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Chapter 11 ethical and bioethical issues in medicine
Current ethical dilemmas in the medical field
How technology impacts medicine
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Practice is an essential component of the development of expertise. Despite the necessity for practice, ethical and practical tensions may arise as a result of it. These tensions are shown throughout the articles, “The Learning Curve” by Atul Gawande and “The Great Forgetting” by Nicholas Carr. Gawande focuses how surgeons have to practice on patients which can sometimes be considered unethical. On the other hand, Carr focuses on how dependence on technology can be detrimental, especially in the aviation industry. In both of these passages, the authors present arguments explaining how practice can lead to several mistakes as well as the loss of numerous lives. However, practice is needed in order to achieve expertise which leads to an ethical …show more content…
In the text, Gawande states, “I punctured a patient’s lung, for example-the right lung of a chief of surgery from another hospital, no less-and given the odds, I’m sure such things will happen again.” This shows how fatal errors can occur during a surgical procedure however, it is something that surgical residents have to grow accustomed to since mistakes like this are likely to reoccur. Gawande also mentions that when practicing on a patient, mistakes are bound to happen however, it is a part of learning. In the text, Gawande states, “She let me continue with the next steps, which I bumbled through. I didn’t realize how long and floppy the guide wire was until I pulled the coil of its plastic sleeve, and, putting one end of it into the patient, I very nearly contaminated the other.” This quote proves that although mistakes can happen, it is a part of the learning process. In this specific part, Gawande talks about how he nearly made a severe error however, he was able to learn from his mistake and complete the procedure successfully. This shows how practicing on patients is necessary for the advancement of the medical field. Therefore, although ethical and practical tensions may arise, practicing on patients is needed in order to save the lives of many in the long …show more content…
In the text, Carr states, “The autopilot disconnected, and the captain took over the controls. He reacted quickly, but he did precisely the wrong thing…The crash, which killed all 49 people on board as well as one person on the ground, should never have happened.” This shows that by depending on technology, pilots run the risk of potentially crashing the plane. Although technology has made it easier to fly planes, many things can go wrong with technology which is why it is dangerous to depend on it the way many pilots do. In addition, Carr also talks about how pilots are unable to react during an emergency due to their lack of knowledge. In the text, Carr states, “Automation has become so sophisticated that on a typical passenger flight, a human pilot holds the controls for a grand total of just three minutes...They’ve become, it’s not much of an exaggeration to say, computer operators.” This shows how pilots are losing their knowledge which is putting the lives of the passengers at risk. Although technology has helped to an extent, it harmful as well since pilots are relying more on the computer than on their
Matthew L. Sanders discusses the necessity of taking responsibility for one’s own education in a section of his book Becoming a Learner: Realizing the Opportunity of Education. In this section, Sanders explains how he initially blamed an instructor for not teaching him sufficiently and then learned that “No matter what kind of teacher you have, no matter what kind of class you are taking, if you are a learner you will set out to understand the material and create opportunities for success.” This statement is true and the concept can be applied through many methods to create success for students if they are willing to put forth effort.
For anyone who has ever worked in healthcare, or simply for someone who has watched a popular hit television show such as Grey’s Anatomy, General Hospital, House or ER know that there can be times when a doctor or health care provider is placed in extremely difficult situations. Often times, those situations are something that we watch from the sidelines and hope for the best in the patient’s interest. However, what happens when you place yourself inside the doctors, nurses, or any other of the medical provider’s shoes? What if you were placed in charge of a patient who had an ethically challenging situation? What you would you do then? That is precisely what Lisa Belkin accomplishes in her book “First Do No Harm”. Belkin takes the reader on
Dr. Gawande’s own story, Personal Best (2013), describes the event in which people tend to reach a plateau and perceive to be in a state in which people have nothing more to learn. As a highly educated surgeon, he measures his level of success based on his low rates of complication after surgery in comparison to those of his peers at the national scale. Dr. Gawande never considered the benefit or the idea of having a coach up to this point.
The writing style of the author is quite interesting to me. Atul Gawande’s honesty, a major aspect of his writing style, beautifully highlights the good and bad of any medical profession. For example, Gawande’s argument over the use of patients for resident training
———. "A surgeon's code of behaviour and ethics, c. 1376." English Historical Documents. Accessed December 8, 2013. http://www.historystudycenter.com/search/displaySuitemPageImageItemById.do?UseMapping=SuitemPageImage&QueryName=suitem&ItemID=10648&resource=ehd&imageNumber=4&scale=100.
We are first introduced to Dr. Gawande in part one, Crash Victim, where he is currently working on a female who was in a rollover accident, and everything seems to be going wrong when he performs an emergency tracheostomy. In section two, Banality of Error,
Dr. Gawande emphasizes the value of making mistakes, and how it is a core component of his daily life as a physician. His mistakes are dependent on the “good choices or bad choices” he makes, and regardless of the result that occurs, he learns more about himself as a physician, and more about his connection with patients (215). Critic Joan Smith of The Guardian newspaper mentions that although his various stories about “terrifying” mistakes that doctors make induce fear and a sense of squeamishness within the reader, it is the “emphasis that human beings are not machines” that is “oddly reassuring” (Smith). For example, in the essay, “When Doctors Make Mistakes”, Gawande is standing over his patient Louise Williams, viewing her “lips blue, her throat swollen, bloody, and suddenly closed” (73).
Automation goes further than the tedious manual tasks of manufacturing. In his article “The Great Forgetting” Nicolas Carr examines how automation has contributed to plane crashes over the past few years. He noted that automation, has turned pilots into computer operators. Because the pilots are not doing many of the manual tasks on a regular basis, they do not develop the deep skills required to deal with instrument malfunctions. Since their skills are not exercised when a malfunction does occur, the pilot often makes an error in response while trying to correct the situation.
Wrong site, wrong procedure, and wrong patient errors are avoidable safety issues. Nearly 1.9 trillion dollars are spent on medical errors each year in the United States (Catalano & Fickenscher, 2008). Between 1995 and 2007, 691 wrong-site surgeries have been reported to The Joint Commission's Sentinel Event data repository (AHC Media LLC, 2008). In 2003 in response to the outcry for better patient safety The Joint Commission published their National Patient Safety Goals. Among the goals was the Universal Protocol. The Universal Protocol is actually drawn from several of the National Patient Safety Goals. It relies on multiple check points and the involvement of the entire surgical team to avoid such errors. Wrong site, wrong procedure, and wrong patient surgeries should never happen. The Universal Protocol is an evolving process which reflects the success and failures of healthcare practice, thus it requires periodic updates and policy revisions.
At the end of the book the authors places a notes of source which include surgeries he’s observed or took part in, books he’s read about while trying to find answers to certain cases, and articles on clinical trials. He uses annotation the most through the book to explain his think or for clarity. While trying to prove that not all doctors are to be trust, he uses annotation to further explain himself. By stating “.. One doctor, who was sent to Neff after several episode of freezing in place in mid- operation, was found to have advanced parkinson's disease..” ( Pg. 101), Gawande addresses to the way of thinking to his reader in order to show that the pedestal surgery is up upon is not all what it entails to show. Essentially the use of annotations is meant to convince the intended audiences that surgery goes beyond what many think it is.
There are weaknesses in professional guidelines and rules because they are unable to provide the directives for moral reasoning and action is health care situations. Many people state that biomedical ethics provides a framework and emphasis on the person rather than the professional code and legal policy (Beauchamp and Childress, 2001). On the other hand they serve a purpose to provide some direction for professionals however codes of practise do not dismiss.
During a pandemic in India, a doctor did exploits and was praised by other team members as Fink narrates: “Colleagues credited her quick thinking with saving lives” (p.472). The respect for the person and his or her dignity is at the core of the nursing practice. The registered nurse, as a member of the discipline of nursing should always remember before any action, this strong ethical piece: First, do no harm.
Diligence is a virtue. This is a theme Atul Gawande presents to the reader throughout Better: A Surgeon’s Notes on Performance. In each story, Gawande provides insight on medical studies he has previously embarked upon. For example, in “The Mop-up” the author tells us about a time when he went to India to observe the efforts to eradicate polio. Gawande explains how he followed a supervisor around and how vaccinations were performed. Additionally, in another chapter he debates on whether physicians should take part in death sentences. Throughout his adventures Gawande provides numerous enriching personal accounts of controversial events and what it is like to be a doctor; each with diligence playing a key part.
Moltow, D. (2014, March 19). EMT 602: Ethics, Education and Professional Practice, Week 4 lecture. Lecture presented for the Master of Teaching, University of Tasmania, Tasmania, Australia.
The health care is extremely important to society because without health care it would not be possible for individuals to remain healthy. The health care administers care, treats, and diagnoses millions of individual’s everyday from newborn to fatal illness patients. The health care consists of hospitals, outpatient care, doctors, employees, and nurses. Within the health care there are always changes occurring because of advance technology and without advance technology the health care would not be as successful as it is today. Technology has played a big role in the health care and will continue in the coming years with new methods and procedures of diagnosis and treatment to help safe lives of the American people. However, with plenty of advance technology the health care still manages to make an excessive amount of medical errors. Health care organizations face many issues and these issues have a negative impact on the health care system. There are different ways medical errors can occur within the health care. Medical errors are mistakes that are made by health care providers with no intention of harming patients. These errors rang from communication error, surgical error, manufacture error, diagnostic error, and wrong medication error. There are hundreds of thousands of patients that die every year due to medical error. With medical errors on the rise it has caused the United States to be the third leading cause of death. (Allen.M, 2013) Throughout the United States there are many issues the he...