Writing this from Dubai, while waiting for my plane to return to Kuala Lumpur. Been away for most part of this week, attending a Workshop in Amman, Jordan, dealing with Medicine and Reconciliation.
1) It is indeed strange that the medical specialties have not been utilized more in achieving reconciliation among people.
2) As doctors ,nurses and paramedics, we have often been in the forefront dealing with human sufferings. It is through this involvement that we see the common values in all mankind.
3) Pain, joy, suffering and wellbeing manifest itself in the same manner across people of different geographical boundaries.
4) In the same manner, the Palestinian people feels humiliated through displacement from their homes, such feelings are shared by others in similar predicament elsewhere on this earth. Hence there is no room for discrimination, whether in the form of apartheid policies or similar unjust practices
5) Here in Amman, we met people who had suffered, but willing to forgive for the sake of greater good. But as one speaker noted, forgiveness starts with admission of mistakes . Once this implied admission is secured , forgiveness opens up endless possibilities for reconciliation among common people which may be somewhat at odds with the wish of some aloof leaders.
6) I found this 2 -day meeting enriching. Meeting people with same sufferings and endurance but coming from different ends of the conflicts. It is only through talking, that they shared common values, and that is in the form of sufferings. How strange. If sufferings and pain manifest in the same manner, surely joy and elation also knows no boundaries.
7) We left the meeting with a conviction that we will do more to help alleviate suffering. Afterall, isnt that part of this noble profession? We will seek to relay this message to everyone, that although we are all burdened by our history and geography, we can still reconcile ,heal pains and sufferings without necessarily having to wait for a greater solution. Afterall this greater solution may not come during our lifetime.
Friday, December 19, 2008
Saturday, December 6, 2008
Ethics in medical education
The Malaysian Academy of Medicine held its annual seminar on medical ethics yesterday. I was invited to be in the panel. Points I considered important are:
1) Core curriculum in medical ethics are already well described. There is an international agreed core curriculum available and is followed by many medical schools
2) What medical students consider as ethical are what they see in practice during their 5 or 6 years being an apprentice in the profession.
3) It is thus worrying as many so-called 'norms' are certainly questionable and have many ethical issues behind them
4) If it has become 'norm' that a service ward round consists of fleeting visits of consultants to see patients, with little eye contacts and communication between the sick and the healer; this 'norm' would certainly 'rub off' and translated into students' behaviour
5) A consultant who does not pay attention to cases being referred to him, but delegate the case to junior colleagues and has little time to reply personally to the referring doctor. This may become 'norm' that will be emulated by students
6)Senior consultants who interact freely with drug companies, are often not comfortable to talk about ethics on pharmaceutical companies and sponsorships of medical doctors.Such relationships may eventually be seen as 'normal' and something to be expected as being part of the profession.This may in the long run affect students' attitude adversely.
7) There are of course many more examples of what medical students may see in their daily life; events which have shaped their thoughts and action.
8) Perhaps medical educationists will have to take extra measures to address these issues and assist fellow colleagues to maintain a high level of etiquette. These are the 'microethics' : so potentially powerful and may even serve to reverse all the good contents of ethics curriculum
9) Academic leaders need to create an environment where ethics and microethics thrive positively. Severe constraints on staff, extreme desire to make them publish research data in lieu of performing their clinical duties may result in them resorting to short-cut , off-the-cuff behaviours that can be unethical.
10) Ample opportunities can be created within the existing curriculum to give students a chance to learn and practice ethics in a real community setting and not in the artificial ambiance of a cosy classroom.
1) Core curriculum in medical ethics are already well described. There is an international agreed core curriculum available and is followed by many medical schools
2) What medical students consider as ethical are what they see in practice during their 5 or 6 years being an apprentice in the profession.
3) It is thus worrying as many so-called 'norms' are certainly questionable and have many ethical issues behind them
4) If it has become 'norm' that a service ward round consists of fleeting visits of consultants to see patients, with little eye contacts and communication between the sick and the healer; this 'norm' would certainly 'rub off' and translated into students' behaviour
5) A consultant who does not pay attention to cases being referred to him, but delegate the case to junior colleagues and has little time to reply personally to the referring doctor. This may become 'norm' that will be emulated by students
6)Senior consultants who interact freely with drug companies, are often not comfortable to talk about ethics on pharmaceutical companies and sponsorships of medical doctors.Such relationships may eventually be seen as 'normal' and something to be expected as being part of the profession.This may in the long run affect students' attitude adversely.
7) There are of course many more examples of what medical students may see in their daily life; events which have shaped their thoughts and action.
8) Perhaps medical educationists will have to take extra measures to address these issues and assist fellow colleagues to maintain a high level of etiquette. These are the 'microethics' : so potentially powerful and may even serve to reverse all the good contents of ethics curriculum
9) Academic leaders need to create an environment where ethics and microethics thrive positively. Severe constraints on staff, extreme desire to make them publish research data in lieu of performing their clinical duties may result in them resorting to short-cut , off-the-cuff behaviours that can be unethical.
10) Ample opportunities can be created within the existing curriculum to give students a chance to learn and practice ethics in a real community setting and not in the artificial ambiance of a cosy classroom.
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