Surgical Conscience or Surgical Convenience ?

Dr. Nancymarie Phillips, RN, PhD, RNFA, CNOR Professor, Perioperative Education Department Lakeland Community College Kirtland, Ohio

Foundations for our students

Definitions Introspection of self as the educator Assess students status

Before After

Teach introspection Provide examples and scenarios Incorporate the concept in routine lessons

Ethics as a Branch of Philosophy

Does not have the same meaning for everyone
Can be influenced by the era and social setting

Family bonds (monarchy, infidelity, chastity) Tribulation (inquisition, crusades, holocaust, conquest) Career relations (hire, fire, promotion, demotion)

Related to loss or gain Personal stance may not be constant in all

situations
3

Definitions
Professional Ethics
Expected rules of

Conscience
Personal sense of conduct

conduct

Standards Recommended practices Guidelines Motivational dynamics

Prefer one set of actions over another Truth and fairness Honor

Moral awareness

Moral choices

Judgment and choices Part of the superego as

Philosophy of moral

relates to psychotherapy
4

values

Right vs wrong

Confucius said.

The measure of a mans worth is what he would do if he thought he would never be found out.

Why you do the things you do

Deontologist
Do the right thing

Consequentialist
Decision is made based on

regardless of the consequences Self-determination

expected consequences Utilitarianism

Freedom Dignity Keeping a promise Look at both sides

Happiness for self and significant others For the greater good

Theory of Conscience
Motivation behind personal duty
Rewards and punishments according to

perceived right or wrong actions Desire for justice Fear of retribution or rejection Reflected judgment of others Virtuous self-concept

Conscience from two views

Subjective Elements Set of common values Good or evil motives Moral Obligation Self-Regulation Self-Sacrifice Fear of punishment Sense of justice Objective Elements Altruistic actions Approval from others with same values: good or bad Open resentment for those who breach common values Show self-resentment if others observe us breaching the values

Real emotions Fake showing of emotions

8

How does conscience relate to me?

As a human person

Values and beliefs; morals

As a family member

Obligations
Role Responsibility
9

As a team member

As an individual caregiver

The Golden Rule:

Do unto others as you would have done to you. Treating your patients as though they were part of your own body.Not always the easiest thing to do.
10

The personal enemies of conscience

Sloth- Laziness
Indifference- Uncaring Avarice (Greed)- Glory-seeking, Power

hunger Selfishness- Inconvenience Anger- Acting out Pleasure

Everett Idris Evans, 1950: Annals of 11 Surgery

Can we force learned conscience?

Encourage personal observation of self-

action and the resultant outcomes Observation of the actions of others Anticipation of resultant outcomes

Favorable Disasters

Who is really hurt?

12

Teaching ConscienceBuilding
Observation of human response

Evidence-based lessons by example (Hume) Relationship between science and reality

Avoid authoritarianism Because I Said so! We always do it this way.

Structuring intellect in the learner

Critical thinking What if philosophy

13

What we cannot do as teachers

Create conscience by threats of

punishment Strengthen morals by comparison to others Convert resentment into respect Instill surgical conscience as inherent second nature in our students

14

Surgical Conscience Reinforcement

Reality and permanence to education

Clinical experiences and post conferences Applied critical thinking Clinical instructors Preceptors
Using science and evidence-based practices Professional bravery and sparking change
15

Learning by example

Discontent with current practices

Opposition from authority

In conclusion
Summary points to ponder Cultural and ethnic aspects Religious influences Social constructs Professional standards Conveniences Free moral agent
16