Better understanding of the purpose of the checklist
It is necessary for me to begin with informing you of my bias - I'm
the Director of the department where Dr. Sokol did his visiting
scholarship and developed the checklist stated in this article. What I
wanted to comment on is the submission from the person who thinks that the
checklist is unnecessary since most competent and humane physicians would
be able to pick up the "few" ethical issues in everyday patient care
without the need of prompting. Frankly that is just wrong. Not saying that
physicians are not able to pick up ethical issues, they are which is why
they know to call me when it is more then they can bear, but physicians
don't have the time or really the need to address all ethical aspects of
everyday care. Saying that there are only few is clear evidence that you
don't practice medicine in a hospital that has an ethics infrastructure.
If you did then the understanding that every patient has mulitple ethical
concerns would be clear. The pratice of medicine is ethical and moral in
nature. We try to do the best for our patients and make choices that have
ethical implications. Not to say that the everyday ethics that accompanies
the practice of medicine is so great it needs a bioethicist to point them
out, but there are enough that if I was a patient I would want my
physician to pay detailed attention to the medicine and let the ethics
people pay attention to the ethics. Physicians don't need to be ethicists
as well as physicians. We complement each other in my institution very
well and our physicians have reaped the benefits of having a trusting
source of ethicists to assist them with their patient care.
When I took
the checklist to our physicians, including the cheif of medicine, the
response was unanimous in agreeing this will help the residents (house
officers) learn how to think about the issues earlier on and call us to
intervene before it becomes so clearly an ethical dilemma anyone could
point it out. Providing this service to our patients not only brings our
physicians to a higher moral authority it makes their job less complicated
because they can see areas for potential conflict and deal with them
promptly. If I was a patient in the hospital I would want my physicians to
act in my best interests from not only the medical perspective, but from
an ethical one as well. The checklist has been adopted by the physicians
in my hospital from the MICU to the NICU and now is working its way into
surgery, nursing and social work. A 926 bed urban teriatry care trauma 1
center must certainly have compentent physicians - can they all be
wrongheaded to feel this checklist is important? Probably not.
Competing interests:
None declared
Competing interests:
No competing interests
09 March 2009
Nneka O Mokwunye
Director, Center for Ethics, Washington Hospital Center
Rapid Response:
Better understanding of the purpose of the checklist
It is necessary for me to begin with informing you of my bias - I'm
the Director of the department where Dr. Sokol did his visiting
scholarship and developed the checklist stated in this article. What I
wanted to comment on is the submission from the person who thinks that the
checklist is unnecessary since most competent and humane physicians would
be able to pick up the "few" ethical issues in everyday patient care
without the need of prompting. Frankly that is just wrong. Not saying that
physicians are not able to pick up ethical issues, they are which is why
they know to call me when it is more then they can bear, but physicians
don't have the time or really the need to address all ethical aspects of
everyday care. Saying that there are only few is clear evidence that you
don't practice medicine in a hospital that has an ethics infrastructure.
If you did then the understanding that every patient has mulitple ethical
concerns would be clear. The pratice of medicine is ethical and moral in
nature. We try to do the best for our patients and make choices that have
ethical implications. Not to say that the everyday ethics that accompanies
the practice of medicine is so great it needs a bioethicist to point them
out, but there are enough that if I was a patient I would want my
physician to pay detailed attention to the medicine and let the ethics
people pay attention to the ethics. Physicians don't need to be ethicists
as well as physicians. We complement each other in my institution very
well and our physicians have reaped the benefits of having a trusting
source of ethicists to assist them with their patient care.
When I took
the checklist to our physicians, including the cheif of medicine, the
response was unanimous in agreeing this will help the residents (house
officers) learn how to think about the issues earlier on and call us to
intervene before it becomes so clearly an ethical dilemma anyone could
point it out. Providing this service to our patients not only brings our
physicians to a higher moral authority it makes their job less complicated
because they can see areas for potential conflict and deal with them
promptly. If I was a patient in the hospital I would want my physicians to
act in my best interests from not only the medical perspective, but from
an ethical one as well. The checklist has been adopted by the physicians
in my hospital from the MICU to the NICU and now is working its way into
surgery, nursing and social work. A 926 bed urban teriatry care trauma 1
center must certainly have compentent physicians - can they all be
wrongheaded to feel this checklist is important? Probably not.
Competing interests:
None declared
Competing interests: No competing interests