Final thoughts continued – Course Reflection

After reading more posts from other participants in the course, I have some thoughts that I think I could share as a continuation of my week 6 overview (two more beliefs/concepts that have changed for me).

Firstly, something that struck me as I read Chantelle’s blog, was how differently we experience and relate to the same topics. Not necessarily because we have different opinions, generally I think they don’t differ too greatly; but because of how relevant these issues are to us. A lot of the topics that we covered were incredibly interesting and relevant for any human being, but in some ways it seems to me that what I was writing was more on a theoretical level. That could be due to not doing enough research etc. on my part in bringing up more solid examples and anecdotes, but I think that there were two reasons, the first was that I am not actually a health care professional, so as a result my experiences with patients who might have been experiencing these issues themselves, were still minimal in comparison.

Secondly, we live in such vastly different cultural climes; Canada is of course not free of these issues we have been discussing, but I have realized that Canadian society has a different view and take on a lot of these issues that I have basically taken for granted as universal. For me, the question of whether torture is ever alright is quite obviously no, whether empathy should be practiced in health care is obviously yes, these answers were a result of my own personal values, but also the socially and culturally accepted answer here in Canada. Some of the South African articles and news reports that you guys have been posting have really embodied the problems we have been discussing in ways that my experiences in Canada do not. For example the video that Chantelle posted in her blog in regards to torture, showed police brutality, which really is common enough in Canada, what with the RCMP and all, but also the nearly systemic application of torture whenever it suits them, for no real reason, and sometimes till death. That is not so often seen in Canada, we kind of abstractly think about it happening in the Middle East (while hoping that the Canadian troops didn’t take part in it), but not necessarily on Canadian soil.

In reflection, I realize that my posts may come off a bit idealistic and academic, due to the lack of direct relevancy to my own experiences. That doesn’t mean that I have been convinced that empathy has no place in health care (in the space of a week or so, since my last post, it’s become more apparent to me that empathy is a requirement for the well being of the patient, whether it is beneficial for the health care provider is another story and in some ways not entirely relevant to the argument).  Or that the act of torture for example is suddenly alright. I feel like maybe we get ourselves a bit confused with things when it hits too close to home, sometimes being a bit further away from the situation might lead to clearer thinking.

A lot of us struggled with the post on torture, would it be alright to torture someone if it meant averting a war? What we unconsciously wonder about is, are we going to be caught in this war? And we start weighing one person’s life and pain with the life of our friends and family. The simple and clean way out of this problem is just to think of the act of torture and the threat of war separately. It’s always going to be wrong to torture someone, morally speaking. And not averting a war that might lead to the death and suffering of a multitude of people is a horrible prospect. It might seem like torturing someone would be the lesser evil, even though just thinking like that feels wrong in itself.

The thing is, it is more morally correct to have to debate and agonize over the decision every time the situation comes up, than to decide without agonizing over the decision, thinking that it is justified. We’re going to do a wrong thing either way here, no matter how much its discussed there’s no way to escape unscathed from this question and that’s the way it should be. Is torture ever alright? The answer is no, but it doesn’t make not averting a war alright. It just means that the situation is going to take its pound of flesh out of whoever gets to make the decision and/or carries it out.

In summary, my participation in this course have led me to realize just how insular my experiences and knowledge regarding the topics of this course have been. I have also realized that I need a lot more practical interaction with patients in order to more fully understand the relevancy of the course topics in a health care environment.

 

Have your expectations of the course been met?

 

Yes, I think that my expectations of this course has been met. I was able to read about the different perspectives offered by the participants of this course. Although, I regret not participating more fully and being able to write a follow up post to each topic afterwards.

Thanks for reading! 🙂

Week 6+: Final thoughts

This is my sixth post for the PHT402 Professional Ethics Course.

Go back over your blog posts from the first week of the course, and review what you wrote there. Write a final post presenting three major ideas, concepts or beliefs that have changed over the duration of the course.

Even though I have pretty much completed most of the posts for this course, I am aware that there is another aspect of the course which I have not fulfilled entirely. That would be the interactive component, which includes reading and commenting on other people’s posts. I really would like to follow up with that and complete that part of the course as well, but I think that is going to come much more slowly. Most likely after everyone has already put this course behind them and moved on to other things.

One reason it is taking me so long is undoubtedly because of work, there really isn’t enough time outside of work for me to even have much of a social life. That’s not a real excuse as such, but one that I’m sure can be related to. Another reason may simply be because I know that when I read posts from other people, it’s really going to make me think and maybe even change my whole perspective on the topics we’re discussing.  That is the whole point, but it can also be a time consuming and daunting experience. I would like to do it justice by being able to dedicate enough time and attention to it.

Segueing into one concept that I have changed my mind about, after reading Umr and Chantelle’s posts in the first week, I began to think about empathy in a different way. I had always thought of empathy as a very important human attribute that people have in varying degrees. The more empathy one is capable of feeling, the more understanding and open we can be to the thoughts and feelings of others. To me, empathy has the power to elevate us from pettiness and hostility, as well as other ugly feelings and characteristics that are a part of us, simply because we are human. It allows us to transcend flesh and blood boundaries and be more than the sum of our parts (or our drive to survive).  But the ideas that have been brought up in this course has allowed me to realize that empathy is not necessarily always beneficial to the relationship between a patient and a health care provider. That it can disrupt a health care provider’s ability to help a patient and perhaps even impede the patient’s progress.

This is actually something I am still thinking about; I am trying to figure out the difference between sympathy and empathy and whether the boundaries are quite that clear cut. I’m sure the situation will be the determining factor, but this course has really changed my thoughts on the idea of empathy and even my own experiences.

As for the other two ideas, I think I will need to take a rain check, as of now. I will add to this post as soon as I have something more concrete, most likely that will be after I have gone through more posts from my fellow classmates… (I would love to be able to just write something and be able to say I competed the course, but like I said I would not be doing this course and topic justice.)

TO BE CONTINUED…

Preview:

  1. Have your expectations of the course been met?
  2. What did you learn? What evidence can you provide to support your learning?
  3. Will you change your practice as a result of taking this course? How?

Week 5: Euthanasia – The right to die

This is my fifth post on the topic of euthanasia for the PHT402 Professional Ethics Course.

An article I came across from the Province, I apologize for the lack of proper resizing of the image.

I think the article in the image above properly illustrates what we are afraid of when it comes to the idea of legalized euthanasia. The motives surrounding the act are unclear, the recipient of the act is no longer able to articulate whether she wished for it  and there are no witnesses or material proof that she ever wanted to be euthanized in the first place. Only the testimony of the perpetrator is accessible to any degree and considering it was not the first time he has been charged with murder, somewhat suspect.

This kind of murkiness is what we are expecting when it comes to the idea that voluntary assisted suicide and euthanasia be made legal. But this is also most likely what happens when euthanasia is not made legal so that it can be properly regulated. Its a far cry from the type of voluntary euthanasia that occurs at Dignitas, where everything is documented and a doctor has to ascertain that the recipient is mentally capable of making the decision and can ingest the fatal brew themselves.

It isn’t really death that we are discussing here, the patient will die eventually as all living things do, but how it happens; who is supporting the patient in the venture, were there any ulterior motives behind their compliance and morally speaking for the administrators, does this count as playing god? These questions are all obstacles to the acceptance of voluntary euthanasia. We bring these questions up, because we know how easy it is to stray from a morally sound purpose. And if one were religious, hard to detract from the idea that life and death is the province of god.

Terry Pratchett’s documentary “Choosing to Die” from Marna’s post is incredibly informative and delivers an extremely realistic experience of the process from a possible recipient’s point of view. What left the biggest impact on me from watching it was actually my own reaction to a couple of the scenes, more specifically the part of the documentary where Peter goes through with the process of euthanasia at Dignitas. He was just getting seated at the sofa in preparation for the brew and his wife asked if she should be away from him and expressed some reluctance to sitting next to him in his final moments. That scene actually evoked some suspicion from me, because she was strangely reluctant to be close to him while he was dying, I became suspicious of her motives. Was she pulling some kind of highly elaborate act? I am no expert on people’s reactions to someone dying in front of them, yet it was easy for me to  become immediately suspicious of foul play, and why is that?

The topic of euthanasia is a heavy one, but one that comes up probably more often than we expect. I often hear my parents saying how its not death that they fear, but how it happens and the possibility of escaping death only to be trapped in a body that is no longer capable of fulfilling its basic needs independently. Unfortunately that was almost exactly what happened to Tony Nicklinson in the article from our course readings. I can’t really imagine a good argument against his right for voluntary euthanasia, his condition; “locked-in syndrome” robs him of dignity and subjects him to a quality of life that is frankly inhumane. And I think any pro-life argument would need to take his suffering in account, as there is more to life than just being clinically able to to sustain awareness and breath. In fact, just imagining myself in his situation instantly reaffirms my belief that the issues around legalizing voluntary euthanasia are going to need to be resolved post haste.

Should assisted suicide be a legal option for those patients who choose it, regardless of their medical condition?

I think that assisted suicide should be a legal option for patients who choose it, but there needs to be some regulation based on a number of variables. Such as their medical condition, the duration of their condition and their quality of life (a big one). As with patients who suffer from locked-in syndrome, there is no terminal illness, no physical pain, but there is a lack of basic ability to survive without the help of others. The resulting humiliation and loss of self expression greatly detracts from one’s quality of life. its a simple question to answer, if you can imagine yourself in the same situation with no end in sight, there really is no question of whether you support the act of voluntary euthanasia.

If we ignore the religious argument (something like, “Only God can decide who lives and dies”), then to what authority can we appeal? How can we make decisions that are not driven by moral or emotional arguments

I think that the ‘decision’, the judgement of whether someone has had it bad enough to essentially warrant death, is inherently based on moral and emotional arguments in some way. Because giving someone a kinder death is rooted in morality and humanity. Maybe there is no authority that we can currently appeal, maybe we need to create one; a multidisciplinary and independent group of medical personnel and counselors that can evaluate the legitimacy of each patient’s claim to voluntary euthanasia, similar to the processes at Dignitas and other groups that administer voluntary euthanasia.

If your role in the healthcare system is to improve the quality of life for your patients, can you rationally support assisted suicide?

Yes, I suppose even agreeing to stop carrying out life saving procedures can be counted as a form of rationally supported assisted suicide. The important thing is that it is their choice.

Week 4: Torture and When it is Justified

This is my fourth post for the topic of “when is torture ok?” for the PHT402 Professional Ethics Course.

1. If all lives are equal, then when, if ever, is torture OK?

Firstly, I don’t think torture is ever okay. The act of torture itself is so malicious in nature, even when it is conducted in a completely ‘clinical’ way that it is not okay –not to mention the fact that a human being is being subjected to so much physical, emotional and psychological pain and suffering that death itself is kinder. What do we do to people who commit murder in our society? We strive to lock them up, some places there’s probably capital punishment, “an eye for an eye” as they say. So what makes torture for the sake of ‘the greater good’ so different? The act of torture itself has to be condemned, whatever ‘good’ that can come out of it cannot be used as an argument to wash it clean. Even if you managed to save a million people with the information you gained from torturing someone, in my opinion, it cannot be used as an argument to make torture ‘alright’. You just have to accept what you have committed or was compliant to, take the guilt and moral conflict that comes with that choice and let it tarnish a bit of your opinion of yourself as a member of that particular society. It would be far too convenient for us if we can just excuse what our country does as justified and move on, not bothering to even feel conflicted or ashamed over it.

And as far as comparing torture to physiotherapy… I don’t think there is any comparison. Even if you inflict pain on a patient to speed their recovery, that patient has chosen to come to you and has accepted your treatment so their health can improve. They want whatever it is you are offering, be it a grueling session or otherwise. I don’t think anyone can say that these prisoners or war criminals have ever wanted to be tortured, even to keep their secrets safe. They most likely would rather to not have been caught in the first place.

As for medical involvement in torture, I don’t really think of those practitioners as ‘doctors’ or medical personnel; I don’t think they have acted in the interests of their patients for a long time. So as such, I think of them as military personnel more than anything else.

2. Do you believe that some lives are more valuable than others? Does the life of a drug dealer have the same value as the life of an 80 year old? What about a small child with the potential for a full life? How do we make judgements about who gets what?

I think that some lives may be more productive for society than others, but if I were in the position of actually weighing these lives, I don’t think I would be able to. The premise would be that my choice would always be wrong in some way, because I don’t think there is a way to judge the value of people’s lives fairly.

3. What other morally ambiguous scenarios can you come up with, where your sense of what is right may be challenged?

This is a hard one… I know how I would react when I’m presented with a scenario, but for me to come up with one is difficult. I guess one of them may be the whole idea of capital punishment, whether we have the right to decide whether someone should be put to death for their crimes. Apparently, the threat of capital punishment does not have much of an effect on crime rates either, so part of the argument is already void. I think the argument for it, is essentially an economical one.

4. Do you believe that those who “live by the sword”, should “die by the sword”? Is “An eye for an eye” a useful criterion against which to measure our responsibility towards other human beings.

No. I don’t believe that should be how we measure our responsibility towards other human beings. An eye for an eye would make the whole world go blind, as they say. I don’t think that this idea is necessarily one that only pacifists have either, for good reason; it is not a viable system. it is one that would lead to anarchy. You steal from me, I steal from you or you kill my friend and I kill yours. That kind of situation is simply dependent on individual strength and a form of revenge, not justice. Although that is pretty much what nations operate on, laws don’t necessarily apply between countries.

Week 3 Continued: Part 2 – LGBTI and everything else…

Lisa Frank's photo on Facebook

Facebook/Lisa Frank

On the subject of LGBTI and why it seems like people more readily discriminate on the basis of sexual orientation than skin colour, I can only deduce that it is because many people view sexual orientation as a ‘choice’ rather than as something innate that you are born with, such as skin colour.

This may in part be due to the fact that sexual orientation is in fact something intangible, it is not a physical value and cannot be seen or identified just by looking at someone. We often find intangible things and ideas to be harder to understand and possibly as a result something to fear. LGBTI discrimination seems like it is often rooted in fear, of both the unknown and the different, as if it is something that can be passed on just by interacting with someone, while skin colour on the other hand is irrefutable and certain.

Sexual orientation is so often tied in with the question of masculinity and denounced by so many forms of religion that it is an incredibly sensitive topic. The fallout involved with discussing the topic might involve being labeled as LGBT youself, which unfortunately is still considered a negative label.

There has been a lot of talk about the LGBT community in the media lately, for those who live in Canada and Vancouver in particular (actually not much has been said about intersexuality but I digress). The annual Gay Pride Parade just took place two weeks ago and there has been massive media coverage and almost all of it in an incredibly supportive vein. In fact, I have heard some people around me say that it is all “too much”,  that it is not fair to heterosexual people in fact, that there isn’t a day to celebrate heterosexuality or that the street hasn’t been permanently painted a certain colour to support heterosexuality (when the streets have been painted in rainbow colours to show support for the LGBT community). All this and in the background we hear about Russia’s controversial new anti-gay law, not unlike the Ugandan anti-gay law mentioned in the article in our course materials. This really shows how different attitudes can be when it comes to the same issue.

For Vancouver, the media attention and emphasis on the LGBTI community during this time is part and parcel of their fight to be acknowledged by society, giving them a voice to be heard. It lets the rest of the population know that it is not going to be alright to ignore or discriminate against them. So the fight is still very much on in Vancouver. While painting the street might not seem to be necessary and I think that some LGBTI might not necessarily want such a blatant display of support either, it is really more about politics than anything else.

I think that it is fundamentally wrong to discriminate against people for their sexual orientation, as it is really none of your business what people decide to do in their own lives. So I really can’t agree or understand the kind of mentality that would lead to the kind of laws passed in Russia and Uganda.

To me, the stance and attitude that a society takes on homosexuality is very telling, I think that the degree of acceptance of homosexuality directly correlates with stability of the society in question. Homosexuality has always existed, I think the stats that people toss around is somewhere around 10% of the population, but the percentage might be greater than expected due to the fact that people often lie in surveys, especially for this issue.

In times of difficulty, where survival is not certain, reproduction and absolute compliance is prioritized, therefore people who have non heterosexual tendencies will act in a heterosexual way if at all possible. That is because there is no tolerance for anything that doesn’t help you survive (the reason may be framed as a religious one as well), so homosexuality is essentially tamped down, but of course still there. In times where survival isn’t quite so difficult and expression of self is possible, people are more likely to risk acting according to their sexual orientation, because the consequences have become less dire. To me, openness and acceptance of LGBTI is an indicator of stability in a society as a result, but please know that I do not mean any insult to any nation or community with this idea, which has not been researched at all.

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On a more personal note, I think that we are always going to have prejudices and negative assumptions against other people different from ourselves, whether we act on them is up to us. It behooves us to change these ideas for the better, especially when we come across people discriminating against ourselves.

It can be like waking up unpleasantly from a dream. The dream is that we are all equal, but then like being splashed with cold water, we wake up and see the real world where there is no such thing as equality. It disturbs us for a long time afterwards, until we go to sleep and fall back into that same dream, which is far more comforting than reality.

Week 3 – Part 1: Racism &/vs. Discrimination Against LGBTI

This is my third post for the topic of equality and discrimination for the PHT402 Professional Ethics Course.

“I often juxtapose conversations of equality and discrimination using race and sexual orientation (for the purposes of this discussion, I’ve chosen these topics but note that discrimination and equal rights issues are far more broad). Discriminating against people who have different colour skin is just as offensive as discriminating against people who have different sexual orientations, but they are often regarded as being two separate arguments. The reason I present the juxtaposition is that racial discrimination is (relatively) easily challenged using legal, moral and scientific arguments. However, the most common argument proposed against homosexuality is a religious one. Why is this?”

– Week 3 Course Materials 

This is a really complicated question, I’m not sure I can do it justice, but I will attempt to give my two cents. To begin with this question would be too ambitious for me, so I will start by talking about my experience/knowledge of racism and how LGBTI are viewed.

According to psychological and cognitive research,  we may all be racists to some degree.  We subconsciously take in repeated information, attitudes and ideas from the world around us and integrate these ideas into our knowledge base (whether it is correct or not),  without realizing it, the term for this in the field of psychology  is “subliminal conditioning“. Conditioning also plays a role in learning. So negative attitudes towards people of certain ethnic groups and people identifying with certain sexual orientations can basically be downloaded from the society around you, as long as these attitudes are presented to you repeatedly. We may not be conscious of the stereotypes and prejudices that we are picking up, so in theory we can even be prejudiced against groups that we belong to ourselves. For example, ethnic Africans may subconsciously be associating others of the same group with crime, even when they personally know it is untrue. Or in the case of this video, absolve Caucasians who are viewed as less likely to commit crimes, from participation in theft when the situation was quite damning.

Of course, these are subconscious attitudes, once we realize that we have them we can consciously fight against them and stop ourselves from behaving in a discriminatory way (if we desire to).

In light of this information and in reference to the “How to Tell People They Sound Racist” video on youtube, I agree that telling someone they are a racist will not produce any useful results. Firstly, because everyone has discriminatory thoughts and the potential to carry them out. Secondly, it would only anger the person you labelled a racist and make them less likely to listen to what you say. You will simply reinforce their discriminatory thoughts, because you are damaging their self image with a negative label (that they are a “racist”) and to recover from that they will simply think they are even more right than before.

People cannot be told what to do or think, they can only be persuaded or they will be even more resistant to new ideas. To change their minds, try to challenge their discriminatory statements and thinking with logic and when possible empathize the similarities between groups of people in layman’s terms.

What I guess I am trying to say is, to fight against racism, you have to acknowledge racism and how easy it is to act in a racist way. Don’t categorize people into groups, such as “racist” and “non-racist”. I think that a more helpful concept is simply to acknowledge that there are no “non-racists”. Yes, you can argue that having discriminatory and prejudiced thinking does not make you a racist, because you never acted according to them. But the world is not that simple, you can’t be sure 100% of the time that you never discriminated against someone for something they can’t help, often times that means skin colour which is so readily apparent. We are wired to think in discriminatory ways, to deny that is to not be open with these issues, not accept the consequences of your own actions and not be motivated to change them.

For example, I was motivated to change my view of First Nations people through this video, which really did not focus on that particular group at all:

It was a video of a discussion on a controversial article featured in the Macleans magazine here in Canada where the author was implying that universities have been over populated with asian students. Something about what one of the professors said about how First Nations people and students have been set back by the events of history and continue to be affected by those events really made me think about how they are viewed by mainstream media and society (at 59:11). The analogy was that they were, as a group, set back in the same way that a student who was not given a proper textbook to study from would be. By second term they would already be behind and yet were expected to be as successful as the rest of their classmates, who were not similarly disadvantaged.

Here are some links that may interest you and provide some food for thought when it comes to racism:

-The classic classroom racial experiment, when such things were still allowed (wouldn’t get you sued at least).

Article: Racial bias in perceptions of others’ pain  – A worrying research article that actually relates to health care and sports injuries

Article: Smart enough to know better: Intelligence is not a remedy for racism – Food for thought, I have not actually looked at how they conducted their research, but interesting stuff.

Part 2: LGBTI perception…

I am still alive!

Hello to anyone who may be reading this post, I am sorry that I have taken so long to reply to your comments and for the lack of posts. I just recently started a new full time job 2 weeks ago and it is kind of sad to say this but I have never had a full time position before. It has always been part time for me ever since graduation. It might be me, but I think it’s just the kind of economy we’re having right now, especially for new grads of non specialized programs. My commute is about an hour and half either way, which really depletes the time I have after work. Or at least those are my excuses. I was planning to add pictures and maybe other media to my posts after getting the posts up in the first place.

Thanks for reading and to reiterate, I am still alive! Somewhere in the world.