How to avoid bad decisions that can ruin your career
BMJ 2024; 386 doi: https://doi.org/10.1136/bmj.q1584 (Published 18 July 2024) Cite this as: BMJ 2024;386:q1584
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Dear Editor
Sokol raises an interesting question about what single intervention could prevent an ethical lapse. He settles on phoning a friend. That is ask a colleague or confidant. Sokol himself describes the cases he has in mind: sex with patients, bulling, lying, invasions of privacy, defrauding the NHS and violent crime. I do hope that Sokol's one-to-one sessions go beyond suggesting to these professionals that check with a colleague before having sex with a patient, being violent or committing fraud.
This is not to overlook Sokol's insight for the more everyday ethical problems clinicals face in their work. Asking for advice is indeed a sensible way to help avoid making mistakes and familiar from the questions clinicians pose each other each day. I do think Sokol needs to go back a step however. A fundamental issue, and one that should concern all doctors, is identifying that the problem at hand is ethical in nature. To phone a friend, you need to know that question you are asking, or the problem one is facing, is an ethical one. Too often issues that in reality are ethical at their root are tried to be resolved as 'clinical' or some other area of relevance to the clinician. Sometimes there is a belief that if we just had such and such a piece of evidence then a situation would be resolved but the mistake lies in seeing a problem as something other than what it is. There is a need then to develop one's 'ethical antennae' to detect such problems in the first place, then one can go on to phone a friend.
If I could offer one single intervention, it would be getting clear on the nature of the problem and in particular identifying ethical issues as ethical ones. After this asking for advice may well be useful. But if you can't see the problem for what it is, it is going to be challenging to make progress on it.
Competing interests: No competing interests
Re: How to avoid bad decisions that can ruin your career
Dear Editor,
Sokol suggests that faced with an ethical dilemma we should "phone a friend". In response, Parker points out that this requires a recognition that there is an ethical question to be asked and rightly points out that we need to hone our "ethical antennae". The first aim of teaching ethics has to be to ensure the ethical antennae of our learners is going to signal loud and clear when we are in danger of taking a mis-step. After that we can phone a friend, or as a student once pointed out during my class, we just need to ask ourselves "What would that look like as a Daily Mail headline?".
Competing interests: No competing interests