I do not care.

“The great gift of human beings is that we have the power of empathy”- Meryl Streep

According to the oxford dictionary empathy is the ability to understand and share the feelings of another. Empathy is to recognise what it feels like to experience something and not merely to label an emotion (Halpern, 2003). The connection between empathy and ethics during clinical practice is that the affects disclosed through empathy should be to support the demands and obligations to the patient (Mark, 2017).

I have been working at Paarl Hospital for the past few weeks. The ages of the patients I treat range from 15 to 85, most of the patients I treated was above the age of 55. The patients I treated were either motivated and excited to see me or they were demotivated because of the pain they were going through or they were simply too tired. The motivated patients were easier to treat as they actively took part in treatment sessions, the demotivated patients however was more difficult to treat.

During the third week of my block at Paarl Hospital I treated a patient with pulmonary tuberculosis, he was 65 years old. One of my clinicians initially treated this patient and I had to re-asses the patient and continue treatment. During my subjective evaluation the patient told me that he is breathing too fast and that he is tired, with my observations I noticed that he had tachypnea. This however did not bother me as the previous SOAP notes indicated that the patient presented the same and still took part in treatment. Starting my objective assessment I asked the patient to cough and he could not, I then asked him to sit up in bed as I wanted to do auscultation. The patient then told me that he is too tired and that he had been sitting all day. I then tried facilitating lying to sitting and the patient told me to stop and that the Lord can come get him now, because he is done.

I did not show empathy towards this patient, I was more worried that my clinicians would tell me to go back to my patient and try again. I could not put myself in his position as I just wanted to finish up with all my other patients. The fact that I did not even think of sitting down and talking to the patient concerns me, as it seems that I only put in effort with treating patients who take part in treatment sessions and without even thinking about what the demotivated patients are going through I then don’t put in much effort in treating them. The patient’s demand was that stop treatment and I am obligated to stop treatment as the HPCSA, booklet 13 (2007) states that the decisions of competent adults patients to refuse a particular medical intervention must be respected, even where this would result in serious harm to them or their own death. The following day I had to see this patient again and treat him if he felt better. I however did not want to do this as I did not want to struggle talking him into allowing me to treat him. The demand of the patient could have been to receive treatment on this day and I would have been obligated to treat him. The affect of the lack of empathy shown by me would not have supported the demands and obligation to the patient, therefor raising an ethical dilemma.

References

Empathy. (n.d). English Oxford Dictionary. Retrieved from https://en.oxforddictionaries.com/definition/empathy

Halpern, J. (2003). What is Clinical Empathy?. Journal of General Internal Medicine, 18(8),670-674.

Mark, K. (2017). The Connection Between Empathy Towards Others and Empathy. Retrieved from https://www.psychologytoday.com/us/blog/empathy-and-relationships/201701/the-connection-between-empathy-toward-others-and-ethics

HPCS. (2007). Seeking Patient’s Informed Consent: The Ethical Consideration. 13(2).

3 thoughts on “I do not care.

  1. Hi Robert,
    Thank you for your piece on empathy.
    I suggest you start your piece in a better way, it is not intriging and the topic is only made known later on. start with the definition and then tell us about what you experienced.
    You need to maybe make your argument stronger by adding more lietrature, maybe add some literature on the effects of students not having empathy on treatment, professionalism attached to empathy. I see you made reference to automy in your last sentence, maybe make a connection to the two topics and how anatomy affects empathy or how that plays a role on your views towards the patient.

    Your topic is relevent but very vague, try and link your infomation to your experience.

    More references

    Your piece made me think of my clinical experience, i can relate, i sometimes also just want to finish and show very little empathy towards my patients, this is a ethical dilemma but sometimes we as students suffer from becoming to involved and sometimes the question arises am I showing enough empathy?

    Thank you for your piece.

  2. Hi Robert

    The reflection you wrote is relatable as it is difficult to challenge the clinician’s authority as a student and as a result, we subscribe to their instructions and disregard some of the things we have been taught in class whether it is ethics module or any other module. As a result, we often go through the motions and push the needs of the patient beneath the needs of the hospital or the clinician.

    Empathy is a fundamental concept in ethics and you have done a good job in selecting a topic that relates to the module content, although them of empathy has a faint presence in the writing itself. The theme only has a strong presence in the last paragraph. Try to introduce the theme of empathy earlier in the writing in the first paragraph. There is content in the writing that appears to be unimportant with regards to the topic. For instance, you mention a lot about physiotherapy management which does not really contribute to the overall topic.

    There is no ethical dilemma which has clearly been highlighted. The ethical dilemma which you could choose to explore is the idea that as students we sideline the needs of the patients to meet the expectations of the hospital and the clinicians.

    To support the statements that you make in your wring use in-text referencing. Do some research on the implications of empathy to support the reason why you felt concerned about not showing the patient any empathy.

    Grammer and spelling
    Paragraph 1
    “…most of the patients I treated (was→were) above the age of 55”
    “Apart from these patirnt→patient’s current diagnosis most of them also present with chronic illnesses like HPT, DM, and COPD
    “The motivated patients was →were easier to treat as they actively took part in treatment sessions, the demotivated patients, however, was more difficult to treat”

    Paragraph 2
    “…with my observations, I noticed that he had tachypea→tachypnea”

    Avoid using too many conjunctions in one sentence

    You have touched on some interesting ideas in your writing which needed to be expanded on more.

    I hope the suggestions help you improve your draft

    Kind regards
    Mfundho

  3. Hi Robert
    Your piece resonated with me as I have previously followed my clinicians instructions blindly only to reflect later that what I did was not the most ethical thing. It is difficult to challenge your clinician’s authority as a student but it is very important to realize that we as forth year students have the necessary knowledge to confront your clinician about things that we do not agree on. I also believe that in order to be good physiotherapist you need to strive to achieve what is in the best interests of your patient even if your clinician does not agree as long that it is safe and ethically correct.
    Empathy is a fundamental ingredient in being a good physiotherapist and it evident that you have attempted to link your post to this theme that was covered within our ethics module. Even though this is evident you need to try to create a strong theme from introduction to conclusion. There is also few sentences within your piece that does not add to the theme you are trying to convey such the treatments and deeper clinical presentationsof the patient. I believe it wwill be best to remove this as it does not add value to your piece
    In order to strengthen the theme you are trying to get across you need reference and engge with more literature
    Writing and grammatical errors
    Paragraph 1
    “…most of the patients I treated (was→were) above the age of 55”
    “Apart from these patirnt→patient’s current diagnosis most of them also present with chronic illnesses like HPT, DM, and COPD
    “The motivated patients was →were easier to treat as they actively took part in treatment sessions, the demotivated patients, however, was more difficult to treat”
    Paragraph 2
    “…with my observations, I noticed that he had tachypea→tachypnea”
    I hope this feedback will assist you in developing your final draft.
    Kind regards

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.