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Ethics and Physio- Hand in Hand

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Over the past six weeks I have found every topic to be an interesting one and it really made me question my behaviour and thoughts as well as other students to a great extent. I say this because everyone will always have their own opinions and thoughts about how something should be carried out but it may not always be the ‘best’ or ‘right’ way.

Because of this I found myself having to do research and having to read other students and physiotherapists blogs so that I could  not only get an idea of how and what they were thinking, but also make sure that I produce a post that is open for discussion that is not too one sided.

Three major topics that was very controversial and stood out for me was equality, torture and euthanasia.

Reading through other blog posts, academic research and watching videos made me realize that 1) Equality in the work place or equality in general is not practiced by individuals as we expect or how it should be practiced. However, fellow students have mentioned that they, themselves try to be the best physiotherapists they can be whether they are treating a gangster or an old innocent lady.

Just yesterday I had an encounter with a patient who came in with very very bad personal hygiene and as physiotherapists we had to somehow push through and provide him with the best treatment.

2) At first I always believed torture was evil and cruel and should never be allowed but after reading and having conversations with outsiders about the topic, it was quite clear that torture does indeed take place all over the world and some people just believe that it is the right thing to do-with or without reason. I personally would still never find it in me to torture the next.

And then thirdly, the topic of euthanasia. I have always been two minded about euthanasia since we started discussing it in second year. However, the more we discussed it the more I realized how normal it could be in this world. People no longer see it as killing or taking another’s life or playing God, but rather as ending ones misery and helping the next individual as a health care professional-which is our main aim at the end of the day.

My expectations for the course have indeed been met. I must say, I never expected to get so involved in one topic and spend a few hours trying to discuss it and challenge the topic question. I found the course to be enjoyable, time manageable and interesting and I think that that the feedback and comments was a great idea as it made us think twice or thrice about what we had just wrote. The feedback that we received from our peers was also very helpful and motivating as I found myself correcting future posts and trying to improve. I also received really good, encouraging comments which made me feel that the past six weeks proved to have been educational and stimulating.

Most of all, I learnt that people behave in a way that they think, believe and are taught is correct. Majority of the time we come across the ripe bunch that are on the right path when it comes to professionalism and ethics and then other times there is just that few that we have to try and educate to do better, even if it is ourselves that has some learning to do.

Remember that everyday should be a learning experience 🙂

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Stuck Right in the Middle

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When it comes to this topic of euthanasia, it’s a 50/50 battle for me. Not too long ago I remember this tweet that popped up on twitter which I haven’t forgotten since. It read, “Your body is a temple, a gift from God, you are not your own“. I found myself thinking about this line for a few hours after reading it and even discussed it with my friends.

                                              

As young adults growing up, we decide what we want to do to our bodies, whether it’s tattoos or piercings, we do what we want to do. In the past I think that “harming “your body was more looked down upon but these days it seems like the norm. Basically as the world has evolved, so have certain thinking and practices changed. Similarly with euthenasia.

The reason why I find myself stuck in the middle is because I do indeed believe in God. So this should mean that I should follow what the Bible says, right? From the BBC Ethics Guide I came across the following:

 

Religious people often refer to the sanctity of life, or say that human life is sacred. They usually mean something like this:

God gives people life, so only God has the right to take it away.

You can look at that sentence in several ways. Here are three:

•           God gave us our lives

•           we owe our lives to God

•           God is the final authority over our lives

•           we must not interfere in the ending of our lives

 

•           God is intimately involved in our lives

•           God was intimately involved in our births

•           God will be intimately involved in our deaths

•           it would be wrong to try and shut God out of our dying

•           we should not interfere in the way God has chosen for our lives to end

 

•           God gave us our lives

•           we are only stewards of our bodies, and are responsible to God for them

•           we must use our bodies as God intended us to

•           we must allow our lives (our stewardship) to end at the time and in the way God want

From this sanctity of life, it is quite clear that euthenasia is unacceptable.

However, after reading the sad story of Tony Nicklinson who is paralysed and suffers from locked- in syndrome, I put myself, a family member or patient in his situation and think to myself, what would I do.  Then I thought about sick animals. Why is it okay to “put a dog out of his misery”, in simple terms meaning kill, but when it comes to a human life, this decision is frowned upon. Did God not create all things? Animals, plants and humans. Yet stepping on a spider or knocking over a cat, has never been a problem.

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

I find this to be a very important question to discuss because as health professionals, we will be the first people that individuals will seek advice and help from when they have a problem whether it is life threatening or not. Because times have changed so much, I feel that yes we can rationally support assisted suicide if this helps the next person end their suffering. Who knows, maybe, making that very fatal decision is actually Gods plan.

 

When someone has drowned and their lungs are filled with water causing lack of oxygen flow, was that Gods plan for that person to die in that manner or was a life guard or random person on the beach supposed to come along and resuscitate them??

This is almost the same situation if you think about in that way; the difference lies between saving a life and losing a life. We will never know whether this is right or wrong. All we can do is hope and believe that it is for the better.

 

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Who gives us the right to torture?!

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From the article,” Torture and Tough Questions: Why Zero Dark Thirty Deserves to Win Best Picture” written by Jason Michelitch the most outstanding line reads,

 

“The argument cannot be that we should not torture because it does not work. The argument must be that we should not torture because it is wrong. “

 

Some people agree with Michelitch’s writing while others disagree. Brett Easton Ellis tweeted the following:

Bret Easton Ellis        ✔ @BretEastonEllis

The US critics lauding Zero Dark Thirty need to admit that they’re admiring a morally indefensible movie. I don’t care how “exciting” it is.

9:02 AM – 19 Dec 2012

 

I haven’t watched the movie yet so I decided to read the plot and watch the trailer to get a better understanding. From the plot it stated that the film’s graphic depiction of torture has generated controversy, with some critics describing it as pro-torture propaganda, as torture is shown as producing reliably useful and accurate information. The film creates the strong impression that the enhanced interrogation technique was the key to finding Bin Laden but some say this is false.

When I look up the word torture it states that torture is the infliction of severe physical pain as a means of punishment or coercion. Now some people may read this and think nothing of it, while others will look at it as being cruel and evil.

I think this appears the same as in watching the movie.

 

Whether one person’s life is more valuable than next I would definitely not agree unless it came to a situation between life and death. For example, to save the life of a baby or an 80 year old person. I think then that may be the only time such a decision can be made due to obvious reasons although we are still not given that authority in this life to make such drastic decisions.

Torture will NEVER be OK. When I picture it or imagine myself getting a beating, I always think to myself how does one fight and give the next person a blue or bloody eye. I also think torture has such traumatizing effects on whoever the victim is; whether it leaves them feeling they are made stronger or as scared as a mouse.

Not too long ago while I was on my second Block, I met quite a few children that I became quite attached to and after seeing them every day it would often happen that this one girl would come running to me for help or I would find her crying on the mat. When I asked her what happened, she replied that the boys would play roughly with her and hit her. I also found that she would hit them too. Because I hate hearing about males hitting females I decided to sit down with her and the boys involved and I explained to them that no matter what she does to irritate them, they must never hit her. I also mentioned to her that she must not start any fights with them.

 

With that said, torture remains highly controversial. I say this because with me or probably most of you reading this, if someone had to hit or abuse one of your family members/loved ones, and you were to run into them at some point, I’m almost 100% sure your reaction would not be a “hello how you doing” one. Instead you might just leave the area handcuffed.

In conclusion, I was not sure how to conclude all of this, so I asked my mother what she thought about this topic and she replied,” whether torture is right or wrong depends on who you are speaking to..” The weird part about this response is that it is so true and I understood why she said that. You could be talking to a dad whose son just got a huge beating and now he is after the attacker, or it could be a very religious person who believes that only God should punish his people. 

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I don’t see Equality

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For the first time, before writing about a certain topic, I was not sure where to begin. This is because, Equality is such a “touchy subject” and I personally do not think people believe in it any longer.

However, the first thing that came to mind after thinking about it for a while was Nelson Mandela. I thought specifically of this great man because of his fight and struggle for equality in our land and all over the world.

On his release from prison he said in one of his speeches, “I have fought against white domination and I have fought against black domination. I have cherished the ideal of a democratic and free society in which all persons live together in harmony and with equal opportunities. It is an idea which I hope to live for and to achieve but if needs be, it is an ideal for which I am prepared to die.”

As many of us know, people all over the world have a strong love and appreciation for Nelson Mandela as our first black president, and his sacrifices he made to end the era of Apartheid. Yet, as a nation we have not respected his deeds enough as right now there is hardly any respect left for one another.

I have not come across a situation where I had to deal with repugnant behaviour, nor have I found myself unable to provide equal care to my patients. I still have a lot of work ahead of me so this may change although I am hoping to treat everyone as I would like to be treated.

On a day to day basis, especially at campus, we are faced with gender, race, culture and sexuality differences. People say that they are not racist and some say they love “gays” yet when they stop at a robot and an African person approaches they lock their doors and roll up their windows as fast as possible. On social networks, we constantly see pictures of superstar Justin Bieber being called gay as if it is a big joke.

 

When did the world become this way? And when will it ever stop? It was supposed to have stopped already and people say that they are not racist or do not judge one another, yet it is still happening every day.

Society has a created an image of what is right and what is wrong. For example, it is wrong to be homosexual and it is wrong to marry someone from a different race.

We grow up thinking and believing this so it just gets passed down to future generations. I find this kind of thinking very small mined of people, to love and care only for your own, to be closed minded to other experiences and opinions.

Personally, I don’t believe that the equality we should be living in will be achieved any time soon.

To conclude I would like to leave you with the famous Mahatma Gandhi quote as at this moment it may be the only possible change that can make a difference.

“Be the change you want to see in the world.”

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Make Morality Your Own

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Growing up as a child, teenager and young adult, I have never been very religious. My family and I would occasionally attend church, pray before meals and celebrate every religious event but yet waking up every Sunday morning was never a must. With this said, I still fully believe in our Creator.

I believe my sense of morality was informed through my upbringing by my parents and family. They taught me what is morally right and wrong and from that I was sensible and strong enough to believe in who and what I want to be.

I use the word strong because many of us have good upbringings yet our choices we make as individuals are out of our parents/caregivers control and we let outside influences change our behaviour. What keeps my morality informed is my individual perspective of what is morally correct and incorrect.

           

I believe that all behaviour stems from a powerful belief system. Through my research on this topic, this was assured by Mr Farouk Radwan, who has his MSc in Psychology, as he stated, “With a positive and powerful belief system there is no limit to what you can achieve in this world.”

As I mentioned above, the relationship between morality and professional behaviour comes from oneself as one grows and learns for themselves, what is morally correct and incorrect, apart from what they believe and should follow.

Lawrence Kohlberg claimed that “without judgment, an action, no matter how beneficial, would not be moral”.

From the 1920s to the 1950s behaviourism was the dominant paradigm in psychology and it was assumed that teaching children moral virtues and social norms of their culture makes them moral. It was not until Lawrence Kohlberg first published results from his follow-up study of the development of moral judgments that it was more widely acknowledged that even children have their own morality and they make moral judgments which are not internalized from parents, teachers, or peers. Consequently, according to Kohlberg morality is constructed by the person her/himself.

 

I find the question “is it possible to be perfectly ethical?” very intriguing because I am sure most professionals would like to know that they are practicing in a perfectly ethical way. We also know that to be “perfect” in anything is impossible yet aiming to be the best and most perfect we can be is possible.

I came across a blog from Lori Bedell which I found to be interesting and made me understand how unethical we can act on a day to day basis, apart from the work place. It read:

“  Obviously, anything produced by people who are exploited and abused is unethical.  Anything that degrades our environment is unethical.  And so some of my choices are clear. In an all or nothing scenario, however, there are some murky areas where I feel I’m a bit tied down.  Is it realistic to investigate every purchase I make or store or restaurant I patronize?  I suppose it’s possible…And then there’s the matter of opinion or values of varying weight.  For example, some would argue that it’s better to buy local than organic.  Some would argue the other direction.  If I buy clothes at a second-hand store but those clothes were still made in a sweatshop somewhere, am I immune from responsibility?  I kind of think, “No.”  Here, my values will be differently ethical from someone else’s.   ”

With that said, it is evident that as individuals, what we see as ethically correct and incorrect varies. So being perfectly ethical is impossible. However, becoming close to perfectly ethical for yourself according to your own morals and beliefs is achievable, hoping of course, that your morals and beliefs are ones that others would dream of following.

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Morality

Morality

(A situation where a colleague is practicing in an ethically incorrect way and he doesn’t even see it as been that much of a dilemma, while Martin is clearly worried by this.)

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What exactly is the empathy limit?

During this course, I hope to learn about ethical issues which I will be facing as a student as well as a professional one day. I have already found myself in situations where I was faced with an “ethical dilemma” and had to see to it that I handled it the best way I could. I was only able to do this because on this specific occasion I had already learnt how to deal with this dilemma correctly. This made me feel professional on a student level and also proud to be practicing my work correctly and morally. This is the main outcome I would like to achieve.

Before I talk about empathy and my feelings towards it, I will first define what it means.

 

“Empathy is the experience of understanding another person’s condition from their perspective. You place yourself in their shoes and feel what they are feeling. Empathy is known to increase pro-social (helping) behaviours. “(Psychology Today, 2013)

 

With that said, empathy definitely does play a huge role in professional practice. On a day to day basis as Physiotherapists, we will be engaging, interacting and working with kaleidoscope of individuals, each with their own problems and experiences.

Alexithymics are people who have no idea what they feel themselves and are at a complete loss when it comes to knowing what anyone else around them is feeling. They are emotionally tone-deaf.

Therefore, empathy builds on self-awareness; the more open we are to our own emotions, the more skilled we will be in reading feelings and responding to them.

 Should you lie to keep from hurting a friend’s feelings? Should you keep a promise to visit a sick friend or accept a last minute invitation to a dinner party instead? When should a life support system be kept going for someone who would otherwise die?

These moral questions are posed by the empathy researcher Martin Hoffman, who argues that the roots of morality are to be found in empathy, since it is empathizing with the potential victims. Beyond this immediate link between empathy and altruism in personal encounters, Hoffman proposes that the same capacity for empathic affect, for putting oneself in another’s place, leads people to follow certain moral principles,

Their social poise lets them easily reach out to new people; they are comfortable enough with themselves to be open to empathetic experiences.