b. Josephson specializes in the subject of public corruption and how to avoid it,
dramatic instances of ethics gone awry (such as the savings and loan debacle of 1990),
the police brutality scandal in Los Angeles in which a private citizen videotaped a police
beating (1991), statehouse wrongdoing, or corporate misconduct. Whenever there is
such a scandal, he gets more requests for help. In his classes, he asks participants to
act out real situations they have experienced that involved moral dilemmas. Josephson
believes that eventually every leading business and government organization will have
an ethics education program.
PATIENT'S RIGHTS VS PUBLIC INTEREST IN SAFETY FROM VIOLENT ASSAULT
Does psychiatrist protect confidentiality of patient disclosure (intent to murder)?
OR
Does psychiatrist protect life of intended victim and compromise patient confidentiality?
Figure 2-3. Moral dilemma
Section II: THE ETHICS OF CARING: RESPONDING TO PATIENT MOOD SWINGS
2-9.
YOUR CLINICAL RESPONSIBILITIES TO THE PATIENT
In the first section of this lesson, we saw how values, beliefs, and attitudes affect
our ideas of right and wrong, good and bad, desirable and undesirable. These same
values, beliefs, and attitudes also affect the patient's tolerance of the hospital stay.
You, as a health care professional, must be aware of common feelings that affect
patients. Such awareness will help you perform the caring aspect of your job more
effectively. By dealing better with the mood swings of your patients, it will also indirectly
allow you to perform the technology aspect (positioning the patient, preparing him for
injections, etc.) more efficiently. It will allow you to anticipate and to recognize patient
behaviors for what they are.
2-10. DEPENDENCY
The caring aspect of your job involves being friendly, cheerful, and sympathetic
to patients. A patient with whom you are not assigned to interact repeatedly asks you
for help, in the course of his stay. One day you direct him to the lab; the next day you
accompany him to the sitz bath. The day after, he asks you to take him to the dental
clinic. When does being helpful and compassionate lead to unacceptable infringements
on your time and ability to accomplish your main duties? You must be on guard against
increasing and unnecessary attachments of this kind. It is your job to draw the line
between a friendly and supportive stance and an intolerable encroachment. There is a
point at which the patient's dependency can seriously affect your ability to do your job,
and the patient's ability to make a speedy recovery.
MD0066
2-12