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Month: January 2017

Do NO Harm.

Do NO Harm.

The evil that is in the world almost always comes of ignorance, and good intentions may do as much harm as malevolence if they lack understanding. – Albert Camus

 

I believe that nothing is perfect. There will be people who have the purest intentions but will end up causing harm. Everyday, we are put through different kinds of challenges, ones that we’ve experienced before and ones we have never seen coming. Each of those challenges causes us to act different ways, and each time we act, we do not always know what the outcome will be.

Sometimes, people can be selfish and think whatever they are doing is good but only good for them and not everyone else. It is all in the matter of perspectives. Sometimes, it can all just be a matter of coincidence. Something happened that made your action backfire, and it wasn’t your fault. There are also many ways to prevent these from happening, and ways to do no harm are to check everything before finalizing, listen to yourself before saying, and re-evaluate what’s good for the people not just yourself.
For me, as I will tackle this myself while working with others, I will make sure that I put my patients first before my own. I will make sure that they feel satisfied with my care, and that they will know everything that goes on in their body, for they have the full rights to know. I will make sure that I will not sign any papers of study that involves me or others to be put at risk. I will make sure to follow the “Modern” Hippocratic Oath and the ethics of medicine. I have an understanding that if I wouldn’t wanna see me or the people I love be put through so much pain without their say that I wouldn’t want anybody else to be put in that position neither. It’s absolutely disgusting that people let that happen without consent. That’s why it’s very important to educate everybody at such an early age about what occurred in the past that we have to avoid making because again, humans make mistakes, but we have to learn from them because if we do not, we won’t be progressing individually nor as a society, and it is vital that we do to make our world a better place. So, be careful with what you do out there. Do no harm.

Good Intentions

Good Intentions

In Henry Wadsworth Longfellow’s novel Kavanagh, he writes, “we judge ourselves by what we feel capable of doing, while others judge us by what we have already done.” This could be interpreted as “every action has good intentions.” For example, I think that all of the Nazi scientists, whose experiments were abhorrent, had reasons that justified their actions. As bad as their actions were, the experiments did produce information with scientific value and real applications that could help people. They may have actually held the belief that they were doing a service for humanity. A less extreme example are the doctors that contributed to the opioid epidemic by overprescribing painkillers. I’m sure that most of the doctors felt that their prescription of painkillers was truly in their patients’ best interests. My point is not that all actions should go unpunished; it’s actually the opposite. I think as future health care professionals, we should always try to judge ourselves by our actions and the consequences of those actions, regardless of intention. The consequences of health care professionals only directly affect one person, the patient, and the health professionals’ intentions usually shouldn’t have bearing on how decisions are made. In other words, health care should be a service focused around the patient, and no one else.

It’s very important to learn about these things because, as Adam said in lecture, the past explains the future. It can teach us and help us understand how to fix things. With knowledge of Tuskegee, we can attribute part of racial health care disparities to African Americans’ perceptions of doctors and health care. This information gives us very valuable insight into places to start when trying to fix these types of problems.

First, Do No Harm

First, Do No Harm

Research is a job where you can become consumed by your job and finding an answer. This week we focused on multiple research projects that marginalized groups in order to gain more information about the human body and diseases. A lot of these researchers got so involved with their work that they lost sight in what they were actually doing. I think that they were so focused on the end goal of their project that they forgot who they were hurting.

 

In order to stop people and researching from perpetuating their behavior laws and regulations have been put into place. The Nuremberg code put guidelines into place that forces researchers to get their projects approved and states that participation is voluntary for everyone. They also put guidelines into place that keep participants away from danger.
It is important that we discuss topics like these in order to stop them from happening in the future. By facilitating conversation people become more aware of what is unethical and will hopefully think before they try to complete similar research. Unfortunately, these occurrences have left multiple groups of people to distrust medical professionals, which has negatively affected their health. Studies have found that there is a correlation between older black men’s life expectancy and the Tuskegee research. My question is, how can we restore trust between the groups in these research projects and medical professionals?

First, Do No Harm!

First, Do No Harm!

This week in class we touched on major instances of medical abuse in the 20th and 21st Century. The cases that we covered in class was both shocking and interesting in my opinion. Some of the cases we discussed I was very familiar with, but the others I didn’t know much about. I was in awe when I saw that in these cases hundreds of people died and they did not make a big deal about it, like it was normal. I believe they reacted this way because they felt they were doing something good, but they were really causing a lot of harm to people at the end of the day. They felt this way because at this point their studies and results meant more to them than people’s lives. Their main focus was to make history and make a difference, but they approached this situation completely the wrong way.

In the future as I become closer to accomplishing my goal in becoming a doctor I will make sure I do not perpetuate these thoughts and actions by finding a balance between my study and my participants. I will make sure my study is something I am passionate about, but I will make sure that the participants are not being harmed and they will know everything they will encounter during the study. It is important that we discuss these topics because several individuals aren’t knowledgeable about what has happened during these studies or in history period. Therefore, if you don’t know about these cases then you are at risk of making the same mistake that they made.  Rather the events in history were good or bad we must learn how to appreciate how they have shaped, and continue to influence, the health care system that we work in today!

First, Do No Harm: Regaining Trust

First, Do No Harm: Regaining Trust

The fundamental purpose of healthcare professionals is–and should be–to help each person achieve optimum health. However, as evident through history, there have been many incidents where health professionals ended up hurting their patients/subjects. In cases such as the Tuskegee Syphilis Study and the Nazi human experimentation, the experimenters believed that they had good purposes; however, the reality was that these unethical ideologies were normalized as perceived as “good” purposes. Unfortunately, there have also been cases where the physician is aware that what they are doing is unethical, as was the case in Michigan’s Dr. Death incident. The physician was still serving a “good” cause–a cause that was only beneficial (to a certain extent) to himself. In both scenarios, the physicians’ purposes shift from helping people attain optimum health to a different purpose that is wielded by social forces. As a result, patients/subjects are dehumanized and are seen as opportunities for the physicians to attain their goals.

I believe that it is crucial to profoundly discuss these topics because they are often looked over. Before this lecture, I was not aware that these sort of unethical medical practices still occur; this means that the negative stigma around physicians and the U.S. healthcare system in general are only being perpetuated. This lecture also made me realize the holistic responsibility that will come with being a future healthcare professional. As a pre-public health student, I realize that my actions will not only affect a single patient, but rather an entire population. In order to ensure that I do not perpetuate any unethical actions as I pursue my career, I will continue to remind myself that I am working WITH the people, not FOR them. By interacting with the people of the communities that I work with, I hope to be able to get as close to putting myself in their shoes so that I can truly understand what is best for them.

All of that said, my question to you all is: what are some ways that you believe health professionals (specifically the type of professionals that you aspire to be) can reduce negative stigma and gain back people’s trust?

How to do no harm?

How to do no harm?

I think that in many cases, people who may have “good” intentions initially can end up causing great harm to a lot of people at least partly due to societal norms and influences of the times. For example, with the Nazi doctors’ experiments, in their minds they may think that they were actually doing something good for their nation’s soldiers’ survival. This may have justified to them the merits of conducting all the inhumane and awful experiments. Also, with the compulsory sterilization in Canada, they justified their actions by citing the possibility of “improving” their nation’s gene pool. In any case, I believe that these people’s actions could have at least been partly influenced by societal beliefs of the times.

As someone who hopes to one day become a healthcare provider and interact with patients on a daily basis, I will make sure that I look at each patient as an individual. I think that in many instances it becomes easy for doctors to consider each patient as simply another case instead of a person. This then could make it easier for them to then disregard ethical concerns in treating patients. It is extremely important for us to discuss the issue of ethics and morality, but also to learn about instances in history where healthcare providers and governments have failed to uphold these standards. We must learn about what is right, but also about what happens when things go wrong. We must learn from our mistakes in order for progress to happen.

 

 

Do No Harm

Do No Harm

I think that researchers, like the ones we talked about in class, thought they were doing “good” in some way but actually ended up doing harm to their study participants because they were only focused and set on seeing results, no matter how they got them, even if that means putting study participants in harm’s way. They forgot that the subjects were actual humans beings.

I don’t think there are that many more steps that I, personally, need to take as I move forward in my career, no matter what research I do. Unfortunately, this is because people in the past have made it required for researchers now to protect their subjects (even though researches should always protect their study participants) with the establishments of the Nuremberg Code and the IRB.

Topics like these should always be discussed, no matter if your research involves humans or not. Conducting research and being on the edge of knowledge will always have its risk and it is important to learn from our past mistakes in order for them to not be repeated again in the future.

What is Good, and What is Bad?

What is Good, and What is Bad?

In the same way that Hitler convinced an entire army to kill almost an entire population, people can ignore the truth and see only what they want to see.  The term for this in psychology in confirmation bias.  Confirmation bias is when we interpret what we see as evidence of what we want to see.  Hitler manipulated is army into seeing the “benefit” of their actions.  In Tuskegee Experiment, the researchers were asked if what they did was wrong, and they said no.  They believed that what they were doing was necessary and important, even if it meant killing many people.  They are so focused on their goal that they block out the truth.  In both circumstances, the “good” of the experiment blinded them from the “bad.”

As I move forward in my career, it is important that I always consider how the other person will feel.  We must consider the outcome of our actions from all sides of the situation.  Sometimes things that we think are “good” others might think the opposite.  We must recognize that others have different lifestyles and values.  It is important that we discuss these topics to recognize that horrible things like this still occur.  It’s not an issue that happened a long time ago and doesn’t come up anymore.  The question of what is right and what is wrong can never be answered.  Not to mention that cultures all over the world have different values and ways of seeing life.  Something that seems “wrong” to Americans may be completely normal somewhere else.  In the medical world, the question becomes, what happens when you treat someone from a different culture who has different ethical standards than you do?

First, Do No Harm

First, Do No Harm

After hearing and reading about the Tuskegee studies, the many Nazi experiments, and countless other unethical experiments, it was hard to believe that the many researchers and doctors doing these experiments did not seem to find a problem with what they were doing. I think the researchers conducting the experiments get very involved in their research and discovering a new finding that it become difficult for them to take a step back and see what they are doing to people. Although the Nazi studies were horrific and caused many deaths and injuries, the experiments they were doing were going to help the soldiers and provided many scientific advancements. With the multiple advancements, they probably thought the work they were doing provided a lot of good in the world, despite the fact they were killing many people for these advancements. In order to prevent these unethical studies, I think it is important to take a step back from the study and try to put oneself in the shoes of the person getting the study done to them. If the researcher would not want the things they are doing to their research subjects it is most likely unethical. I also think it is important to look back at the Nuremberg Code and ensure that the researcher is following all those rules.

As a person who hopes to go into the health field and who will most likely be a part of research sometime in my life, I hope to pay attention to my research subjects and make sure that I am not getting too involved in the possible findings. With every step within the research, I will look at the subjects and ensure they are not being put in any harm. I also hope that the people I am working with or someone around me will tell him if something is unethical like I would do if I saw anything unethical.  It is very important to discuss these topics where ethics have come into question. We are able to see previous examples and learn from them. It is crucial to understand the previous unethical experiments to ensure history doesn’t repeat itself.

WEEK 3 – IT’S OKAY TO CHANGE

WEEK 3 – IT’S OKAY TO CHANGE

Sometimes, people who think they are doing the right thing can still end up causing harm to those they are trying to help.  I believe this happens because people become set in their ways.  I found it hard to imagine how anyone could become so blind to the fact that they are hurting others until I realized it’s the same line of thinking that other scientific researchers can have.  For example, scientists can become very attached to a hypothesis they are testing.  If later, it is discovered that the hypothesis is incorrect and needs to be modified, the scientist could be hesitant to change it and start over because of this attachment.  People want to hold on to their initial ideas for as long as possible because of our desire to be correct and because we don’t want to change.  In some extreme cases, this mentality can cause larger problems, such as changing test results to align with predictions.  This same mentality can affect people in all professions.

In my future career, regardless of what it is, I will need to remain as open to change as possible.  This can be a matter of life or death for medical professionals, but it can also pertain to other careers.  As a doctor, sometimes things will go wrong and it will be necessary to deviate from the original plan.  This must be done without hesitation to minimize risks.  Doctors need to be ready for everything.  And they must be open to all forms of change.  The patient always must come before your ego.  First, do no harm.

I believe it’s important we discuss all past research, no matter how unethical it may be.  We need to educate ourselves on the past and learn from our mistakes so we don’t make the same ones in the future.  No matter your profession, all of us must know that it is okay, and sometimes necessary, to change our ideas.