[Sent – 14 December 2018 to the 170+ surgeons et al of our Surgical Ethics (Education) Consortium]
The challenge introduced by this slide is to compress the essence of the ethical dimension of patient care into an accessible answer to the question – “What do I intend for this encounter?”
I have (co)authored enough articles over the past 3+ decades to understand and appreciate the investment necessary to craft insightful extended commentary and interpretation re the ethical complexities associated with the practice of medicine and surgery. These resources are invaluable. However, they are often not easily or quickly retrieved and utilized within the time constraints and the stresses common to the daily care of multiple patients. So as a complement to these more lengthy resources, I began working in the other direction – toward brevity, toward a single centering sentence, toward capitalizing on the few ‘take a deep breath’ seconds before the physician or surgeon approaches the next patient. I realized early on that using those few seconds to recall the four anchoring concepts/principles – non-maleficence, beneficence, self-determination, justice – lacked the pause effect needed for physicians or surgeons to reset their attention to include the ethical dimension of patient care. I began to test the question – “What do I intend?” One reason – ‘intend’ and ‘intention’ are etymologically linked to ‘tendon’ (i.e., to extend, to stretch)! Years of observing, listening, questioning, drafting, revising while working alongside physicians and surgeons have led to the compressed answer proposed in the slide – “I intend to do what makes medical sense – to the patient as well as to me – in a fair and gentle manner”. I am still searching for more efficient ways to reach the essence of the ethical dimension of patient care. I will welcome learning about your answers to the question.
I am currently midway through Irving Stone’s biographical novel about Michelangelo – The Agony and the Ecstasy. Perhaps what we are attempting with surgical ethics education is analogous in certain ways to the sculptor with chisel and hammer in hand passionately chipping toward the image s/he sees inside the marble block. Last night I sensed this connection when I read this description of Michelangelo’s work on the Pieta –
“He broke into his marble block at the left side of the Madonna’s head, worked to the left of the block, the north light behind him. By getting (his assistant) Argiento to help him turn the block on its beams he was able to have the shadows fall exactly where the cavities were to be carved, a play of light and shadow to show him where he must cast out stone; for the marble he took away was also sculpture, creating its own effects”.
I look forward to hearing from you when convenient.
Doug
