Sent 26 April 2021 to my wife and our three daughters]
Greetings. I trust you are well. As an answer to “What does Doug/Dad do?” -- I have inserted below a communication I sent the 200+ surgeons Ira Kodner (WashU emeritus colorectal surgeon) and I have gathered/nurtured over the past decade into a surgical ethics working group. They are all variously invested in advocating/educating for surgical ethics in surgery departments across the country. The communication I sent them yesterday is #44 in a series I began in May 2018, sharing with them ethics education tools and resources I have created during my career.
Also, when the Derek Chauvin trial began, I began reading Andrew Ward’s The Slaves’ War: The Civil War in the Words of Former Slaves (2008). I found the attempt to see from/through their experiences and observations to be illuminating, sobering, haunting, convicting. I fought off the instinct to rush, to gloss over, to look away, to talk back. In his Author’s Note at the end, Ward repeated the insights careful (and courageous) readers will gather inductively as the slaves guide them chronologically through the war years and the years immediately after the war. The slaves gave me a painfully realistic context within which to place Derek Chauvin’s trial.
Doug
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[Sent 25 April 2021 to our surgical ethics working group members]
Greetings from St. Louis and WashU. For my ‘Surgical Ethics Education Resources -- #44’ communication, I am sharing with you two versions of a PowerPoint slide (inserted below) I created for educational purposes when differentiating the ethical dimension of care in a comprehensive/multi-faceted pause – informal or formal, individual or as a team -- to reflect on a case/surgery. Five dimensions of care are identified, with each dimension requiring a distinctive professional language to answer a specific question. The five questions are intentionally worded to concentrate on the core accountability associated with each dimension of care.
These two versions of the PowerPoint slide – one worded for ongoing cases, the other worded for retrospective review of cases -- draw attention to layers, complexities, and nuances too often missed/absent on rounds, in EMR notes, and/or during M&M conferences.
The use of the word ‘language’ points to the specialized vocabulary and syntax necessary for each of the five dimensions of care to be considered/discussed. Also, I use the word ‘spiritual’ in an existential sense that includes/respects those who self-identify as ‘not religious’ as well as those who self-identify as ‘religious’.
Physicians/surgeons, nurses, social workers, and allied clinical colleagues are necessarily most fluent with the clinical/scientific language. Those who staff risk management are most fluent with the legal/regulative dimension of care. Those responsible for operations and administrative supervision are most fluent with the economic/business dimension of care. Palliative care teams and chaplains are most fluent with the spiritual dimension of care.
For patient care to be authentically humane and just, all five dimensions of care need to blend, to weave together, to be evident, to be respected.
Doug
