The ethicist
When you add such complicated issues together in a career such as how to be as humane as possible in the face of trying to make enough money to feed your family and pay your staff against the physician vs the surgeon and all the competing interests that those provide, then where the individual sits on the ethical continuum is absolutely fundamental. Not only to their own success and fulfilment but to the outcomes to the people that they seek to serve.
In recent years much more consideration has been given to non-clinical aspects of clinical work such as the ethical framework.
‘Ethical drift’ is a situation that occurs over time in all aspects of healthcare where people’s styles and incentives change their practice and decision making over time.
It’s easy to see how this could happen with someone who runs a business who’s trying to make a living, pay the bills and pay the team and continue to develop as an individual but who is inherently linked to the patient saying yes to treatment and ideally to treatments which are well remunerated.
Putting systems in place to be able to check where you sit on the ethical continuum and whether your decisions are changing or altering over time depending upon the circumstances in which you find yourself, is critical in modern day healthcare and in shared care decision making with patients.
In a world where medical ethicists are now commonly seen in large healthcare institutions to be able to advice doctors externally on decision making in, for example, patients who are terminally ill or patients with religious objections to treatment, we find ourselves in smaller organisations having to be our own medical ethicist.
The consideration of ethics and philosophy, in my opinion, should be something that is provided from primary school so that people are able to think about where they exist and what their morals and values are.
It’s easy then for someone to understand whether they fit into the moral framework of the society in which they inhabit and this falls back to how healthcare is provided and what the morals and the ethics and philosophical approaches are to the healthcare we provide and what we hope for in healthcare professionals.
It’s one thing to be a successful ‘cosmetic dentist’, it’s another thing to want to receive that treatment yourself or for your mum.
Being able to understand whether the treatments you’re recommending and the quality that we’re providing for our patients is of a standard we would be happy and even delighted for our own family to receive, is a great test to see whether we are operating in the right ethical sphere.
The understanding of all of this and the ability to create and live with values which are consistent with societal dues of our healthcare should be provided are the responsibility of the surgeon and therefore the knowledge of this and the training and reflection on this is also the responsibility of the individual.
Where to find the time?
To be all of these things before you’ve even ‘lifted a knife’ is a challenge indeed but I think it should be seen as a wonderful journey of personal development and that is exactly how it’s felt for me.
In every one of the areas previously described here I fail on a regular basis, it’s only through the failing, the reflection and the adaptation that we make any forward progress.
Blog Post Number - 3187
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