“…then I come back, and you [the government] treat me like a piece of shit… I stuck up to my part of the bargain; I signed a contract saying what I was going to do, and I did it.”
– Tom Martineau in A Soldier’s Contract
Recent Veteran Affairs office closures across Canada has led to passionate rallying for better medical care for veterans. Reinforced by a meeting with Veteran Affairs Minister, Julian Fantino, that went “off the rails,” veterans feel that their service is not valued by the government. This leaves us with an important question: what obligation does the government have toward its war veterans?
Michael Gross, a leading military Bioethicist, argues that a nation with nationalized health care such as Canada, owes no special privilege to its severely wounded veterans. In a paper published in the American Journal of Bioethics, he states:
“Because the goal of military medicine is salvaging the wounded who can return to duty, military medical ethics cannot easily defend devoting scarce resources to those so badly injured that they cannot return to duty.”
His defense of non-privileged status for veterans is strictly utilitarian; those who can be salvaged will receive treatment so that they can return to fight, but those who cannot, should be stripped of their identity as a veteran in the eyes of the medical system and be treated as a “patient” equal to all other patients who have comparable injuries. His argument rests on the idea of fairness and that veterans should not use up extra scarce medical resources. Gross gives the example that we should not give an individual with a neurological injury from a bike accident less care than a veteran with comparable neurological injuries. Although it makes sense to not provide care for individuals at the expense of others who will suffer harm as a result, Gross’ utilitarian argument misses the point of the issue: veterans feel like they are expendable. Not only does his argument miss the point, but it reinforces their expendability since he argues that only those who can be “salvaged” to continue fighting should receive special attention.
The rift between gross’ bioethics and those who argue for Canada’s “sacred obligation” to veterans goes back to a classic philosophical debate between utilitarian ethics and deontological ethics. Utilitarianism is based on doing the greatest good for the greatest number. Deontological ethics is based on doing one’s duty. Utilitarianism relies primarily on the moral foundation of not doing harm, and promoting fairness, whereas deontological ethics relies more heavily on the idea of loyalty, authority, and sacredness. This ethical clash has also manifested in the abortion debates where a strict utilitarian would not have an issue killing a fetus if it will result in a better outcome for the individual and society at large, whereas an individual with a strict deontological perspective would argue it is our duty not to kill based on the sacredness of human life. Although both sides can reasonably argue their perspective, the point is that they are not having the same conversation. Whenever this utilitarian/ deontological split occurs in a debate, the two sides end up talking past one another, failing to see the merit of the others point of view. This is precisely the issue with Gross’ argument that Canada should not privilege its severely wounded veterans.
Any veteran would tell you that they wouldn’t want to have others suffer at the expense of their treatment. The issue is that veterans feel like they were used and forgotten. I recently attended a protest in front of the Windsor Veterans Affairs office on the day of its closure. A large image of a poppy hung nearby, and “lest we forget our veterans” was a major sentiment of this event. Veterans felt disrespected and offended by the closure. I heard a WWII veteran question whether or not he wasted his time. Access to services is of course the main issue, but underneath this demand is a feeling of deep abandonment. The feeling of betrayal experienced by veterans cannot be rationalized away by utilitarian bioethics. Our veterans fought for a sacred ideal beyond their individual self-interest. Whether for nationalism, humanitarianism, or for their comrades in arms, a sacred ideal compelled their altruistic service and sense of duty. Upon their return, our government must fulfill their half of the social contract and demonstrate its sacred obligation to the veterans of its wars.