Rethinking ward rounds

Although common sense dictates that it should, I do not know if the
ethics checklist will lead to better patient care. This is why it is
important to conduct research to investigate its impact on healthcare
staff and patients and why I am so grateful to Washington Hospital Center
and any others who are willing to pilot the checklist. There is little to
lose and much to gain, and I would be more than happy to visit any medical
team to offer my thoughts on how to use the checklist in practice.

What is clear is that the ethics checklist will not resolve ethical
dilemmas. It identifies the key ethical issues and signals the need for
deliberation and sound judgement. However, it is well known that moral
perception is the first step towards moral action. Spotting ethical
issues does not come naturally to most of us, although we can usually see
one when it stares us in the face, if it has startled us in the past or if
we have spent time studying its features. Even those who are adept at the
exercise will have times when their moral gaze, through fatigue or some
other interference, fails to spot certain issues.

The legendary Gary Kasparov, that most precise and meticulous of
decision makers, made the occasional blunder on the chess board and most
of us, clinicians or ethicists, are no grandmasters of medical ethics. We
too blunder, with potentially far greater consequences than losing a game
of chess. If a simple checklist can help reduce the frequency of our
ethical blunders, it is consistent with the principles of beneficence and
non-maleficence, allowing us to benefit our patients with as little harm
as possible.

Competing interests:
I am the author of the article