningthat wider beneficencewhich expends itself in care for sick persons not belonging to the family, it is difficult to say anything definite. Each case is rendered lllore or less .special by the character of the patient and the circunlstances; so that general proposi tions can scarcely find place. We may set down, how358 THE ETHICS OF SOCIAL LIFE. ever, the considerations by which judgment should be guided. If,as aU will adnlit, the care of pne who is sick devolves primarily on members of the family-group, and devolves secondarily on kindred, it devolves only in smaller measure on unrelated persons. These lnay rightly limit themselves to indirect aid, where this 'is needed and deserved. Only in cases where there are no relatives, or none capable of undertaking relatives' duties, does it seem that beneficence deluands from unrelated persons the requisite attentions. How far such attentions shall be carried must, again, be determined in part by thought of the claims arising froln character and conduct. If, with Friendly Societies around· him throughout life, the man ,,"ho is at length taken ill, refused to make any provision against sickness, it cannot be held fit that his necessities as an invalid shall be ministered to as well as they might have been had he made such provision. If sympathy prompts an equal attention to the improvident as to the provident, the sentiment of justice puts a veto. Then, again, there is the question of character. If as much sacrifice is lnade for the sick good-for-nothing as is made for the sick good-for-something, there is abolished one of those dis tinctions between the results of good and bad conduct which all should strive to maintain. Further, there is the allied question of value. Much more may rightly be done for one 'whose abilities or energies promise public benefit, than for one who is useless to his fellow men, or is a burden on them.

Besides the beneficiaries, their characters and circum stances, there have to be considered the constitutions and circulnstances of the benefactors. On those \vho have but little vitality and but small recuperative power after illness, a rational beneficence does not impose as heavy duties as it does on those in high vigour, who can bear AIDING THE SICK AND THE INJUR]j~D. 359 disturbances of health without permanent mischief. Dif ferences of claims hence arising, are seen to be greater on remetnbering that those with low blood-pressure, are more liable to contract infectious diseases than those in whom the tide of life rises higher: especially when, as commonly happens, there is fear in the one case and not in the other. To the check which, for these reasons, a reasonable egoism puts upon altruism, must be joined a check of an· altruistic kind; namely, consideration for those on WhOIll evils will be entailed by contracting an infectious disease, or an illness caused by exhaustion.

These evils are· of several kinds. One who, engaged in nursing a stranger, comes home to· the family-group with a fever, risks their health and life as well as her own. Moreover, she entails on them the troubles and anxieties attendant upon nursing her, as well as the moral pains which her. sufferings and perhaps her death, produce. Even when a fatal issue is escaped, there is necessarily fOT: some time an inability to discharge such obligations as she has ordinarily to discharge; and, occasionally, a permanent inability to discharge them. Evidently, then, while beneficence prompts such aid to sick persons who have no clainls of relationship, as may be given without considerable risk, it does not dictate the giving of such aid by those who have family ties and important duties. Nevertheless we ill ust not ignore. the fact that such aid may, be, and often is, given without injury by those who, if the above reason is valid,ought to hesitate in giving it. In a way somewhat relnarkable, medical men (taking, h0wever, in most cases some precautions) daily visit patients suffering from· fevers or kindred diseases, and but rarely 'take then1-1Ve must suppose that use, and perhaps an acquired mental indifference, unite to give theul" imlllunity; and yet, even if so, it is not easy to see how, during the earlier stages of their professional Iives, they escape. Hospital nurses, too, apparently become 360 THE ETHIOS OFSOOIAL LIFE.

hnpervious. So that the risks of evil run by those whose sympathies prompt them to adopt nursing as an occupa tion, are not so great as at first appears; and where the 'nursing is of those suffering from other than infectious diseases, it may be consistent with fairly good health. That. strange enlotion,. so difficult to analyze, the luxury of pity, is an incentive to the sacrifices ,vhich nursing implies; and when with this there coexists a large share of the maternal instinct, which is in essence a love of the helpless, the care of the helpless sick becomes a source of subdued pleasure, which in large measure neutralizes the pain, and even makes the occupation a gratifying one. Without enjoining the beneficence which issues in these results, one lnay fitly look on and admire. § 443. Though due regard for all circumstances puts some restraint on ministration to the sick who have no farnily-claims, it puts no restraint on ministration to suf ferers of another class--those "rho have met. with aGci dents. Everyone is from time to time witness to injuries caused by falls, or by runaway horses, or by carriage collisions; and everyone is, in such cases, bound to ren der all possible assistance. None save those in whom the brutality of the barbarian still predominates, fail to feel contempt for the Pharisee in the parable and approval of the Samaritan.

But while the duty of caring for the injured is com monly recognized, as demanded even by the most ordinary beneficence, there is an ancillary duty which has only of late gained partial recognition-the duty of acquiring such knowledge and skill as shall make efficient the efforts to aid. Up to our own days, and even still in ninety nine people out of a hundred, the "rish to help the wounded or mainled is unaccompanied by instructed ability-nay, worse, is accolnpanied by an ignorance which leads to mischievous interferences. The anxiety AIDING THE SICK AND THE INJURED. 361 to do something ends in doing harm; for there is con1 lnonly no adequate consciousness of the truth that there are many ways of going wrong to one .way of going right. Hence a provident beneficence Eluggests the acquire ment of such surgical and medical knowledge as Inay be of ayaH to sufferers before professional aid can be ob tained. Unqualified applause, then, must be given to those Alnbulance Societies and kindred bodies, which seek to diffuse the requisite inforlnation and give by discipline the requisite skill. Unfortunately, when there come the demands for the acquired kno'wledge and aptitude, the hoped· for benefits are not always forthcolning: nervous ness or indecision, or perhaps perplexity amid the various lessons which have been lear:qt, leads to failure. Still, the inference to be drawn is not that such preparations for aid ing the injured should be abandoned, but rather that they should be more thorough, and should in fact forDl a part of the education given to all. .