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A Combat Doctor's True Duty
Dr. Kevin Patterson was judged unethical for publishing a dying Canadian soldier's identity. Did he not serve a greater good?
Dr. Kevin Patterson: Broke official silence.
Cpl. Kevin Megeney, a 25-year-old reservist from Stellarton, Nova Scotia, died two years ago, of a gunshot wound in the chest, in a medical tent at Kandahar Airport, in Afghanistan. More than 60 other Canadian servicemen have died in combat since then, but we still don't know the full circumstances of Cpl. Megeney's death.
We don't know why he died. But we know how, in a description of graphic, hair-raising, heart-stopping detail that evokes the fiction of Dalton Trumbo, or medical reports from U.S. Civil War battlefields. We know that his lungs bulged out of the chest incision, "inflating and deflating," and we know that litres of blood poured out of his chest wound in a "gelatinous heap." We know that Megeney had red hair and blue eyes and that he looked "cheerful even in death."
The Canadian surgeon who tried to save him called the Megeney shooting "another blue-on-blue" -- military jargon for "friendly fire," which is itself a distasteful jargon for the aberration of one soldier killing a comrade-in-arms, reasons unknown. (A court-martial is scheduled for this June.)
These observations into Cpl. Megeney's death appeared near the end of a 2007 article in the San Francisco-based magazine Mother Jones, an article written by Dr. Kevin Patterson of Saltspring Island, entitled "Talk to Me Like My Father: Frontline Medicine in Afghanistan."
The Canadian Forces make no apology for the fact that, two years after the corporal's death, we still don't know what prompted the shooting. Investigations into "friendly fire" incidents, it seems, unfold in extreme slow-motion, at a pace that seems designed to flatten adverse publicity. By comparison, the military inquiry into Dr. Patterson's act of non-fiction was nearly instantaneous.
'I will never reveal'
Before the end of October 2007, a so-called Summary Investigation found that Patterson had committed a "breach of patient confidentiality." A copy went to the BC College of Physicians and Surgeons, Patterson's professional regulating body.
And the college itself took more than a year before ruling that Patterson had indeed broken the doctor's code by naming the dead soldier. He was reprimanded, fined, and told to brush up on medical ethics. As part of the deal, Patterson apologized to the Megeney family, and confessed to having made a "bad decision."
Patterson was also put on a kind of creative probation: In any future writing, journalism or otherwise, he would not include the names of patients, or use information that could identify patients. (Interestingly, the deal says nothing about Patterson's freedom to divulge names, or details, with a patient's approval.)
Patterson gets little sympathy from fellow doctors, or from the arbiters of professional ethics. They all fall back on Hippocrates, the father of medicine, who said, "All that may come to my knowledge in the exercise of my profession... I will keep secret and will never reveal." I talked to several doctors and ethicists, and they all agreed that Patterson should not have used Megeney's name, or details that could have revealed his identity. Dr. Gabor Mate, a well-known commentator on social issues, said flatly that without doctor-patient confidentiality "there is no basis for a healing relationship." And bio-ethicist Dr. Margaret Somerville of McGill University had no time for the argument that the horrors of war need greater exposure. "The problem is, that's the argument that should have been put to the Megeney family (to get their permission) before the article was printed," Dr. Somerville said. "It's a valid argument but it definitely doesn't take precedence here."
What's the 'greater good'?
Stephen Ward, a professor of journalism ethics at the University of Wisconsin, in Madison, is not so sure. He said that telling the story of the death of Cpl. Megeney, in all its gore, may serve a "greater good" -- giving citizens needed insight into the "nitty-gritty" of the soldier's experience in wartime. "If the writing has anything to do with the pressures placed on the soldier," Ward said, "then it's good to know. We are too often accused of sanitizing war."
The "we" in Ward's quote, of course, are journalists, and Kevin Patterson is not a journalist. He is a civilian doctor who, in effect, keeps a journal, and shares this journal with his readers. (He is also an accomplished author of fiction and non-fiction.) Should he not, then, get a special dispensation from Hippocrates' inflexible rule of "Never tell?"
Patterson put forward this argument himself shortly after his article was published in 2007, as the controversy began to build. "It is necessary," he wrote, "to face with open eyes the grotesque nature of war trauma. The recent disengagement and fatigue of the public with these matters is itself grotesque." Who better to chronicle the "grotesque trauma" than the nurses and doctors who have to treat the wounded, often under extreme conditions? The military, sensitive to any news that may hurt recruiting, certainly won't tell these stories. And embedded journalists with the Canadian soldiers in Afghanistan are well aware of the price of breaking military rules about disclosure: you're on the next flight home."
Name of the deceased
Leaving Cpl. Megeney's name out of the Mother Jones article, of course, would not have protected his anonymity since Canadian newspaper readers already knew the soldier's name, and knew that he died from friendly fire. All that Patterson added to the story were the medical details of his final minutes of life.
Tom Maddix, an ethicist with Providence Health, said using Megeney's name was unnecessary. "Stories have great power," he said. "and the exact name of the person is not the issue." Professor Ward disagreed. He said using the name gave the story credibility and authority.
It's instructive that it was the Canadian Forces, and not Megeney's family, that provoked the investigation into Patterson's conduct. Mother Jones magazine contacted the soldier's family in Nova Scotia before the magazine hit the streets, to alert them to what was coming.
A military victory
Clara Jeffery, the Mother Jones editor, says she spoke with Karen Megeney, the soldier's mother, by phone. As she wrote in the magazine's blog, "She assured me that the family would like to see the article, and that she was a nurse and would read it before any other members of her family; she said it would help to have closure to know more about what happened. We heard from other members of the family who also wanted to read it, and some whom after they did expressed the desire to write to Dr. Patterson 'to express my appreciation to him for exhausting every effort to save [him]'."
It was only later, after the Canadian Forces completed their investigation, and the College of Physicians weighed in, that the Megeneys went public with their displeasure.
The Canadian military took an uncompromising zero-tolerance approach to Dr. Patterson, even though he was a civilian volunteer in a war zone. "The issue here is entirely about medical ethics, not military law or discipline," a Canadian Forces spokesman told me. Did the Megeney family bring an official complaint to the military about the Mother Jones article? "The family was not happy," is all the CF spokesman would say.
All arguments about the need for patient confidentiality aside, should the Canadian Forces be the sole judge of what information can and should be released about how soldiers live and die in foreign lands? Is there not a case to be made for the claim that the stories of the war dead belong to all of us since we have a moral, physical and spiritual investment in their sacrifice? Is it not arguable that, in some cases, their names and their violent stories should transcend our norms of "privacy?"
Is a policy of official silence not at least as grotesque as the stories of how soldiers die?
Related Tyee stories:
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Doctor and novelist Kevin Patterson says we need $200-a-barrel oil, or maybe a good narwhal hunt. - Blood on the Lens
Take cover from online interactive war reporting. - Al Jazeera's New Canadian Boss
Tony Burman ran CBC news. Now he calls shots at the top Arab news network's English arm. Why can't we see it here? A Tyee interview.




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G West
3 years ago
Patterson
Patterson is an excellent writer. The suggestion that he's done anything wrong is absurd. Just as photos of the carnage in Vietnam helped bring that atrocity to an end, the writing of people like Patterson will help bring this one to its long overdue conclusion.
Hopefully before too many other young Canadians suffer Megeney's fate.
If people don't want their names used, they shouldn't be accepting the queen's nickel.
LeftSeater
3 years ago
Dirty Laundry
"If people don't want their names used, they shouldn't be accepting the queen's nickel."
I disagree.
It is a matter of ethics. Even Patterson admitted as much.
"a professor of journalism ethics"
Journalism purports to have ethics? Now there is a laugher. Do they really think they are on par with Medical ethics?
I guess the good professor hasn't cranked up the eight track and listened to Don Henley's "Dirty Laundry".
And good on the Canadian Forces for standing up and shielding their members from individuals who might take advantage of those who no longer have the ability to protect their rights to privacy and dignity.
G West
3 years ago
Did you read Patterson's piece?
From Mother Jones.
It wasn't disrespectful at all.
I think we always need to chose reality over pretend; authenticity over artifice and the idea that you can be involved in a shooting war without spilling blood is absurd.
There is no way on earth Patterson's prose could limit Megeney's dignity or the pointlessness of his death.
Citizens pay the bills, they don't need their servants in the Canadian Forces or Ottawa telling them what they're allowed to see and read about what's being DONE IN THEIR NAME.
Time to grow up people.
BC Mary
3 years ago
Military cemeteries in Europe
Many of us have visited beautiful cemeteries in Europe for our War casualties of WWI and WW2.
Although each cemetery carries its own powerful message of regret, none is more powerful than Canada's own Vimy Ridge memorial in France.
Then I began wondering why "war-torn Europe" had no military cemeteries pre-dating WWI. If you haven't stumbled upon this information yourself, you'll find it very difficult to believe ...
Prior to WWI, the practice was simply to leave dead soldiers where they fell, allowing ... well, you get the picture. When a suitable number of months had gone by, wagons from England would arrive in France, rake up the bleached bones, carry them back to England and ... are you ready for this? ... and pulverize them into bone meal for agricultural purposes.
It made a whole lot of difference, when people found out about this abominable practice. The ugliness of war should never be shielded. Names, yes. But the grief, pain, suffering and loss of dignity, never.
LeftSeater
3 years ago
Respect.....
"It wasn't disrespectful at all"
In your opinion Mr. West and I welcome but do not share your point of view.
Nevertheless, Patterson’s actions were deemed to be unethical by Patterson's peers. Patterson admits to having made a "bad decision" and my opinion concurs with both Patterson and his peers.
And may I respectfully suggest Mr. West that we try and keep a modicum of decorum in this discussion. I certainly respect and appreciate your opinion, however, the “Time to grow up people” admonishment is, in my opinion, unnecessary.
Thank you.
G West
3 years ago
No lack of decorum in any of my offerings
But one recognizes that the discussion takes place between more than just ourselves. There is an audience and, in truth, my business isn't so much to respond to your points or to have a personal discussion with someone who calls him or herself 'LEFTSEATER' as it is to make others, who might happen to read this, consider, or reconsider, their own views.
As for decorum, I'd only also suggest you might look to your own words.
Cheers.
And of course it's my 'opinion'.
lereid
3 years ago
either or?
I can see the attraction of finding a martyr for Canada's anti-war movement, given its inability to muster an effective public presence. But this article smooths over several wrinkles in the story to create that impression.
The displeased reaction of some members of the Megeney family was rather more swift than this article lets on--it began within days of Mother Jones' posting of the article. And the military investigation hardly had a zero-tolerance result: it cleared Dr. Patterson.
A simple and respectful way through the issue would have been to discuss the story with the family himself, and prepare whoever did give permission for the likelihood of family dissent. That conversation would have been good medical ethics--and good peace activism.
G West
3 years ago
lereid
That's a defensible position, in retrospect: But only in retrospect.
Clearly, Patterson meant no disrespect; he was doing what good non-fiction writers should do - that is, put the reader into the action in a believable way. He was bringing the horrors of war home to the people who pay for it and who, at least in some cases, support it mindlessly and thoughtlessly.
I suppose one could argue that Megeney's parents should have some say but I'm far from happy with that conclusion. Megeney was an adult, doing a job (on behalf of the Canadian people) he accepted pay and shouldered risk to do. Why aren’t his fate and the fact that it came about because of a stupid accident an appropriate subject for reflection? Why is it not dishonest to make his last moments anonymous merely because his parents don't 'like' the idea that he died in the way he did?
Surely that kind of official censorship is a thing of the past – a past where the folks at home aren’t considered ‘capable’ of dealing with harsh realities. The country, servicemen and their parents are more than willing to have their stories fashioned into propaganda pieces by the Canadian Armed Forces, the media and our elected political 'servants' in Ottawa when it suits THEM. Surely the reciprocal of that situation is also true. If we are a mature democracy made up of responsible adults, then every citizen ought to have the right to make those choices and understand their implications for themselves.
Surely the photographer who took the picture of Phan Thị Kim Phúc was doing something worthwhile that was not in any way demeaning or disrespectful.
I think we need the courage to be adults about the 'real' costs of war and I think we should avoid the kind of cleaned-up and clinically heroic ‘niceness’ that much of our media serves us from Afghanistan: The dusty soldiers marching their fallen comrades into the belly of a plane, the boxes flag covered, the Don Cherry mindless pumping up of their manufactured heroics, the phony ‘support our troops’ bumper stickers. Patterson was going beyond that curtain to show his readers a clear view of what ‘really’ goes on, how broken bodies bleed and life seeps into the dust – and often for no apparent reason or positive outcome.
Surely, we do our soldiers a disservice when we pretend there is something about their actions there and what they are doing that should remain hidden.
War is a brutish nasty business; people suffer and bleed and are turned into mental and physical wrecks; they die and death is messy and nasty.
Pretending something else is true does their sacrifices and our own 'easy' acceptance of these 'facts' makes the waste of their young lives a double sacrifice.
And this has, in my case at least, absolutely nothing to do with 'peace activism'.
Aimless
3 years ago
Funny how the ethics of war
Funny how the ethics of war itself rarely come up, but when a simple article is written that reflects badly on war then the medical and journalism ethics flags are hoisted forthwith. We must talk of war without any disturbing images of blood.
I'm with Patterson -- name the names.
jwlaurie
3 years ago
I agree totally with
I agree totally with Dr.Patterson's story except in one major area, publishing the soldiers name. I see nothing gained by this and much lost.
Yes, the story should be told and by someone who was close to it with the knowledge of how and why the body expires the way it does in these cases. That's a good thing.
The military reaction to the story was most correct in that they have a duty to the larger good and that is to guard against this practice becoming too prevalent and out of sensible journalistic control.
TYRONE
3 years ago
Bloody politics are every where!
Did the Megeney family bring an official complaint to the military about the Mother Jones article? "The family was not happy,"-
Is this a legitimate answer to the Question???
The military should investigate a case of "friendly fire" casualty immediately, if not sooner! Just in case a court marshal has to be held. Does any one know at this point, whether it was an accident or a deliberate shooting for who knows what specious reason!
I think Dr. Patterson did the right thing, in order to bring out the absolute folly to have our young men dying far away from home for absolutely nothing!!!
They should never have been sent to Afghanistan to start with. Those people over there should be left alone to sort out their own troubles. In my opinion they do not deserve 'our help', nor do they want it. A friend of mine, dearly departed, courtesy of those people, used his own initiative and resources to build a school over several years and was murdered by these goons for this privilege!