Ethics and social media

Recently I have started my quest to enhance the synthesis between my work and my academic training. One of the implications: ethics should become a larger component of my work. How? What? Where? It's all part of my search. In that search I came upon the Dutch Center for Ethics in Healthcare (sorry, Dutch only). Almost against my will I was drawn to the page that asks you to contribute. Do you have any suggestions as to what should be on the ethical agenda? Experiences in healthcare that you would like to share so that the practice can be changed evidence based?

Should I? Should I not? Healthcare, being a patient in that system is a very personal and intimate experience at the best of times and when things go wrong and your experience turns into a nightmare, it becomes even more intimate. Because it almost makes you feel as if you are a loser or somebody who was not worth caring for. Rationally this is of course not true. But it is a nagging feeling. Maybe too intimate to share with an organisation I did not know?

But I kept going back and thought long and hard. Explored my gutfeeling. My conclusion: my knowledge obliges me to contribute.

I have hands on knowledge of good and bad practices, of my own moral dilemma's in those situations, of dialogues with doctors on how the wrongdoing and going affected me and them. If you don't share what you know and what you experience, how can true change come about? So I filled out the form, taking my experiences to a more general abstract level, signalling the moral issues in e.g. training of young doctors, the needs of informal networks surrounding Alzheimer patients, good care for gynaelogical patients and the increasing responsibility that is allocated to patients by the Dutch health care system. I was not sure whether to expect something: the possibility to deliver feedback is all too often offered by organisations without giving thought to or taking the consequences. You have to do something with the feedback you get.

What followed to me is a prime example of good practice. Within 4 hours I received a personally written (in contrast to automatically generated) e-mail thanking me for my contribution and offering the possibility to discuss my contribution by telephone. Which we did the next day. What resulted was a true meeting of minds on ethics in practice, dilemma's in health care and how to get moral considerations out of the taboo sphere into the open, into informal communities onto the layman. Ethics and ethicists do not tend to be overly communicative. It is all too often taken into an abstract, academic domain. Which I strongly feel is at par with the heart of ethics. Aristotle already noted that ethical theory is distinctly different from theoretical sciences as the methodology must match its subject matter which is the nature of good action. And so it must inevitably recognize that many generalizations will hold only for the most part and that it is essentially practice based. Ethics is studied in order to improve our lives, to enhance ourselves, thoughts and actions. This essential relation between practice and ethical theory in my opinion deserves center stage. So I happily consented in thinking along on  how to realise this and equally happily consented to writing an article on ethical and moral issues in the training of doctors. If you want to think along with me, let me know or go to the comments page of the CEG.