2013-2014 Ethics and Professionalism II
<-- 2013-2014 MCH Competency Reflections
Josie Badger, a second year LEND trainee, engaged the class in a discussion about ethics—its definition, purpose, and application to LEND clinical cases. She started with basic definitions to bring into perspective why ethics are important for reasons beyond one’s inherent belief of what is right. Ethics protect vulnerable populations, which include the Maternal and Child Health Bureau (MCH) population of children with disabilities on which LEND was founded. Josie went on to present additional definitions of words such as justice, autonomy, and dignity, stating that “Just by being human you have dignity—dignity is worth”. Josie expanded the ethics presentation to pertinent topics of decision-making ability and power, which were directly relatable to many of the students’ clinical cases. This included a conversation about competence (understanding of a situation and having the ability to communicate) and capacity (adequate ability to make decisions, which cannot be decided solely by one’s diagnosis). The group continued to participate in a large discussion about decision-making power: what it is, and how it protects an individual’s best interests. The discussion of vulnerable populations, the recognition of barriers, power differences, as well as the definitions of human rights resonated with the MCH ethics and competencies in professionalism. This includes going beyond the definitions to identify the ethical implications of health disparities and then formulating strategies to solve these problems.
Josie reviewed the core ethical principles: nonmaleficence, beneficence, justice, autonomy, dignity, integrity, and vulnerability. The power of using such words to recognize barriers of vulnerable populations was realized when Josie asked the students to parse out the ethical dilemmas of a presented case study, and even more so in relation to the LEND clinical case examples. The students were asked to gather in their clinical teams to spur discussion of complicated ethical dilemmas as well as initiate conversations on possible solutions, which align well with those aspects of the ethics and professionalism in MCH competencies. The activity gave each LEND team an opportunity to examine individual cases and get to the root of many pertinent issues. These discussions revealed the difficulties of being faced with an ethical dilemma, as well as the process used to create opportunities for solutions and questioning of the present system. Josie’s expertise in this area was very evident as she provided insight with respect to turning abstract ethical concepts into concrete solutions. Josie put it well when she stated that the presence of a law does not necessarily imply fairness or being ethical.
<-- 2013-2014 MCH Competency Reflections