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.

12 thoughts on “Good Intentions

  1. I agree that the past definitely explains the future. Without the knowledge gained from the Nazi’s experiments, we would not be able to have that valuable information. Although their experiments were horrible, they have brought the issue of medical ethics to attention. We as healthcare professionals, are still making these very same mistakes that some of these past experiments have demonstrated.
    The healthcare professional still have a strong say in what a patient should do instead of informing them. It is really up to the patient to make these decisions of whether or not they want to continued with a certain surgical procedure. Assisted suicide still occurs in hospitals today which violates some of the ethical concerns regarding if this was justifiable or not. What are ways that healthcare providers and professional can do to help reduce the bias and also to refrain from putting their beliefs and intentions in their medical practices?

  2. Without a doubt, evidence based medicine is becoming the norm over the previous empirical format. As future healthcare professionals, it is imperative that we understand the consequences and risks associated with all our actions. In the past, some healthcare “professionals”, such as those in the Third Reich, provided valuable information that we could not get otherwise. The ethics of that situation must be understood which is why I agree with utilize the claims made by the Nazi medical scientists. In our current state, our ethics boards and process would not allow the abhorrent conditions under which the experiments in the past were conducted. However, our current research also now protects those involved in the research, an imperative agreement so that our research is both safe and ethical.
    No matter what profession of healthcare professions we choose to enter, we must have a responsibility to maintain an ethical consideration in our professions. Every action we will perform will have a risk and an opportunity cost associated with it. WE must be able to evaluate these factors combine them with our ethical morality. In doing so, we will be able to ideally minimize the risk associated with medical practice and maintain our understanding of consequences. In doing so we can become ethical, moral, and competent healthcare professionals.

  3. I agree very strongly with what you wrote about having health care only focused on the patient, I think sometimes physicians and researchers might get too caught up in trying to solve a problem and new and interesting way that may not actually be the best for patients. Patient care is everything that healthcare should be about, not about winning the most awards for the physicians or the hospitals.

    I think that the past shows we are not very good at learning from history, the Flint water crisis is a perfect example of this. We often look at the past and think that could never happen again, we are better than that, we have more knowledge, ethics, etc., yet it did. We must be better at holding others accountable and not ignore warning signs just because that is the easy thing to do. We must educate ourselves about the past, so as to truly prevent it from repeating itself.

  4. Your explanation on how the past plays a role in the future and how the patient should be the sole focus are two ideas that I agree wholeheartedly with. Moreover, your thought on how doctors have the patient’s best interests at heart and how they all have justifications for their actions was an interesting perspective that I found myself agreeing with as well. While some actions taken in the health care field can be questioned skeptically, it is safe to say that the majority of doctor’s provide care in the way that they think will benefit the patient the most. However, there also may be a sense of self-assurance that plays a role as well. In other words, a doctor would rather be safe than sorry when diagnosing a patient or prescribing them medicine. Take the screening tests for example; would a doctor rather falsely diagnose a patient or tell the patient they were perfectly healthy only to have them realize later on (or perhaps too late) that they do have cancer? In the end, the doctor can only do what they feel is right but like you said, we must constantly question our actions and behaviors in order to minimize any possible wrongdoings in the future.

  5. Albert, I appreciate your presentation and analysis of that Longfellow quote, connecting it to healthcare and ethicality. I would agree with your assertion that actions should be judged based on their consequences, not merely just the intentions. Certainly, when examining many of the experiments this week, it was evident that the physician or scientists thought that their experimental work would benefit the public. The motivation was noble in that it anticipated some form of progress or development that would revolutionize techniques, habits, or a way of life. Nevertheless, the decisions that are made, coupled with the natural tendencies of humans, often produce results that are undesirable. This is not to say that the motivation should be ignored or condemned. Rather, a case-by-case evaluation of each experiment must be initiated, looking at the motivation, procedure, and results in order to determine its inherent ethicality.

  6. I agree that health care should be more focused on the patient rather than having every choice be controlled by the physician’s input. In the end, physicians are there to help the patients whether that be providing quality over quantity of life is up to the patient. Healthcare should be centered around helping out the patient. We were reminded that learning about these travesties that occurred throughout history would tell us not to repeat history. However in more recent times, things like the Flint Water crisis are still happening today. These are the results of selfish actions that ignore the saying “first, do no harm.” We can still learn from these events and create laws and other things that prevent things like the FWC from ever happening again.

  7. That makes sense. People who do what others consider horrible things never believe that they themselves are doing horrible things. What’s important is make sure that horrible events such as the Nazi medical experiments and Tuskegee Syphilis experiment never again. That being said, I also agree that there were findings that did end up benefiting humanity in some way. That’s why the Nuremberg Code was written. I’m very grateful that these written to protect future generations, but I also find it strange that it look as long it did to commit the tenets to a list of rules.

  8. I agree that the intention of one’s action does not interfere with judging this action and the consequences it causes. For the Nazi scientists, their intention was to help German soldiers, which was nothing wrong. The problem is they were using other people as their experiment subjects and hurt those subjects in a way that should not even be done on animals. That is why people need to emphasize “first, do no harm” and wrote the Nuremberg Code. Because these might prevent people from hurting other people purposely using “good intentions” as excuses.

  9. I agree that the patient should come before the needs of the physician. There is a lot that we can learn from the Nazi experiments. Even though they were unethical, I think it would be a waste if we didn’t use the knowledge obtained from these experiments. The people involved would have died in vain if we didn’t at least use the research although it was very unethical. I agree with “do no harm.” Doctors should always think of the patient before themselves because being a doctor is a selfless job.

  10. Albert, I appreciate that you considered the other side of the Nazi experiments before immediately writing them off as senseless and inhumane. While the latter is certainly true, it shouldn’t be denied that those experiments produced an observable benefit in the scientific field. That being said, acting like the knowledge gleamed from those experiments has no value due to the means it was developed is tantamount to saying the hundreds of thousands of people that died – died for no reason at all. As long as people manage to understand where the knowledge came from and make the distinction that the Nazi scientist’s experiments were completely unethical, the knowledge itself shouldn’t be readily discarded.

    And regarding how you feel there should be a greater shift towards the patient in regards to healthcare, it should be noted that the patient is not always aware of what their best decision is. Certainly, there will be situations where the patient’s own circumstances propel them to a certain lifestyle or avoidance of a treatment, but when those circumstances are built on fear and fallacious knowledge – then I hesitate to say that patient’s should have more decision making power.

  11. As you stated above, the past can hold insight that is beneficial to the future. Without these horrific experiments occurring and being made public, other scientists may come along and attempt this same test. Through these awful crimes, powerful advances in medicine have been made. If those in the medical field choose to ignore results from the Nazi experiments, those who were tortured would have died in vain. As a future medical professional I hope to be a an actual person, not just a robot that takes no ethical and human aspects of treatment into consideration. Being aware of past events can help the field to grow in a direction where the patient is the primary focus, instead of placing the focus solely on scientific discovery.

  12. Darren, I agree with you in regards to the use of knowledge gleaned from the inhumane Nazi experiments. However, I fear that a bad precedent has been set and that we haven’t fully learned from history. Take for instance the the syphilis experiment conducted by the US government. Six hundred men didn’t know their lives were being manipulated and hundreds could have been saved by penicillin, yet the researchers prolonged their illness to see what would happen. A more recent ethically dubious research experiment was conducted by University of California San Francisco in 2015. The purpose of the study was to test whether cooling kidneys before a transplant would result in fewer post-transplant complications in the recipient patients. In the study, 572 patients received kidneys from deceased donors whose bodies either were kept near normal body temperature or were slightly cooled following declaration of brain death. However, the researchers did not obtain voluntary informed consent from the patients, which violated their rights. I fear that the sheer atrocity of the Nazi experiments may be used to justify less outrightly abhorrent, yet still unethical research. We think we’ve learned from the past, and that such heinous acts could never be committed again, but this is not the case. As such, we must be ever vigilant when it comes to research ethics.

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