The End with New Beginnings

Tell me and I’ll forget; show me and I may remember; involve me and I’ll understand. — Chinese Proverb
The six weeks of the Ethics course has come to an end and I feel I have gained a huge amount of knowledge about ethics in general and also things that are happening around the world that were being referenced to on other people’s blog posts that I was not aware of for example, although I have been in South Africa for the past 3 years, I did not know about Black Economic Empowerment up to the time when I read ,Cecil’s, post on equality.

When I started this course I did not know what to expect hence I found it very difficult to formulate my learning outcome as I was like what is there to learn about ethics? In the corse of the course I discovered that there is alot of things that I do not know for example at first I did not understand the difference between empathy and sympathy and yet I thought I was practicing it. The other thing I found remarkable was the way this module has been facilitated, it is the interactive and stimulating nature it has, as my opening quotes says I retained the things in the module because I was involved. It has not only changed my attitude towards some bias I had concerning different things but it has also helped me to improve the way I express myself on paper for other people to understand my ideas although it has not been easy.

The choice of topics could not have been better. I found it very hard to discuss the last weeks topic on authenasia as I could not reach a decision but looking back on the past weeks I realized that sometimes it s ok not to be able to make a conclussion as ,sarah, put it in her final blog that it does not make you look stupid.

Looking back at the last few weeks I can say that the hours that I invested in this module were not a waste as I had a chance to learn from Physiotherapists around the world and my classmates since some of the dilemmas other people have written I might face them in the future as over and over again the issues that we have been discusing were shown to be cross cutting not affecting one society only.

As a person I must admit that I have changed my attitude on how used to view other things for example treating gay/lesbian who has the characters of one. Finally I will leave with this quote on learning;

“Excellence is an art won by training and habituation. We do not act rightly because we have virtue or excellence, but we rather have those because we have acted rightly. We are what we repeatedly do. Excellence, then, is not an act but a habit.”

Aristotle (384–322 B.C.)

Assisted Suicide or Murder?

I was touched to read Tony Nicklison’s story about how he has lost his independence and his desire to die even though the state think that it is not right. I am trying so much to put my morals out of this and discuss this issue objectively but still take or leave out the religious arguements that “God giveth and God taketh”I can not agree with assisted suicide, as a person and also as a medical profesional.

Why I’m I saying so? If human were given this unlimited rights even to a point of killing yourself if your life sucks, it may result in chaos, just last year here in Cape town a woman threw herself and her 1 year old baby infront of the train just to find an easy way out. She made a choice but what about this young child. She thought that it is the best option for both of them since this child will not know the pain of being an orphan. But was that doing justice to the poor baby? Man has free will but this will needs to be checked. I might want to have a nice car but have no money, my free will will make me steal just becuse I want it but because there are laws to check that, I might start considering other options to get the car that I want. I can see that this is what may happen if there were laws that would allow terminaly ill, severely handicaped, or patients in pain to opt for death. People may abuse this laws and when they are tired of caring for a severely disabled person they will send them over to the death bed even if they have not make the decision themselves. Just imagine someone that is not able to communicate to defend themselves.

Secondly as a health profesional my moto is to do good to patients and not cause harm. Isn’t euthanasia doing good if the patient request?  Now talking from the Physiotherapist point of view, our aim is to improve quality of life and not to end life but if your patient wants to die and does not want to participate in therapy what could you do? Is it appropriate to support this choice? An easy way of course is to refer to psychologist.

To conclude my post I would find it very difficult to deal with such a person and I can not even see myself in a suppoting role:(

“Torture” It Can Never Be Ok!

Torture is the act of inflicting excluciating pain as a punishment, or revenge, or as a way of getting confession, or information, or for sheer cruelty! Looking at the above definition there are two parts to torture; an action that is done and the expected outcome, but the question is; is it justifiable? Are there instances where torture is ok. What about in medicine does torture exist?

Personally I view torture as cruelty and believe that torture has no place in humanity and worse still in medicine regardless of the outcome of torture. As human beigns I believe that our brains are not more developed than other mammals for nothing but because we have the ability to critically analyze things and consider other options. I am sure that there are always other means of getting an outcome for example information from a person than torture.

Maybe there are other instances where torture may be permissible, I am not sure. Once my friend told me that never say I can never kill a man until when you are in a situation, and he proceeded by giving me an example of what happened in Rwanda during the genocide that just imagine you watch someone killing your whole familly brutally and you have recognized the face, what would you do to that person if you had a chance to revenge? Torture breeds violence according to Williams, the victims of torture are more prone to violence and possibly may opt to options of torture themselves(http://bjp.sagepub.com/content/early/2013/04/08/2049463713483596). Having said this I believe a healthy human beign would not torture another beign.

If I briefly go back to last weeks topic abot equality I believe the other thing that justifies torture is when you believe that the value of this human beign is less than the other or that they deserve what thay are getting, for example in 2004 there was a dry spell in Malawi and there were no rains. Many elderly people were tortured or even stoned to death in the community because people believed that they were responsible for the dry spell.(were practicing witch craft to prevent the rain from coming) This is cruelty but the thinking was lets rid the community of one witch and save the entire community.

If we could count any life to be precious just like the next person we would not be talking about torture. Be it an 80 years old man or a 2 years old boy they are all human beigns and they are special in their own ways and deserve the best treatment our resources could afford. Who says a 2 years old has a full life a head of him so he should get priority? Who knows what will happen to him in ten years down the line?  What if he becomes a robber and kill people or might as well live to be a president? An eye for an eye will result in a blind world because we all have done wrong at some point in our lives.

Are we really all equal?

First I would like to try to define what being equal is. I liked the definition that the National youth council of Ireland used on their website.

Equality is not always about treating everyone the same – it is about treating people in such a way that the outcome for each person can be the same. This means putting things in place to support people to achieve similar outcomes.

It is easy to put laws or claim that we are giving equal opportunities to everyone but the question might be do people have the resources to access this opportunities? To illustrate my point further I will give this example; There is an HIV education movie that is being screened in the second floor of the council building, that has no elevator or lamps for a wheel chair user to access the building. The viewing is free for all the residence of the township. There is no organization as to how people that use wheel chair will view this move. In the above scenario the organizers of this event may claim to have given equal opportunity to all the residents of the town ship as the viewing is free. But is there equality to the people that use wheelchairs who will not be able to attend because of structural barrier?

Having said this, I think equality never exist even in the most civilized society, because it is not about equal treatment but modifying the treatment in a manner that everyone will benefit at the end.

Considering the issue of equality and discrimination this is a very important and critical issue because there are other things that people are more willing to accommodate than others for example the sexual orientation issue. I have also difficulties coming to accept the gay/lesbian marriages, but my not approving does not mean that I condemn this people to death. It is their life and their decision, who puts us to be the dictators of each others life. Although I do not approve gay/lesbian marriages I do not have problem being friends with them and let alone treat them as a patient.

It is very pathetic that governments instead of focusing on really issues that are affecting people ,they spend time arguing or drafting bills to criminalize something that is not harmful to society. The world is facing so many pressing issues like wars, hunger and etc where the focus and money should be spent  not on people that are living their lives quietly. I was also saddened by what Caster had to go through in order to participate in the athletics. Is this really necessary? Should human suffer for what they are? How far are we really going to go in order to ensure equality.

Just imagine all the trees in the world were mango tree, and all the food is pizza and there was only one type of cloth and in the same shade! What would life be like? BORING BORING BORING!!!!  Life is beautiful because of diversity. Don’t get me wrong although. Its wonderful because there are inequalities and differences but that does not mean we should ill judge or mistreat each other. Respect and Love is what make the world go round:)

Morals Vs Ethics

Morals and ethics are two words that are often used together and sometimes interchangeably but with a slight difference in their meaning. First  I define morals as personal beliefs of what is wrong or right. This is shaped by the laws, norms and beliefs of our society and I being a christian my morals are influenced a lot by my religious belief. On the other hand ethics are principles that are supposed to guide the conduct of people in a certain set up for example work ethics.

Our morals are what we are and what we are is how we behave. In other words our morality influences the way we behave or react to various situation despite having ethics that would guide us to react the other way.

Personally I have never encountered any ethical dilemma because of my personal belief. I believe that there is one right way of living ( same coin can not have two heads, it’s either the heads or tails) I also happen to believe that ” thou shall not judge.” so people can choose to live their life the way they want and despite what they do judgement is not for me to make. This belief helps me to tolerate other people, also knowing that what I believe in is not what other people believes.

Morality has an upper hand in our behavior and although Physiotherapy is different from other professions like nursing where you would be asked to do something that directly conflicts with your morals like abortion I know it has it’s own ethical dilemmas.

The role of Empathy in Physiotherapy!

Empathy is a complex word that is often misused and often times misunderstood.  I thought I understood empathy and was practicing it every time I had a patient, but after my interaction with the learning resource this week I realized that there is more to empathy than putting yourself in the place of another person, or telling someone that I do understand how you feel because it is impossible to as feeling is subjective.

I am not much of a writer so I will borrow this expression on empathy

“Be someone else, It takes great empathy to create a good experience. To create relevant experiences, you have to forget everything you know and design for others. Align with the expected patience , level of interest, and depth of knowledge of your users. Talk in the users language.” Niko Nyman

This is what I would call empathy. Letting go of ourselves and putting our self in the place of the patient and trying to feel and understand what the patient is going through. By bringing our selves to the level of the patient we will be able to form that connection that will allow empathy to take place. I know that this is scary as it puts one in a state of vulnerability and no one likes to feel vulnerable but this is the only way to connect with our patients.

We don’t deal with customers or clients let alone users but we deal with patients that are vulnerable and who have put all their trust and confidence in us. For the success of our treatment and career  we need to develop empathy as it has been illustrated that the art of healing is in part made up of a therapeutic use of oneself or a therapeutic presence for patients. This presence is more than knowledge and skill alone, it is also composed of compassionate understanding of a patient and a communication that the therapist is worthy of the trust that the patient has bestowed……….empathy enhances the process of healing (Davis, 1990). We can not do away with empathy. It has a major role to play in our discipline. We can never be effective without empathy.

But the question that may arise is, how can one maintain their sanity at the end of the day if they are sharing the burden of 10 patients in a day? I think this is where the keeping of professional distance comes to play. We need to learn to separate us from the problems of our patients or avoid becoming emotionally attached to our patients because this may prevent us from making objective decisions, thereby leading to emotional burnout at the end of the day.

Before I close I would like to leave you with this beautiful poem about empathy

Can I see another’s woe,
And not be in sorrow too?
Can I see another’s grief,
And not seek for kind relief?

Can I see a falling tear,
And not feel my sorrow’s share?
Can a father see his child
Weep, nor be with sorrow filled?

Can a mother sit and hear
An infant groan, an infant fear?
No, no! never can it be!
Never, never can it be!

William Blake

It is a world of Technology

Hi, My name is Emma Gondwe, I am a third year Physiotherapy student at the University of the Western Cape(UWC). I am from Malawi , a small country in the South eastern Africa where health system is very poorly developed and Physiotherapy is on the bottom of the  Government priority list. The population of Malawi is above 14  million people but there are less than 35 Malawian Physiotherapists which means more than a third of the population does not know or has ever heard of what Physiotherapy is. I came to South Africa to study because there was no Physiotherapy school in Malawi but now the school has been opened and the first graduates will be finishing in 2-years time. I am very excited to do this course on line and to get to know and learn from Physiotherapist all around the world. It is indeed a small world and with the dawn of technology I feel like I can be at all places at the same time. I am looking forward to having a great and informative time 🙂

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