Wednesday, June 20, 2012

Integrity, principles and veracity - Food for thought!

The ups and downs of life, yes we all have them hopefully there are more ups than downs. I have so many blogs to write, this blog is going to be about ethical behavior; integrity, principles and veracity it seems to be foremost in my mind, it is my attempt to be philosophical. It is to get you thinking about the people, jobs, organizations and activities you are involved in..... stop and take a breath, and remember the basic principles of life, integrity and veracity. Abraham Lincoln said "Important principles may, and must, be inflexible"

I have been contemplating veracity, principles and integrity and how is it that people make decisions - I was conducting Health Assessment exams with students as I was intently watching the student go through the process of auscultation (listening) of the heart sounds - aortic area, pulmonic area, ebbs point, tricuspid and mitral (apical).... her actions and explanations were good, then she listened with the stethoscope to detect the different sounds, here the student has to listen with the diaphragm (wide bit) firmly on the chest, then lightly with the bell (with our stethoscopes you have to turn bell around so you can hear. This student listened with both the diaphragm and bell without turning the bell, therefore she would not be able to hear the heart sound. I asked the student to explain what she had just done and could she tell me what the heart rate was using the bell - and she did. I was surprised that the student would lie outright - when I asked her to listen with the bell of the stethoscope and tell me what she heard - her eyes met mine, then her head drop, she held her breath and then said sorry -  it was the moment of realisation - its the oh F___K moment....her eyes dropped, the moment of shame. There was no need for me to say anything.... the student knew the impact and we all felt the disappointment. 

My question is whose principles are correct - I demand from you in the name of your principles the rights which I shall deny to you late in the name of my principles....Walter Lippmann.

So we are all on the same page, I'll start with Integrity - according to it means; adherence to moral and ethical principles, soundness of moral character and honesty. Ralph Waldo Emerson said "A little integrity is better than any career" and Oprah Winfrey said " For me real integrity is doing the right thing, knowing that nobody's going to know whether you did it or not".

This then leads nicely on to Principles again states an accepted or professed rule of action or conduct a person of good moral principles. Franklin D Roosevelt said "Rules are not necessarily sacred, principles are".

Finally veracity as per, means conformity to truth or fact, accuracy., such as, honesty, truthfulness, credibility and many more. Thomas Henry Huxley said, “veracity is the heart of morality”. I just love the word veracity..... it's not used much these days.

I wonder how many people get disillusioned with the lack of these very important principles in life? yes we all know the meanings of the profound words and probably all profess to abide by them, but do we truly do that? I challenge you to think about it.... why do people particularly leaders known for integrity and leadership engage in unethical activities?

Is it they think they won't get caught or believe that the elevated status puts them above the law? was this the first time they did something inappropriate, or have they been on the slippery slope for years and no one it as simple as being in a situation where you have to make a choice between what is right and what is easy? remember the famous words from Martin Luther King Jr “The time is always right to do what is right”. 
Sometimes it is just much harder to do what is right, no one knows that better than Toni Hoffman the senior nurse who put her career on the line to expose killer surgeonJayant Patel in one of Australia's worst medical disasters - Queensland Health and the Bligh government had treated her "like a leper" since she blew the whistle.

Another person that springs to mind is Tiger Woods, no one expected his life would unfold to the public and expose such a degree of infidelity "Gone is the mystique that once surrounded him. His aura of invincibility has evaporated, leaving only the very human man where the red-clad, club-twirling superhero used to be".

John Edwards  former Senator of North Carolina  During his presidential run and wife's cancer battle, Edwards had an affair, fathered his mistress’ child, and lied about the mess. Sadly the list is endless.
Do you think it is ever justified to tell a lie? This is a question I always ask my students in my ethical lecture, and as usual its a split class, sometimes I have majority that say its OK to lie and other times the decision is reversed. Most students will agree they should not lie and it is good practice not to lie, but in reality this does not happen, often it has been a split second decision to lie.... and this can be detrimental as the domino effect of the lie takes place together with the inevitable consequences of the lie.. However most students also seem to accept that lying is a fact of life, and that there are many degrees to lying.

This attitude is highlighted in a A study in the Uk that showed  Lying, adultery, drug taking, breaking the speed limit, drink-driving, and handling stolen goods are all seen as more acceptable than they were at the turn of the century. Prof Paul Whitely,..... “It appears Britons are growing more and more tolerant of low level dishonesty and less inclined to sanction activities which would have been heavily frowned on in the past.” 

As a society, if trust is eroded this will lead to economic and social consequences. I think its time to enforce these basic fundamental principles of integrity and veracity as essential elements to maintaining a cohesive society.

"Public confidence in the integrity of the Government is indispensable to faith in democracy and when we lose faith in the system, we have lost faith in everything we fight and spend for".
(Adlai E Jr Stevenson)
Next time you are going to tell a lie, think twice and choose not to lie.

Monday, June 18, 2012

Choices Women Make in Childbirth

This is a short blog about a few conversations with several women regarding the choices they made for the birth of their babies....I was  in a shopping center promoting midwifery and chatted to some pregnant women.....  I’m sharing some of these conversations for two reasons; because the choices these women made blew me away and in light of the vigorous homebirth debates after the release of the SA coroner’s report where he suggested that women who have a high risk factors should possibly consider a caesarean section rather than a homebirth or words to that effect...... (which will be my next blog).

I have to note that the women concerned all had private health insurance and wanted to birth in a private hospital. First two women were 35 and 36 weeks respectively, they were having repeat caesarean sections. When I asked how they felt about their impending c/section Mary said “look I have accepted that is my reality”, I asked was she happy to discuss her decision and she said she was happy to share and talk about it.... she went on to say “my first section was an emergency.... when I was pregnant again we saw the same obstetrician and we were told the risk of the scar tearing was high and its best to have another section. I then said I would get another opinion..... You know, I could not find another obstetrician that serviced the private hospital that would do a VBAC.....and besides my husband did not want to take the risk and I have to consider his wishes,” I asked “did she know the risk was really in 0.04%” and she said “yes, but my husband did not want to take that chance, I wanted to have my baby in a private hospital and did not want to go to a public hospital, so I accepted the second section, now its baby number 3 and that’s the choice I’ve made, it would of been nice to birth normally, but that’s the choice I made, I wanted to have my baby in a private hospital”.

Janie who was her friend had a similar story.... except this was her second section...she also knew about the risks involved regarding a VBAC but really did not mind having a section, again her main reason was she wanted to birth in a private hospital as opposed to a public one....

Sally was an older professional woman, 39yrs old first baby and elected to have a caesarean section, currently she was 34 weeks and was not interested in a vaginal birth, she said ‘I never wanted to give birth naturally, I want to protect my pelvic floor and besides it took me longer to get pregnant than I thought, don’t think I could deal with all that unexpected stuff, now I know the date my baby will be born.....’ her mind was made up – we did go to talk about breast-feeding to which she was not interested in, however we did manage to talk about skin to skin at birth for bonding and the possibility of expressing for the first few weeks and bottle feeding with  breast milk as an option.... I asked had she ever spoken with a midwife, her response was ‘I have private health insurance therefore I have a very good obstetrician.... and he does have a midwife I see from time to time....but he makes all the decisions....”

The last woman was 35 weeks booked for her repeat section at a private hospital – first section was an emergency, no VBAC offered and she elected for a section because her husband is a fly –in-fly-out and she wanted to plan his time off for the birth and this was the easiest way....she also did not want to birth in a public hospital....”on no I only go to private hospitals, that’s why I pay for private health insurance...”
Out of the 10 women I spoke to 5 were having elective sections, 3 were booked in secondary hospitals and another two for private hospitals and hoped for a vaginal birth but all knew about the chance of a caesarean section.... “if all goes well, I will have a vaginal birth..... we have discussed if the need arises we might have a section”.....

I must say the aspect that surprised me most was the desire to birth in a private hospital even if it meant having a c/section as opposed to birthing in a public hospital.....that puts a different perspective on some of the issues.....what is it that the majority of women want and is this the expected norm of place of birth?

Again I come back to the point of education and informed choice..... these women wanted to birth in a private hospital and how that happened did not matter, their main issue was the place of for thought.

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