Medical Ethics and Recognizing the Higher Faculties of Humans - Assignment Example

? “Tuesdays With Morrie Medical Ethics and Recognizing the Higher Faculties of Humans “Tuesdays With Morrie”: Medical Ethics and Recognizing the Higher Faculties of Humans In the past, in order to become a great medical practitioner, one had to learn how to disengage themselves from their patient’s issues. Student nurses and doctors were taught never to be emotionally involved with their patients so that they can make objective decisions. Though such practice has its advantages, it has led to the de-humanization of the medical field. Death became a normal expectation and caring for someone meant that their medications and other medical needs are met. But with the rapid advance in biology and medicine, several ethical questions have arisen: what is the connection between life sciences and the field of law and public policy? How do the social sciences touch upon the issue of life and death? How does one care for a person who is dying? “Tuesdays With Morrie” verbalizes these connections and raises issues about gerontology, geriatrics, and end of life care. This paper outlines some of the moral dilemmas raised by the book as well as some of its implications to health care. Written by Mitch Albom in 1997 to pay for his favorite teacher’s medical bills (CNN, 2001), “Tuesdays With Morrie” has sold more than 1 million copies and is one of the top literature used to teach and cultivate critical thinking skills in undergraduate health care courses. The novel tackles the true story of Morrie Schwartz, a sociology professor of Brandeis University who developed amyotrophic lateral sclerosis (ALS) or more commonly known as Lou Gehrig’s disease. It is a summary of the weekly conversation between the author and Morrie which dealt with issues such as marriage, family, relationships, culture, love, emotions, forgiving, aging and death. Mitch described it as their “last class together…[where they] talked all day about what’s important in life once you know you’re going to die” (CNN, 2001). The book is often categorized as a biographical and philosophical novel and is read for entertainment but it also provides different insights for medical practitioners. Over the years, it has served as a guide towards understanding health equity, and social justice in health care. Its lessons about aging and dying provides readers with a unique approach towards dealing with individuals who are terminally ill. The story raises various moral dilemmas, perhaps the most important of which is the understanding of death. In the book, Morrie remarks, “Everyone knows they’re going to die, but nobody believes it” (Albom, 1997, p.76). This was a comment not only about the fear of death, but also, the lifestyles that people live. Morrie believed that most Americans do not prepare for death, hence they are unable to appreciate their lives. He expounds, “[M]ost of us walk around as if we’re sleepwalking. We really don’t experience the world fully, because we’re half asleep, doing things we automatically think we have to do” (Albom, 1997, p. 77). People prioritize work over their families because they think they need money in order to enjoy life, but in the process, they waste their time working, never realizing that their families are moving on without them. People have become so involved in materialistic things that they never really appreciate the beauty of nature, “the loving relationships we have, the universe around us, we take these things for granted” (Albom, 1997, p. 78). Morrie’s insights were unique in that it talks about the failure of the American culture to provide its people with a sense of purpose. The American belongs to a society of consumers – their homes, cars, and bank accounts determine their success. Hence, early in life, most people are already conditioned to work hard in order to fulfill their economic needs. For Morrie, people waste their time running after things that does not provide them with purpose. He says to Mitch, “…if you really listen to that bird on your shoulder, if you accept that you can die at any time then you might not be as ambitious as you are” (Albom, 1997, p. 77). Often, we hear words like “when I’ve earned enough, I will retire and have a trip around the world” or “when I’ve bought a nice car then I will go on a road trip”, etc. But people don’t know the meaning of “enough” and “nice” so that they go on their entire lives looking for such, but they never find it. They never learn when to stop because they do not think about death and how short their time on earth is. So for Morrie, “Learn how to die, and you learn how to live” (Albom, 1997, p. 77). Only when a person realizes that they are going to die, then they begin to focus on the essentials. For people taught by society to never give up, Morrie’s actions may elicit various responses. Some may think Morrie as an enlightened person because he continued to search for meaning despite the limited time he had left. He was a courageous man. If Morrie did not hold the view that man should learn how to die in order to live life to the fullest, then he would be pestering his doctors to sign him up for an experimental drugs and therapies. When this happens, he could experience all sorts of side effects which might worsen his condition and could even affect his relationships with his family. But then again, one may say that Morrie’s mindset was that of defeat – he just accepted that he was going to die and that he couldn’t do anything about it. Perhaps some may say that he became selfish because he did not fight so that he could be with his family. But then again, in this case, one has to remember that Morrie’s condition was different. In his first meeting with Mitch, Morrie said, “You mustn’t be afraid of my dying. I’ve a good life, and we all know it’s going to happen” (Albom, 1997, p.36). There was no point on denying Morrie’s fate because ALS is a degenerative disease and no cure has yet been discovered. Morrie contracted ALS in his older years when he has done almost everything in his life. If ALS happened when he was younger, it is possible that he won’t be so accepting because there will be things he would want to experience but he will be too sick to enjoy it. People must realize that perhaps age and experience may affect a person’s point of view, hence, there is no point in arguing that one is right and the other is wrong because it can happen that two individuals are looking at the same thing from different angles. With regard to health care, Morrie’s point of view also had its implication. In a book by Kevin O’ Rourke he said, “Persons offering medical care must remember and respect the worth and higher functions of the individual; this implies something more than mere ‘autonomy’” (2000, p. 19). This statement supports Morrie’s view that there is something more to life than simply working and fulfilling economic function. Medical professionals have to realize that man is more than just an animal which needs to be cured. Instead, doctors and nurses have to realize that health care overlaps with a person’s human functions – through better health, man can continue to pursue the understanding of his life’s meaning. Hence, medical practitioners have to consider not only the physical and psychological state of a patient, they must also understand the cultural and religious background which defines and individual value system which can help or harm a person struggling with an illness (Barbour, 2000, p. 46). Often, a person’s religion or cultural background will affect not only the healing process but also the functions of medical professionals. For example in an episode of the House, M.D., a medical drama on the Fox network, the doctors had to defer an operation because their patient refused to have surgery on a Sabbath. Also, a cancer patient may choose to forgo curative or palliative treatment to devote his savings for his children’s future. Such instances can happen, and doctors who do not realize the importance of meaning-giving institutions (such as culture and religion) on an individual may find himself frustrated or worse, can lead him to become a tyrant who imposes procedures to his patients. When this happens, a doctor may not be able to garner the patient’s trust and could lead to ineffective treatments or a malpractice lawsuit. O’Rourke says: “The patient-physician relationship must be permeated with trust” (2000, p. 19) – an understanding that both the physician and patient has to help one another. The relationship is imbalanced wherein the patient is vulnerable in different dimensions, but by consenting to be treated by a doctor, he expects that the doctor will respect his personal worth and dignity, whatever the circumstances may be. If a doctor, like everyone else, works like an automaton, described by Morrie as “people [who] walk around with a meaningless life…half-asleep, even when they’re busy doing things they think are important” (Albom, 1997, p. 42), then he will not realize the integral part he is playing in the life of his patient. His patient may die and he will not care. This is a direct violation of the patient-physician relationship described above because it means that the doctor will not bother to go the extra mile to ensure the health of his patient. Moreover, he will not understand when a patient refuses to undergo some treatments due to personal conviction, and will end up disrespecting his patient’s wishes. According to O’Rourke, medical professionals are concerned with healing a person’s physiological and psychological functions, but they must realize that they are dealing with a human being. Hence, in a sense, they have to remember that “the ultimate goal of health care must be health in the fuller sense: the coordinated functioning of human powers” (O’Rourke, 2000, p. 18). Medical care is not a commodity which can be bought or sold like merchandise. Instead, it is a service that has no corresponding price because it allows a human being to pursue a meaningful life. This belief, at first glance may contradict that of Morrie’s who says that the recognition of death allows a person to live life to the fullest. Yet, careful deliberation says otherwise – Morrie’s approach is more practical, while O’Rourke’s words are directed to the doctor who might that think that Morrie’s case is a hopeless one. By keeping in mind the basic goal of health care, then medical practitioners will realize that their profession has a deeper meaning, one that transcends the physical. For a person like Morrie, who is certain to die soon, medical professionals can help ease the pain he might feel so that Morrie can function normally and do the things he loves, according to what his body will allow him. In a sense, the medical career has its spiritual purpose – it allows a terminally ill individual to take advantage of the remaining days to fulfill (or at least find) his purpose. Morrie’s main goal in the narrative is to wake people up, to help them search for meaning. “The way you get meaning into your life is to devote yourself to loving others, devote yourself to your community around you, and devote yourself to creating something that gives you purpose and meaning” (Albom, 1997, p. 42). This is something foreign for the American people who are taught by society to become go-getters. In this modern world, everyone work only for their selfish gains, to the detriment of their “soul”. In fact, the mention of the word “soul” begets a scowl from many people. Nobody believes in it anymore because science cannot prove that such a “thing” exists. Spirituality has become a foreign subject, religion nothing more than a cult. Without the realization that medicine is a spiritual profession, medical practitioners have entered the field in search for profit – of the income they can get when they become full pledged doctors or nurses. With this view, physicians may charge exorbitant fees and hospitals may turn away patients who have no insurance, which has happened already and has given the profession a bad name. Many people distrust doctors because they think that doctors are out to make money, and they question almost every procedure or medicine prescribed. In this case, the jobs of medical professionals become even more difficult because they have to continuously appease their patients that expensive treatments will help cure their ailments. Meanwhile, by realizing that medicine has a spiritual basis – that its main purpose is to serve man and the role he has to play in the world, medical practitioners will realize why it is important to provide free services and why fees should be adjusted according to an individual’s capability to pay. By seeing the greater purpose of the profession, doctors and nurses will not hesitate to cater to individuals who have financial difficulties, and they can also begin to have a deeper appreciation of their part in the process of healing. When they see the spiritual basis of health care, then they will understand what the “higher functions of the individual” are, and they will have less trouble in respecting their patient’s view point. Moreover, it will enable them to become better at their practices because their patients can teach them how to deal with specific circumstances instead of applying standard practices which are taught in medical school. When medical practitioners realize that they too are human beings, then they will understand that they are not infallible, and they will be able to bond with their patients more, and earn their trust and respect much easier. As a doctor or nurse, it is important to realize that only a patient can know exactly what he/she is experiencing. Without the help of the patient, a medical practitioner will not be able to provide the right solutions for the ailment. Also, even when the doctor or nurse has diagnosed the problem correctly, it is still up to the patient to consent to the procedures and treatments. A patient can refuse a procedure or treatment simply because he/she feels that the doctor is not doing his best to give him/her the right cure. In this case, a doctor may respond by forcing the treatment on the patient, let the patient find another physician or let the patient be. Whichever response the doctor chooses, one thing is clear: he did not do his job properly. In a sense, the patient-physician relationship is equal – while the physician has superior skill and knowledge in medicine, the patient has his/her human rights. Physicians are bound by medical ethics to afford a patient the respect he deserves. By looking at patients as human beings with higher functions, physicians and other medical practitioners will understand that there is really no one way to treat people. While one person may opt for life-prolonging therapy, another may choose pain-relieving therapy, and a physician has to respect the patient’s decision regardless of his personal convictions. For many people, following ethical codes in medicine defuses moral responsibility and avoiding malpractice lawsuits, medical professionals have to realize that medical ethics is there to protect both the patient and the physician and serves to seal the relationship between these two parties. It is an understanding that a doctor, like his patient, is a human being and can make mistakes, but that he will do his best to prevent such mistakes from happening to the best of his abilities. Meanwhile, it also binds the patient to provide his doctor the right feedback about treatments and procedures so that the physician can gain an insight on the effects of his prescriptions and help him make better decisions for future cases. In one sense, medical ethics shows that medicine is not an exact science: illnesses may be misdiagnosed due to lack of information, uncertainty and ambiguity can happen because of the patient’s value system. Medical ethics, is supported by the organization, individuals and society (Morrison, 2009, p. xiii). Hence, in understanding it, one has to look at these three factors. As such, the discussion of ethical issues is a recognition that “medicine is primarily concerned with a patient’s physiological well-being, but this well-being in turn is directed to the individual’s social and spiritual (cognitive-affective) good” (O’Rourke, 2000, p. 24). It is a contract of justice between the physician and his patient. It does not guarantee a specific prognosis, but it does assure the patient that the physician has done his best to diagnose the ailment and find the cure. This contract is a “dialectical decision founded on scientific knowledge but influenced by the particular physiology of the body; the ambiguity of the symptoms, signs and tests; and the differing value systems of individual persons” (O’Rourke, 2000, p. 25). It is a contract between equals, and a recognition of the part that each party plays in the process of health care. Works Cited Albom, M. (1997). Tuesdays with Morrie. Random House. Barbour, J. D. (2000). The bios of bioethics and the bios of autobiography. In D. H. Smith (Ed.), Caring Well: Religion, Narrative, and Health Care Ethics (1st ed., pp. 41-63). Louisville: Westminster John Knox Press. CNN. (2001). Mitch Albom. Chat Books. Retrieved December 20, 2011, from http://edition.cnn.com/chat/transcripts/mitch_albom_chat.html Morrison, E. E. (2009). Health care ethics: Critical issues for the 21st century (2nd ed.). Sadbury: Jones and Bartlett Publishers. O’Rourke, K. (Ed.). (2000). A primer for health care ethics: Essays for a pluralistic society (2nd ed.). Washington: Georgetown University Press. Read More