[As written/circulated 2008-09 for the Barnes-Jewish Hospital Ethics Committee members]
“What do we need/expect from patients and families?”The trust upon which safe and effective healthcare depends is multi-dimensional, is a partnership, is a collaboration between healthcare teams and patients (with their families and friends).
The ‘follow through’ metaphor is especially vivid for a sports enthusiast. Baseball has held my attention from childhood. I still have a home-movie clip my father made of me as an aspiring teenage pitcher attempting to demonstrate in slow motion the components of a proper follow through. Perhaps your favorite sport is basketball, football, tennis, golf, fishing, soccer, or . . . -- the follow through is integral to success in each one. In order to follow through on what we invite patients and families to trust about us and the hospital, we need their cooperation, participation, assistance. Thus the question – “What do we need/expect from patients and families in order to follow through on what we invite them to trust about us and the hospital?”
These four answers serve as counterpoints (in the music composition sense of combining melodies) to caregivers’ intent to be very careful (non-maleficence), to make a valued difference in the patient’s well-being (beneficence), to honor the patient’s perspective/expectations (self-determination), and to discipline their biases and use limited resources wisely (justice). Each answer highlights the accountability patients/families bear for one of the four basic concepts of medical ethics.
