Thoughts on ethical boundaries…

I think I missed one of my blogging days so I thought I’d share some of my recent thoughts on the ethical dilemmas 

I’ve spent a lot of my time at their hospital that specializes in maternal care and deliveries. The experience has been absolutely fascinating, both in the things I see on a daily basis and the fact that I have the opportunity to see them at all.  And I don’t mean that just as a nod to Penn for sending me on their dime, but that after only 6 weeks, I can walk into the delivery room of the hospital and assist in childbirth.  In the beginning I was simply observing child-births and patient consultations, shadowing the nurses and doctors on their daily rounds.  But by now they’ve put me to work monitoring fetal heart rates, taking blood pressure, cutting sutures and umbilical cords, and helping to resuscitate babies, deliver placentas, and insert breathing tubes and IVs.

I find myself thinking about ethical codes and boundaries pretty often.  But frankly, the lessons from my bioethics class and from Beauchamp and Childress’ classic “Principles of Bioethics” are falling flat.  It’s very difficult to reference one’s own code of ethics when that of the place you are working is so markedly different.  In such a case, how can one judge if an ethical code has been violated?  How can you navigate through a hospital with a medical team that holds such a different idea of ethical boundaries?  What if you’re expected to perform a task that’s perfectly permissible in the new environment, but violates everything you’ve been taught as right and wrong?  And then there’s that solicitous temptation to take advantage of this gap, bypass what you know (or thought your knew) in your heart to be “right” and “wrong,” and test the lax ethical boundaries of the new setting  And for what?  To see something you’d never be allowed to see (without mountains of paper work and consent forms, that is) at home, learn from people who don’t expect to be treated well to begin with, test one’s own personal boundaries, etc.  And who am I to make judgements about these things anyway?  I’m just some idealistic young buck thrust into a situation she knows so little about.  In all of these dilemmas, the potential to exploit patients is ubiquitous.  And avoiding doing just that, at times, feels as precarious as walking on a tightrope.

I’ve developed a little rule of thumb to help me wade through these unchartered waters.  For all of the moments I experience something at the hospital that infringes upon my own personal code of ethics, there’re usually as many opportunity to fill in these voids with some form of compassion.  Staying back to have a conversation with a family that has just welcomed a new one while the nurses and doctors hurry to the next patient.  Holding back a woman’s hair while she vomits from the labor pains.  And holding hands. Lots of hands.  It turns out, amidst all the things I’ve learned so far, these moments are some of the more gratifying.

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