Ethics of autonomy (3635472)

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(Van Gogh, V. (1890). Portrait of Dr. Gachet).

The artwork chosen is the portrait of Dr Gachet done by Vincent van Gogh in 1980. Many critics believe that there is a close resemblance of van Gogh and Dr Gachet, whom is depicted in this portrait. In the painting, he appears to be suffering from some sort of sadness, melancholy and is somewhat dispirited as can be seen by his bored facial expression (Baxter, 2016). The reason I have chosen this artwork is because I feel that there is a close resemblance between me and my patients when I look at this painting. During physiotherapy sessions both of us becomes dispirited- for example, the patient feels depressed regarding the diagnosis and the treatment I provide is sometimes not that effective and I feel disheartened. In addition to this, Gachet’s and van Gogh’s relationship was borne out of medical need (Costello & Storr, n.d.) correlating with the theme of my writing (being physiotherapy management and medically orientated).

As a physiotherapy student, it is expected to remain professional constantly, so at times, I have to keep my emotions under wraps and not allow my inner emotions to be illustrated on my facial expression. When referring back to the art, it is clear that van Gogh wanted to depict Dr Gachet’s emotions on his facial expression. In addition, at times I feel the same emotions creep onto my facial expression, which the man on the portrait has. Some patients are very demotivated and do not always want to participate in the physiotherapy session, some reasons include their depression over their own diagnosis, the fact that a student is treating them or that the therapy is not showing visible improvements. Whenever a patient does not want to participate in the sessions, I tend to get disheartened.

At some point in my clinical practice, I have had clinicians instructing me to get the patient up and out of bed in order for them to mobilize and be discharged. When I arrive to the room the patient is in, the patient refuses to do anything in my treatment session. Taking into consideration that I am only a student, when my clinician instructs me to mobilise the patient and the patient refuses, it places me in a difficult situation, as I know that it is unethical to force the patient. I have adapted some persuasive techniques in which I try to convince my patient to participate in the session, where I urge them to get out of bed, as this will help them get better quicker. I felt very uneasy throughout this whole ordeal, as my clinician demanded that I get the patient at the bed. She went on saying that I am the physiotherapist and I know what is good for the patient and so, to not take no for an answer. However, physiotherapists are responsible for conducting themselves ethically in every professional situation.

As a student, I am aware that it is unethical to ‘force’ the patient to participate in my sessions as indicated by an article. The REACH values and the foundational ethical principles form the basis for ethical decision-making (College of Physiotherapy in Ontario, 2013). The REACH values include respect, excellence, autonomy, communication and honesty. Moreover, the values acknowledge that it is the patient’s right to self-determination and to be empowered to participate in decisions regarding his or her health care is an expression of the ethical principle of autonomy. Furthermore, as students, we are constantly being challenged ethically at the work place by clinicians, nurses, doctors or even the patients. Adopting the REACH values, will allow me as a physiotherapy student to feel more secure in my ability to make the best decision possible and that is in the best interest of my patients.

References

Baxter, J. (2016, February 17). Vincent van Gogh’s Portrait of Dr. Gachet: a study of sorrows. Retrieved on 16th of September 2018 from https://think.iafor.org/vincent-van-goghs-portrait-dr-gachet-study-sorrows/

College of Physiotherapy in Ontario. (2013, March). Code of Ethics. Retrieved on the 16th of September 2018 from https://www.collegept.org/rules-and-resources/ethics

Costello, A; Storr, E. (n.d.). Artists and their Physicians: Vincent van Gogh and Doctor Paul Gachet.

Van Gogh, V. (1890). Portrait of Dr. Gachet.

2 thoughts on “Ethics of autonomy (3635472)

  1. Hi Jana, I really enjoyed reading your piece. I decided to comment on rubric so that you can see what perhaps needs to be worked on.

    Content: Does the essay reflect the module content so far? Is it aligned with class discussion? – Your essay does reflect the module content thus far, however I think that you should perhaps read the PDF that Prof Rowe sent, so that you can see what are the “main topics” in ethics and then try to slot them into the essay” For example you can say that to be equal to everyone is part of human rights ethics.
    Argument: Are claims made? Are the claims supported with evidence? Are reasons given for claims? – You do use evidence to explain your usage of the Gibbs’ model, however I do not think that it is so relevant to have that in the essay. I really liked how you explained how the feelings of the artist may be expressed through the facial expressions of the DR in his painting. I think that you should say why it is important to treat all patients equally, even though some might not want to be seen by a student physiotherapist.
    References: Are they present? Correctly formatted? Your referencing was good!.
    Writing: Is the writing grammatically correct? Are there spelling mistakes? Does the text flow logically? Perhaps consider not using the Gibbs’ model of reflection for the essay, maybe use the format of reflection that we used in our English module in 1st year, I think this will make your already good work flow even better. There are a few spelling mistakes such as “froce” however I am sure that you will make sure that that is corrected in the final.

    Comments: Through the essay you tend to elaborate on your own experience which is great, however maybe instead of focusing on how you had to get the patient out of bed. Rather focus on how you can treat all patients equally even though they are not keen on your treatment. Perhaps discuss what equality is and common techniques in achieving this with patients. You can also discuss how another persons facial expressions and body language may affect your treatment quality.

    I hope that this feedback is beneficial to you, these are just some ideas that I thought of.
    I think that you are on the right track!

  2. Hi Jana,

    Thank you for sharing your writing with us. Please see my guideline table below and feedback following this.

    Guideline Poor Satisfactory Excellent

    Content: Does the essay reflect the module content so far? Is it aligned with class discussion? X- (SATISFACTORY)

    Argument: Are claims made? Are the claims supported with evidence? Are reasons given for claims? X- (POOR)

    References: Are they present? Correctly formatted? X- (EXCELLENT)

    Writing: Is the writing grammatically correct? Are there spelling mistakes? Does the text flow logically? X- (POOR)

    Comments:
    I think it may have been helpful to get your thoughts on paper by following the Gibbs model but perhaps for the final submission write more freely and don’t feel restricted by following the Gibbs model criteria. I think in your case it is limiting. For example, in your ‘description’ I think you can describe and introduce the painting and what it means for you to choose this for your ethics assignment similar to the description in the Gibbs Model (but you do not need to include the aim of the assignment). Following this your ideas jump because of the headings you are following – without the headings I think you can make the whole piece flow more and your ideas will start linking. The idea of the painting is lost from the evaluation onward. I think this is because you are focused on filling the criteria of the Gibbs headings.

    Content- your content definitely addressed the module content and ethical discussions although you can emphasize this more in the way you write and describe. I think once you take the Gibbs model away you will link ideas more easily and then you can find areas in which your claims can be strengthened or even add a few more. Perhaps you mention more of the article information on The REACH values.

    Argument- you have included arguments, but these can be justified more strongly either my referenced statements or the use of stronger words. For example, you speak about why it is important o be professional with patient’s, perhaps you can find a reference that justifies why this is important and what the influence of professionalism is on the management of a patient?

    References- good referencing.

    Writing- the piece does not flow easily for the reader, see below advice about not using Gibbs model. To start off the piece, I have restructured your beginning just as an idea…

    The artwork chosen is the portrait of Dr Gachet done by Vincent van Gogh in 1980 (Baxter, 2016). Many critics believe that there is a close resemblance of van Gogh and Dr Gachet, whom is depicted in this portrait. In the painting he appears to be suffering from some sort of sadness, melancholy and is somewhat dispirited as can be seen by his bored facial expression. The reason I have chosen this artwork is because I feel that there is a close resemblance between me and my patients when I look at this painting. During physiotherapy sessions both of us becomes dispirited- for example, the patient feels depressed regarding the diagnosis and the treatment I provide is sometimes not that effective and I feel disheartened. In addition to this, Gachet’s and van Gogh’s relationship was borne out of medical need (Costello & Storr, n.d.) correlating with the theme of my writing (being physiotherapy management and medically orientated).

    Many times, patients are apprehensive or anxious when they hear physiotherapy students are going to treat them, however later on they start to become less anxious and start to open up towards us- I wasn’t sure why you had included this, maybe you can restructure it in later on with a similar idea?

    Well done!

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