Week 6: Close one door, open another

After a long delay, here are my final thoughts about completing the PHT402 Professional Ethics Course.

One Door

Let’s look back a little and then move forward!

Were my expectations met?

Definitely! I wanted to do this course because I thought it sounded like a novel way to engage on the topic of Ethics. It sounded way more interesting than the typical “boring” ethics course – where we get taught things instead of wrestling with them ourselves. Thanks to Michael Rowe and the Physiopedia team for providing us with such a great way to “dig” into Ethics. It was refreshing to hear so many different opinions of Physio students, practicing Physios, people interested in Physio, or somehow involved with Physio!

What did I learn?

I learnt that for every topic, there are multiple views and opinions. Just like the rainbow, no one colour is more important than another. In the same way, no one view is more important or more “correct” than the other. I learnt that we should spend more time listening to others viewpoints then trying to get our point across. I learnt that our upbringing and culture has a big role to play in what “colour” we see the world in. But despite what we’ve been taught, we can choose to see the colours that other people see in, or even learn to see by different colours.

light_beam_through_glass_prism

 

 

 

 

 

 

 

 

I learnt to not spend so much time trying to say things with the “right” words but just to say it! Especially with blogging, I sat for days sometimes not sure what to write or how but I’ve learnt to relax and just get something done.

The topics of Ethics, Morality and Equality were easy enough to deal with. The topics of Torture and Euthanasia were a bit more difficult to engage with. But I learnt that “difficult” topics doesn’t mean that we shouldn’t engage with those topics, in fact we should probably engage with them more. And most importantly, KEEP AN OPEN MIND.

How will I apply it?

We live in a world where there’s so much emphasis on doing things faster. We get told that time is money and that listening is not a productive use of time. But I think if we listened more, we’d understand more and become more effective at “being human”. So I’m going to try to listen more to my patients and to those around me. Another thing I’m going to try do is not to assume what someone will think or say or believe, but to give them a chance to have their say.

Lastly, I’m going to (try) take myself less seriously. I’m going to try not to have the “perfect” words or the “best” argument. I’m going to engage more with the difficult topics instead of sidestepping them or pretending they’re not there.

Thank you to all of the course participants for giving me “food for thought” and reading/responding to my thoughts. I look forward to another similar course in the future!

You can read a few of my fellow course-mates overviews of the Professional Ethics Course:

“Euthanasia Coaster”

The Euthanasia Coaster is a concept for a steel roller coaster designed to kill its passengers. In 2010, it was designed and made into a scale model by Julijonas Urbonas, a PhD candidate at the Royal College of Art in London. Urbonas, who has worked at an amusement park, stated that the goal of his concept roller coaster is to take lives “with elegance and euphoria.” It is a ride to the death. The seven loops or “inversions” put the human body under such stress that it causes the brain to be starved of oxygen, as the heart simply cannot push blood against enormous g-forces. Even if it kills you, it is designed to still be a fun death. An honourable thought, if rather macabre.

Euthanaisa – Yay or Nay?

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After reading the material for this week, 2 words popped into my mind: Hope and Equality.

Hope – the Wiki about Locked-in Syndrome named a few notable cases of people who had the syndrome.  I must admit, the suffering that these people went through (or are going through) is almost unimaginable.  But, hope still seems to prevail. Some of them made the most of their circumstances and wonderful things resulted.  It would be interesting to see how many people support the idea of euthanasia who are religious.  The atheist would argue that religious types would be opposed to euthanasia because their god says its wrong.  I tend to believe its because the religious types have a sense of hope that the atheists do not.  Tony Nicklinson seemed without hope, was a self-proclaimed atheist and technically ‘killed’ himself – coincidence?

Equality – In Death Becomes Him, Ludwig Minelli is quoted as saying that the right to die is “the last human right”.  He thinks we should all have the right to decide when and how we will die.  He implies we should all be equally able to make this decision.  However, the process people have to follow at Dignitas does not seem one of equality.  It very much seems like one of inequality, profitability and elitism.  (Check out the Wiki on Dignitas…)

It apparently costs R 52,701 (4,000 euros) – R 92,227 (7,000 euros) for assisted suicide at Dignitas, not including the airfares and other costs involved.  Only the upper-crust can decide if they are ‘worthy’ of dying.  Dignitas has repeatedly refused to open its finances to the public, despite being a non-profit organization.

Dignitas opened an office in Hanover, Germany in 2005. This article from The Washington Post, reported on it.  Kurt Bliefernicht, director of Hospice Luise, across town from Dignitas’ office in Hanover, refuses to give out Dignitas’ number to people calling asking for their number.  He fervently opposes assisted suicide, which he calls “a really cheap” way out. He said he tries to chat with the callers about hospice care and other alternatives. People are most often driven to consider suicide out of fear and ignorance, he said.

“That shows that this is a real problem in Germany, as far as awareness goes,” he said. “We’ve forgotten how to deal with death and dying. We don’t know how to talk about it.”

In the same article, Margot Kaessmann, the Lutheran bishop for Hanover said the following about desperate people:

“These people need treatment,” said Margot Kaessmann, the Lutheran bishop for Hanover. “They need new possibilities for life. They might take a dangerous shortcut instead of listening to people who love them and take care of them. For me, that’s not dying with dignity. That’s very sad.”

From a Christian perspective, I feel the following questions are important to ask:

  • Does life cease to have ‘meaning’ beyond certain thresholds of suffering or loss of vital functions?
  • Can we find meaning in suffering?
  • If we believe God is the source of truth and wisdom, should we not turn to Him when we are suffering?
  • Is there ever a situation where euthanasia is not ‘murder’ i.e. do the ends ever justify the means?
  • If we believe life is sacred, when should we draw the line between ‘preserving life’ and ‘prolonging death’?

Interesting reading from a Christian viewpoint:

  1. Who is really ‘playing God’—the doctor who euthanizes a dying patient, or the doctor who extends the life of a terminally ill patient?
  2. “What does the Bible say about euthanasia and/or having a living will?”

A Torturous Decision

…because the human torture pics were too ghastly…

 

 

 

 

 

 

 

 

 

 

“When is Torture OK?” – The  topic for Week 4 of the Professional Ethics Course.

Wow.  This is an ugly topic.  Just browsing for an image to use for the post left me feeling disgusted by humans.  I literally had to walk away from my computer.  As a race we are capable of such beauty and good, and yet there is such a tendency towards evil and the macabre. But here we go…

Torture = “any act by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person for such purposes as obtaining from him or a third person information or a confession,”  The UN’s Convention Against Torture.

The Convention also declares: “No exceptional circumstances whatsoever, whether a state of war or a threat of war, internal political instability or any other public emergency, may be invoked as a justification for torture.”

So when it comes to torture I feel that there are 2 important questions that need answering:

1.  Is torture EVER right? Are there certain circumstances where torture is allowed or morally correct?

With the previous week’s topic of Equality so fresh in my mind I tend to agree with Mohammed after reading his post. He says there may be reasons for torture but that no situation ever justifies torture. No one ever WANTS to be tortured (maybe some with strange fetishes?) and if the situation were turned around, the torturer would not not want to be in the tortured’s shoes.  In Mary’s post, she answers the questions posed for the week in pretty much the same way I would.  Her argument is that “the ends never justify the means”, that torture is wrong – and stays wrong even if something good comes from it.  A thought-provoking, opposing view can be found here, even though it didn’t change my mind.  In terms of medical professionals ignoring the Hippocratic Oath and justifying their lies, cover ups and wrong-doings by citing the common good, hmm.  I don’t know if they truly believe they are doing the “right” thing for their country, or if deep down they know it’s wrong but just push it to the back of their minds.

Is Physiotherapy akin to torture?  Some of my patients would say yes!  But seriously, sometimes it comes pretty close.  Take for example a burnt baby, who requires painful but necessary stretches and mobilisations of the burnt areas to prevent complications.  The baby will most definitely experience severe pain and suffering; it would definitely be done intentionally by the physio; but the ultimate reason or purpose is different.  Torture is never aimed in the best interests of the person being tortured.  Treating a burnt child, or any patient for that matter, requires that our overall aim is that the patient benefit.

2.  Is torture EFFECTIVE? If it doesn’t work then why do it? And more importantly, if torture is not right, is the second question even relevant?

After reading ZERO CONSCIENCE IN “ZERO DARK THIRTY”, and Interrogational Torture: Effective or Purely Sadistic?, I don’t think torture is effective.  There is no guarantee that it will work, in fact sometimes it can result in false information, which I’m sure would waste more time than it would save.  My thoughts on this subject were re-iterated in Torture and Tough Questions: Why Zero Dark Thirty Deserves to Win Best Picture:

The argument cannot be that we should not torture because it does not work. The argument must be that we should not torture because it is wrong.

Some more interesting reading on this and related topics:

Just Equality

The topic for Week 3 of the Professional Ethics Course is: “Are we really all equal?”

(Apologies for the lack of posts, life doesn’t seem to care that I’m trying to blog, in fact I think it’s trying it’s best to undermine my efforts!)

“There is neither Jew nor Greek [race], bond nor free [social status], male or female [gender equality], for we are all one under Christ Jesus.” – Galatians 3:28

Equality

 

 

 

 

In my mind the word equal means ‘EXACTLY THE SAME AS’ (for a better definition of Equality, see Sheila Marie’s post here).  Maybe it comes from the good ol’ days in maths class.  Whenever you saw a “=” sign it meant that what followed was the precise answer to the question.  Nothing more.  Nothing less.  So when I try answer the question, “Are we all created equal?”, it confuses my brain a little.  Are we really all exactly the same?  There are so many aspects to this question…

Are we created the same way?  Usually a sperm and egg are involved, then LIFE happens

Are we made up of the same ‘stuff’?  Yup, blood, guts, bones and some DNA

Do we believe the same things, do we think the same, do we make the same choices?  No, no and no

Are we entitled to the same things?  Yes

Do we have the same abilities and interests?  Nope

Are we essentially, equal?  Yes

Is everyone treated equally?  Definitely not

Should we be trying to remedy this?  YES

As a Physiotherapist in South Africa, I am expected to treat ALL patients and human beings equally.  The South African Society of Physiotherapy (SASP) Member Credo states: “I will place health care above consideration of race, gender, sexual orientation, creed, social standing, political allegiance or nature of disease”.  The Health Professions Council of SA (HPCSA) sees it as my responsibility as a Health Professional to: “at all times act in the best interests of my patients; and to respect patient confidentiality, privacy, choices and dignity”.  In terms of my faith, I am also told to treat everyone the same, but it’s not always easy is it?  It’s sometimes hard to realize that we can engage with people about their beliefs, religion, politics, sexual preferences, etc. without necessarily agreeing with them.  That we can respect their views without adopting them as our own.

Now what about Justice?  Should we try to treat everyone equally and leave it at that?  Justice by definition means being fair and reasonable.  Treating someone equally without trying to correct an imbalance or disability won’t always help.  An example would be allowing a child with a disability to attend a ‘normal’ school without attempting to cater for their disability.  Equal access doesn’t mean equal function or participation.  It’s sometimes easier to treat people equally instead of just.  I found this picture to better illustrate the difference between Equality and Justice.

Equality doesn't mean Justice

 

 

 

 

 

 

 

I really enjoyed Reham’s post about her experience with people assuming things from the way she dresses.  You can read her post here.  What an honest and insightful post.  Assumptions can be dangerous and hurtful.  I learnt anew not to assume anything because I will most often get it wrong!  Treating someone equally means allowing them the freedom to just be themselves.

Lastly, I like the way Chantelle summed up her post on Equality (it’s something I strive for as well):

I believe that focusing on how you act and engage with others, is what is important. It is a personal goal to try and see people without judgement, as your equal, a human being, deserving of equal respect, protection, understanding, kindness and care.

Moral Dilemma – In Practice

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Here’s a moral dilemma that I experienced this week…

Mrs N, a middle aged housewife, opened up to me and told me her husband had been physically, verbally and psychologically abusing her for the past 12 years. He only let her take the car to come for her physio session; and she was supposed to go straight home afterwards. Mrs N had finally had enough of it all and wanted out. She wanted to go to the police station to get advice and report the matter. She asked me to lie to her husband if he called and tell him she’s still at her physio session.

Is the lie justified?

What would you do in the situation?