How I became interested in medical ethics
The truth is: I should get out more. I mean, who likes medical ethics as a subject? That 160-slide PowerPoint presentation on some random Thursday afternoon at undergraduate level when you spent the time updating Facebook (and not about the fascinating lecture!).
That was me. When you’re trained to give drugs and not hugs surely everyone should be treated the same, regardless of how actually dead or dying they already are? I mean, the motions of resuscitation should be administered without deviation to give the patient the best chance, innit? Well, I thought so until 3am one morning when I got told: “Sonny boy, how long are you going to continue because we can all see Granny is dead?!” And another morning, slightly earlier, at 2am when I got told, “thanks for coming but please let grandpa go, he’s suffering” only to be met in the next room by another family member begging me to do something.
Who do you call for advice after pumpkin hour when you’re actually the one in charge and everyone is looking at you and you’ve only read Fifty Shades of Grey and now there are at least Seventy, just like the patient’s age (is that even a factor in itself? Three score and ten, good-innings, and all that.).
Well shit. Suddenly words like beneficence, non-malfeasance, justice, utilitarianism, adjhgskjgsahkjns, and etc. come rushing back to mind but since you weren’t paying attention you have no idea what they mean, how to apply them, or what the hell to do now. So you do what any skilled professional would do: you ignore the family and RESUSCITATE.
It’s a pretty good thing we pick on the dead to do this stuff to because of we did it on healthy, alive people they would take your glasses off and crunch them under their feet before smashing your face in with a brick.
Try this as an exercise: Ask ten colleagues what they would do in these situations and you will get fifteen non-committed, VAGUE answers and probably see a goat.
The problem with this (as warned by THE Maggie Thatcher) is that when you stand in the middle of the road you get run over by traffic from both sides.
So, it became clear that I had to get across the road somehow and so I started reading and consulting… and the more I read and consulted the more I had to read and consult. Basically back in matric trigonometry where nothing made sense from any angle. And so I enrolled in UNISA’s year-long Certificate in Medicine and Law where things became a little clearer and less muddy, like algebra where if you worked through things you got an answer. And the marks come from the logic and workings, not the final answer.
Oh, and I learned not to rely on what the law says because that’s another branch of study entirely that doesn’t always answer our ethical questions…!
So I’m not here to give you the answers. I’m here to show you that I’m just like you: full of confusion, ambiguity, and terror (at 3am). And that this stuff matters because we’re dealing with people – something I think we often forget. And not just dead people, also the ones left behind. And it’s for them that we need to know what the hell to do in various unclear situations. Even if it means putting away the drugs and getting out the hugs.
So, my plea to YOU is to please speak with colleagues, read books, consult, attend that blerry two point Ethics CME, and do some scenario planning so you feel comfortable in dilemmas of Ethics.
Oh, and don’t phone me. I’m gonna get out more.
Post by guest blogger Darren van Zyl @darrenmedic911