ETHICAL DILEMMAS IN THE TRAINING OF HEALTH PROFESSIONALS

PROF. Midion M. Chidzonga

BDS; FFDRCSI; MMedSc (Clin Epid); PGDipIntResEthics; PGDipHPE; MPhil (HS Edu).

DEAN,

University of Zimbabwe College of Health Sciences

Oral and Maxillofacial surgeon

MEDICAL ETHICS, BUSINESS ETHICS, ETC

• No such thing

• There is only ethics • Different set of ethics,

• Professional life • Spiritual life • At home with family • Training of health professionals.

ETHICS IS ETHICS

• To live ethically

• One standard across the board

• Not always easy

• Strive to live and work ethically to achieve greater success.

THE ETHICAL DILEMMA

• An undesirable or unpleasant choice reaching to a moral principle or practice

• Do we do the easy thing or the right thing?

KING SOLOMON

• The ways of right living people glow with light the longer they live the brighter they shine but

• The road of wrong doing gets darker and darker, travellers can’t see a thing they fall flat on their faces.

• CHRISTIANITY: • “Whatever you want men to do to you, do also to them.”2

• ISLAM: • “No one of you is a believer until he loves for his

neighbour what he loves for himself.”3

• JUDAISM: • “What is hateful to you, do not do to your fellow man.

This is the entire Law; all the rest is commentary.”4

• BUDDHISM: • “Hurt not others with that which pains yourself.”5

• HINDUISM: • “This is the sum of duty; do naught unto others what you

would not have them do unto you.”6

• ZOROASTRIANISM: • “Whatever is disagreeable to yourself, do not do unto

others.”7

• CONFUCIANISM: • “What you do not want done to yourself, do not do to

others.”8

• BAHAI: • “And if thine eyes be turned towards justice, choose thou

for thy neighbour that which thou chooses for thyself.”9

• JAINISM: • “A man should wander about treating all creatures as

he himself would be treated.”10

• YORUBA PROVERB (Nigeria): • “One going to take a pointed stick to pinch a baby bird

should first try it on himself to feel how it hurts.”11

THERE ARE REALLY ONLY TWO IMPORTANT POINTS WHEN IT COMES TO ETHICS.

• THE FIRST IS A STANDARD TO FOLLOW.

• THE SECOND IS THE WILL TO FOLLOW IT.

• Ethics is how we ought to live and do our business.

TRAINING OF HEALTH PROFESSIONALS

• Recruitment

• Training Process

RECRUITMENT

• Student selection

• Qualifications

• High fliers

• National needs

• Student numbers

DILEMMAS

• National needs Versus Facilities

• Infrastructure

• Pass rates

• Colleagues

• Standards of care to which health workers are trained.

• Training Facilitator• Student/lecturer ratio • Deteriorating infrastructure• Low cost of training

• Dilemmas • High pass rate/failure rate• Gender issues• Lower grades• Affordability

• Training • Failure rates • Commitment of trainers • Training environmental • Facility development

• Dilemmas • Commitment • Ill preparedness. • Economic development • Western standards • Production relation to resources • Equitable distribution• Fair financing

APPROPRIATE TRAINING

• Training

• Licensure

• Continuing education

• International optimal standards.

SUPPORT FROM THE HEALTH SYSTEM FOR ITS WORKERS

• Train people and then not support them, basic level

• Resource intensive training procedures, not available

TEACHING STANDARDS

• Ethics health care

REFERENCES

• 1.Proverbs 4: 18-19, The Message

• 2.Matthew 7: 12

• 3.The traditions of Mohammed, quoted at www.thegoldenrule.net, 23 September 2002.

• 4.Talmud, Shabbat 31a, quoted in “The University of the Golden Rule in World Religions,” www.teaching-values.com, 23 September 2002.

• 5.Udana-Varga 5, 1, quoted in ibid.

• 6.Mahabharata 5, 1517, quoted in ibid.

• 7.Shast-na-shayast 13:29, quoted at www.thegoldenrule.net, 23 September 2002

• 8.Analects 15:23, quoted at ibid.

• 9.Epistle to the son of the Wolf, 30, quoted at www.fragrant.demon.co.uk/golden, 23 September 2002.

• 10.Sutrakritanga 1.11.33, quoted at ibid.

• 11.Ibid.

• 12.Cash R. Ethical issues in Health work force development. Bulletin of worker health Organisation 2005; 83: 280-284,

Thank you for your

time