The question of equality

The question of “who pays what” has been an age long debated. This question stems from whether we have equal opportunities to access available resources such as education, health, freedom and income. It is in this regard that Rawl set out a theory of justice for a liberal society. He sees justice as fairness as answering to the demands of both freedom and equality. He thinks society should be structured in a way that favours the least advantage. This is because the form of society’s basic structure will have profound effect on the lives of citizens, influencing not only their prospects but most deeply their goals, attitude, relationships and character. Institutions that have such pervasive influence on peoples’ life requires justification.

In a quest of setting out justice as fairness, Rawl makes a simplifying assumption that society is self- sufficient and closed, so that citizens enter it only by birth and leaves it only by death. Social cohesion in some form is necessary for citizens to be able to live a decent life. This is not far from what the disciples did in Antioch. The love and unity they exhibited at the time made them earned the title “Christians” which is widely accepted today.

In determining justice as fairness, Rawl set out two guiding principles of justice: First, each person should have the same indefeasible claim to a fully adequate scheme of equal basic liberties, which is compatible with the same scheme of liberties for all. The second principle is that social and economic inequalities are to satisfy two conditions;

1. They are to be attached to offices and positions open to all under conditions of fair equality of opportunity.
2. They are to be the greatest benefit of the least- advantaged members of society (the difference principle).

                                            Read the continuation ( The difference Principle)

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Self- Control : 7 of 21 Virtues every Professional must Possess

The ultimate conflict in the professional setting is from within. I termed it as the ‘universal relativist conflict’ (Read my book- “The Cardinal Virtues” for more insight). A Professional without self- control is twice defeated in the war of professionalism, no matter his/her stature. Self-control helps the professional to sacrifice him/herself instead of the corporate image or profile. Consider this;

Case study

The inappropriate sexual encounter with two patients made Dr. ABC to be stripped of the medical license he had since 19XX. During one of the Doctor’s appointments with patient 1, she asked if he (the doctor) would help locate her G-spot. Dr. ABC then stimulated her to orgasm in the call room of hospital KKB. The pair had sex a week after the encounter at the same hospital.

Dr. ABC also calls his encounter with patient 2 “a very brief relationship” and says that he did not have sex with her but testified that one night, in an administrative room at same hospital KKB, the girl asked him to show her where her G-spot was. He admitted that he did “stimulate her to orgasm” that night at the hospital. 

This is not the first time Dr. ABC has been asked to answer for his inappropriate behavior with patients.

 Let's Talk

“How would you justify or unjustify the decision of revoking Dr. ABC’s medical license by the medical professional body?” Explain your answer…………...;;;;;;;;;;;;;;;;;;;;;;;;;

Simplicity: 6 of 21 Virtues every Professional must Possess

Contrary to the popular notion we believe, real professionals are those who are able to keep things simple. Simplicity enables them to maintain clarity of purpose.

I still recall that hot Saturday afternoon when I entered ‘AA’ publications for the first time with my manuscript. I was ready to publish my first book. The young publisher I met at the office decided to use technical terms in publishing such as ‘bleed’, ‘formatting’, ‘interior design’, ‘type setting’ etc to communicate with me and I couldn’t understand anything. I really felt lost in my dream, hence walked out of the office and decided never to return again.   

Professionals should note that their true worth is not in their complexity or how they complicate things; rather, a great professional is the ‘simplifier’.

Case Study

NASCO and PICO were the leading brands in terms of the production of fertilizers in the country. The sales agents of the two companies were surprisingly fluent in only English. Their sales nationwide were massive and production rates kept increasing by the day.

In a particular year, they both realized that their sales were declining and they kept wondering about the cause of the decline. They both had a meeting and agreed to go and make a public query about the decline. It then came to their notice that the farmers find it difficult to comprehend the explanations given by the sales agent, hence they apply the fertilizer wrongly and the crop eventually dies. They decided to take independent actions to curb the issue. This was their plan;

NASCO

They decided to send their sales agents for a professional course in marketing that will make them give vivid explanations to the use of their product.

PICO

They decided to enroll their sales agent in local languages clash so that they can speak and explain to the farmers in their prospective local dialects for easy application.

“Which of the two companies is most likely to have a rise in sales? What are the possible reasons that will account for this?”………………………...;;;;;;;;;;;;;;;;;;;;;;;;;

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CLIENT AUTONOMY : 2 of 21 VIRTUES every PROFESSIONAL must POSSESS

2. Client Autonomy

´  Client Autonomy suggests that the professional’s right to decide is qualified by the client’s responsibility to him/herself. The right of the professional is decided by the responsibility of the client.  Jack Kevorkian (medical pathologist, euthanasia activist & author) admonished that “the patient’s autonomy always, always should be respected, even if it is absolutely contrary- the decision is contrary to best medical advice and what the physician wants”. Do you agree with him?

´  It is often a difficult ethical issue to navigate when the client autonomous decision (his/her intentional act) conflicts with the professional’s beneficent duty (action done to benefit the client’s best interest without his/her knowledge). Thom Mayne teaches; “I’ve learned that in order to achieve what I wanted, it made more sense to negotiate than to defend the autonomy of my work by pounding my first on the table”.

 Case Study

A 74-year-old man with multiple chronic medical problems was hospitalized for respiratory distress. He experienced recurrent aspiration and required frequent suctioning and endotracheal intubation on several occasions. The patient was deemed competent and steadfastly refused feeding tube placement. The patient demanded that he should be allowed to eat a normal diet despite being told that it could lead to his death. The patient wanted to go home, but there was no one there to care for him. Additionally, neither a nursing home nor hospice would accept him in his present condition.

The case is especially interesting because of the symbolic value of food and the plight of the patient who has no alternative to hospitalization. The hospital staff experienced considerable stress at having to care for him. They were uncertain whether their obligation was to respect his autonomy and continue to provide food or to protect his health by avoiding aspiration, pneumonia, and possible death by denying him food. This ethical dilemma posed by the physician’s duty to do what is in the patient's best interest versus the patient's right to decide treatment serves as the focus for this case study.

What should the physician do in this situation?

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Food for Thought

“Professional- Client relationship at its best is to be regarded as a partnership in which decision-making authority is shared. Professionals are not dictators but enablers”.

CONFIDENTIALITY: 1 of 21 VIRTUES every PROFESSIONAL must POSSESS

1. Confidentiality

´  Issues of confidentiality fraught with recurring storms of professional- client relationship. Standards in some professions have been very high with regards to the issue of confidentiality. For instance since the Oath of Hippocrates, medical practitioners have been bound to protect confidences. The principle as reaffirmed in the 1949 International Code of Medical Ethics states,

“A doctor shall preserve absolute secrecy on all he knows about his patient because of the confidence entrusted in him”.

´  The professional’s foundation is built on confidence (Trust). Trust is the glue that holds people together, hence the professional life is greatly affected when trust is broken. This explains why most successful counselors create an environment conducive enough to inspire confidence among clients.  When professionals offer trust, they expect clients to reciprocate.

´  If a professional reveals information about his/her client to an unauthorized person, it is known as breach of confidentiality. This is a very problematic issue in professionalism especially when the information needs to be accessed for future preventive purposes. In the nutshell, Confidence must be highly respected by all  professionals.

Case Study

Mr. Y was taken to hospital by his relative after complaining of stomach pains and bowel destruction. Following his admission, he underwent a laparotomy, where 20 pellets of carefully- packaged cocaine were found in his abdominal cavity. During the surgery, it was found that Mr. Y’s bowel was perforated, as nine of the pellets had penetrated the bowels; although 17 pellets were successfully removed and three passed from the body in Mr. Y’s stool. Shortly after the surgery, Mr. Y’s condition deteriorated and he developed sepsis as a result of the bowel perforation. After being transferred to intensive care, Mr. Y’s condition eventually improved and he was discharged after making a full recovery.

However, the surgeon who removed the cocaine pellets instructed the other clinical staff present not to take any photographs of them, and to instead repackage them in a resealable storage bag. They were then returned to Mr. Y.

The matter leaked to the media who focused on the failure by the clinical staff to report the illegal drugs.

In view of confidentiality, how can you justify and or unjustified the surgeon (with the clinical staff inclusive) decision of returning the cocaine pellets Mr. Y, instead of reporting the illegal drugs to the appropriate authority?

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Food for Thought
“In every intelligent work, there are limits to the amount of information one can share