“The kingdom of the Father is spread over the earth and men do not see it.”
– Jesus of Nazareth
“Ethics is everywhere; we just don’t see it.”
– Davidicus Wong
Health-care providers use clinical practice guidelines – standards of care based on the scientific evidence that evolve with the advance of knowledge. These provide the current best practices for managing clinical conditions, such as congestive heart failure, heart attacks and strokes.
In any acute care hospital, there are standard investigations, medications and interventions for each diagnosis or problem.
Clinical practice guidelines are essential to modern medicine. With ever advancing research, the medications, investigations and interventions are better and safer than what we have used in the past.
But in our zeal to provide the best, state-of-the-art care to our patients, we sometimes forget these are but the tools of health care. Ethics instructs us in how we ought to use them.
Medical ethics has been the heart and soul of medicine since ancient times. Though every health-care provider is called to the profession by our desire to help others, the first rule of medicine is to do no harm.
That is one of the perpetual dilemmas of medicine. Every investigation and treatment, including blood tests, radiologic examinations, biopsies and interventional procedures, including operations and scopes, comes with the potential for harm, side effects and risks, major and minor.
And central to any decision are the preferences and values of the individual patient. This is the principle of autonomy. It requires informed patients who have been given and understand all of the information they require to make a decision. What is the purpose of this test, medication or procedure? What are the common risks? What are the most serious risks? What are the alternatives?
This is information a patient needs to provide informed consent for treatment, weighing benefits against risks and arriving on the choice that is best for that individual.
It is of course guided by your values. What gives your life meaning? (Independence? Connection with others? Your work?) What treatments are against your beliefs and values? What is a good and acceptable quality of life to you?
For 17 years, I chaired the ethical resources committee at Burnaby Hospital, and during 10 of those years, I led a team that provided ethics consultations in difficult situations. Most of them involved patients in the intensive care unit and long-term care.
Like all else in health care – and in life – a proactive and preventive approach saves time, resources and most importantly heartache and suffering.
As part of the Burnaby Division of Family Practice’s Empowering Patients public health education series, I will be speaking about What You Should Know About Medical Ethics at 7 p.m. on Monday, Oct. 17 at the Bob Prittie Metrotown Library.
Admission is free, but seating is limited to 50. Please register by calling the library at 604-436-5400 or online at bpl.bc.ca/events.
Davidicus Wong is a family physician. For more on mindfulness and achieving your positive potential in health, see his website at www.davidicus
wong.wordpress.com.
