enough, this attitude, itself, is a reflection of an American value that places almost
unlimited faith in the power of technology to overcome obstacles, including disease and
death.) In fact, caring and values account for more than we think when it comes to
good health care.
(2) Consider the comments of Dr. K. L. White, Retired Deputy Director for
Health Sciences at The Rockefeller Foundation, in the preface to Lynn Payer's book,
Medicine and Culture: "Although things are much better than they were a generation
ago, it is still the case that only 15 percent of all contemporary clinical interventions are
supported by the objective scientific evidence that they do more good than harm. On
the other hand, between 40 and 60 percent of all therapeutic benefits can be attributed
to a combination of the placebo and Hawthorne effects, two code words for caring and
concern, what most people call `love'."5
placebo effect: a positive therapeutic effect resulting from an inert
medication, preparation, or intervention given for its psychological effect,
or as a control in an experiment.
Hawthorne effect: a temporary positive effect resulting from any
change in environment or conditions.
1-2.
ETHICS IN YOUR DAY-TO-DAY WORK
a. Radiographers and Diagnosis. You have just taken an x-ray of a patient's
lungs. He seems visibly anxious and asks you if there are any suspicious spots on the
x-ray. You can see that the lungs look clean. You feel for him, and would like to say
there's no cause for alarm. It would also feel good (enhance your sense of self-
importance) to be the bearer of good news. Do you tell him the results on the spot?
b. Self-Interest vs Moral Imperative. How do you balance personal
compassion (a desire to satisfy the patient's need to know) with the moral (professional)
imperative to leave the diagnosis to the physician? Do you go with your personal
feelings when wearing your professional hat? As a professional, you are bound to put
your personal feelings aside and follow the moral imperative, the "ought to" that means
leave the diagnosis to the physician. (See Appendix A, principle six of the code of
ethics.)
c. Giving Precedence to the Moral Imperative. In the above example, self-
interest (the patient's need to know now, and your personal desire to comply) is in
conflict with the higher moral imperative (to leave the diagnosis to the physician). The
choice is quite clear. You must choose in favor of the moral imperative. When there is
conflict between self-interest and moral imperative, the moral imperative should win out.
Many ethical choices in life are easily resolved, like this one. We generally live our lives
making the morally right choices (or consciously selling out, that is, making the morally
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