[Sent 27 May 2018 to the 170+ surgeons et al of our Surgical Ethics (Education) Consortium]
Greetings. With this e-mail, I am formally beginning the sharing project I introduced a few weeks ago. Several of you sent very encouraging responses to my proposal to share with you the ethics education resources I have created/tested (often in collaboration with medical faculty members) over the past 30+ years embedded in various hospitals, medical school departments, biomedical research teams, and medical practices. Please let me know if you prefer to be removed from the distribution list. My plan is to circulate a few PowerPoint slides with brief commentary every three weeks. I will welcome your observations if/when you can send such and will respond promptly to any questions you may have. You are at complete liberty to use these resources in every way that seems to have potential education value for your efforts to advance surgical education.
For this first communication, I want to return to the slide I included with the introductory e-mail as an example of the didactic resources I will be sharing with you. For two academic years, Dr. Wall and I framed our every-other-month ethics conferences with the WashU Ob/Gyn residents as ‘a look just beyond residency’. This particular conference alerted the residents to powerful forces that pull away from practicing ‘evidence-based medicine’ in patient care. I have inserted below the pivotal slide. As you will likely expect, the residents in response to the first few slides about their residency training were nearly unanimous that they were being trained to practice evidence-based medicine and that they fully intended/expected to practice ‘evidence-based medicine’. They were jolted by the quotations from senior leaders re the harsh realities in the trenches. Here are some of the questions I recall we discussed with the residents –
⦁ Is ‘evidence-based’ always unambiguous?
⦁ Why/how is grounding patient care decisions in ‘evidence’ ethically significant?
⦁ Do these pressures to diminish/surrender ‘evidence’ cut across all patient groups?
⦁ What are patients or their surrogates seeking if an ‘evidence-based’ foundation is not essential?
⦁ Can this subject be addressed when interviewing for a position with a practice?
Thanks for the privilege of sharing this didactic resource with you.
Doug
