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?

10 thoughts on “First, Do No Harm: Regaining Trust

  1. I completely agree with you about everything you said. It also came as a shock to me to realize that these unethical medical practices still happen today. I like how you said that you want to work with the people rather than for the people. I think in a lot of health professions, it is easy to assume that we are doing a service to others and what we do can only bring good. However, it is important to place yourself in other people’s shoes to understand their needs and work to the best of your ability to see that those needs are met. Your goal or vision for the future shouldn’t affect the way you treat patients or interact with communities, it should be their needs that should take priority, because after all, we are here to help others, not do any harm.

  2. I agree with you on everything that you said, especially the point about how unethical ideologies are normalized. I think that one of the hardest parts about removing this stigma is the fact that one person’s actions have such a widespread impact on whole populations of people. The doctors in experiments such as the Tuskegee Syphilis Study and even today with doctors such as “Dr.Death” really thought they were working for the best, or that their actions had greater benefits than consequences. I think the only way to combat this is to train healthcare professionals to be aware of their own mistakes and not feel that they always know best. I think it’s also important to have more oversight on medical professionals to keep from repeating these mistakes. Although it’ll take a long time to earn back people’s trust, it’s worth trying because the idea of first doing no harm is integral in medicine.

  3. I think it would be very effective if the payment system was changed. If we connect payment to results instead of our current system of connecting payment to treatments the financial incentive for doctors to over prescribe will be eliminated.

    If the people believe that their providers are genuinely invested in their well being, then they will be more likely to trust their providers.

    If this change were to happen, I think our healthcare system would be revolutionized. But, it would be hard to do so.

  4. Great blog post! You did a great job of summarizing and comparing some of the studies we covered in lecture, in addition to understanding that a similar shift seemed to occur in both scenarios due to social forces. The fact that many physicians took the opportunity to partake in dehumanizing experiments for their own advancement is terrifying, but to put thousands of participants at risks, and possibly to their death is even horrifying.

    As future health care providers, It’s extremely important to understand these past unethical experiments in order to prevent them from ever happening again. We will be put in frustrating situations, times when we may feel like giving-up, however we have to realize that our sole actions affect the whole population through every patient we treat. We have to remind ourselves to always prioritize our patients, and ensure that they are not being put in any harm- in addition to educating others around us the importance of ethical values.

  5. Part of the reason I believe that so much harm is done to people is because the people doing harm are too busy looking at the big picture. They see the cure for cancer slapped underneath their name on a golden plaque. They see themselves becoming international heroes for their contributions to science. Doing this, they fail to take into account their test subjects. Now, one could argue that the overall impact of discoveries is more significant than the lives taken at the expense of the experiments. However, the fact of the matter is that harm is constantly being done. In my career, I hope to contribute to society in a meaningful way, but I do not wish to do that at the expense of other people.

  6. I think an important way for physicians to gain patients’ trust back would be to build a relationship with the patient outside of their medical needs. This does not mean to become best friends with the patient, but get to know the patient enough so that they feel comfortable and you have enough information to look at the patient as a whole. It takes time to earn someone’s trust, so it’s important to not try to rush the process.

  7. I was also very shocked by what I had learned in this lecture. Throughout middle school and high school, I had been taught multiple times about the terrible research that Nazi doctors had performed, but I had never been taught about the terrible studies that have gone one in the US and continue to go on in the US. As someone who aspires to be a future physician, I think that a good way to reduce negative stigma and gain back people’s trust is to be honest with them. Being honest can definitely be a challenge, especially in difficult or sad situations, but being honest is the best way to gain people’s trust. I also think that it is very important to get second or third opinions on difficult patient cases, so that you are sure you are providing patients with the best treatment plans possible. Although it will be challenging for me to change a whole population’s perspective on the health care system, I can do my best to change positively impact each patient that I see.

  8. As a health professional you possess the power to either make or break relationships with your patients. If I where to become a dentist I would be faced with the stigma that we cause more pain to our patients. To gain people’s trust I would simply explain what I am going to do to help them. If I had to give them a numbing shot (which is painful) I would explain that, but also explain how this shot will be their best friend when I am in the middle of a procedure causing more pain that they cannot feel.
    In regards to your post, it was well written and put together. I find it courageous that you can simply state the problems you face and how you support the population as a whole and not individually. It is easy to shift from doing the right thing to obtaining ignorance and thinking of only yourself. I, just like you, was not very familiar with cases that where similar to the statement I previously said; Also, I, like you once again, believe it is important to know such cases and the history about them to better the future. So once again, very nice job!

  9. As a nursing student, we will have a lot of interaction with patients. Something nurses want to avoid is to give false assurance.  The patients often rely on us to provide them support and they want to be able to trust us as to what we say we will do to help them.  If we say that we will be back to check on the patient in an hour, we need to make sure that we fulfill what we promise. We need to gain the trust from our patients.

  10. I agree with everything you said. As a pre-med student who plans on being a doctor one day this plays a big role in my profession. To get right to the point and answer your question I think some ways that health care provides can reduce some of the negative stigmas and gain back the trust of patients is to be explanatory with the reason for the treatment that they are giving them. I do realize that not every health care provider will want to go into deep explanation on to what they think is best for there patient but this is what’s necessary to gain trust between patient and provider. I liked how you touched on the Tuskegee syphilis study because this is one of those studies that is unethical and should not go unnoticed.

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