Tuesday 30 June 2009

Member Care and the Hippocratic Oath, Part 3

Some Ideas for Responsible Practice:
Respect, Relate, Reproduce
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Diego Reivera, The Flower Carrier, 1935
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Non hay tan dulce cosa
como la fidelidad
nin miel tan sabrosa
como la buena amistad.
Tem Tob, 14th century, Spain
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Translation:
Good, faithful friends are sweeter than anything.
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To consider dear to me, as my parents,
him who taught me this art;
To live in common with him and, if necessary,
to share my goods with him;
To look upon his children as my own brothers,
to teach them this art.”
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This second section of the Oath, quoted above, might not seem too applicable for us in the member care field. The type of close teacher-student relationship described here is not exactly the same today as it was 2400 years ago in Greece. But let’s look into it more closely. I would like to suggest that we extract three broad principles from this section that are relevant for member care practitioners.
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Applications
1. Respecting Senior Colleagues.
We show respect to (and “consider dear”) the senior practitioners in our field. For me, this applies to people whose proven character and proven contributions are sustained over time. It especially applies to those aged 70+ who were working in the pre-member care field in the 1970s and even 1960s. We show respect by listening carefully to their input and honouring them in our gatherings.
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Personally I so enjoy learning more about our roots as a field and the efforts of those who trail blazed so long ago. Often these folks were not even aware that they were blazing anything but rather thought that they were just doing their job. These folks in their steadfastness and depth inspire me: Stringham, Lindquist, Foyle, Narramore the Grossmans and surely many more! As Tolkien says of Aragorn, a “senior (Ranger) practitioner” in the Lord of the Rings, “the old that is strong does not wither, deep roots are not reached by the frost.”
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The Oath indicates that the teachers and the students have a close personal and working relationship. They may even “live in common”. I likewise want to encourage member care workers and senior practitioners to connect closely together for personal and professional learning. Would it ever be possible for practitioners and senior practitioners to “live in common” in some sense? Now that is quite an idea! Perhaps the closest thing that I am aware of is sharing a room together at a conference for a week, or working on a field-based project for a few weeks, or working on staff together as part of a course or school for a few months. And maybe there are additional types of relationships that we can creatively consider. Why not?
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The Oath also mentions providing practical support for teachers/senior practitioners as needed. The labourer is worthy of her/his wages. Note that there is no clear requirement for remuneration in the Oath, and perhaps this is not mentioned so that senior practitioners would not be tempted to exploit underlings for money. Perhaps the default arrangement as much as possible was pro bono instruction. Paul the Apostle gets into this point in 2 Corinthians 11 regarding his status as a senior (apostolic) practitioner. He reminds the Corinthians (as he did the Thessalonians and other churches, e.g., I Thes. 2:9) that he served them freely and was not a financial burden to them even though he could have honourably and ethically asked them to help meet his needs. Bottom line: keep our financial relationships clear, and don’t exploit anyone who needs our services or whose services (such as training) that we ourselves need.
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2. Relating Closely with Colleagues.
Our relationships with the family members of teachers/senior practitioners is the next broad principle. Apparently priority was to be given to children (sons) of the medical teachers. There seems to be a sense of duty to look after the teacher’s children as well as a strategic sense that the children will be in a good place to continue the medical profession, having watched and learned from their parent who is a physician.
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How to apply this? Well, I like the idea of getting to know the families of senior colleagues and also the families of a few close colleagues. Many family members and others can benefit beyond the dyadic teacher-student relationship. And maybe we will be seeing second or even third biological generations of member care practitioners. Again I say, why not? But consider these caveats: let’s avoid any type of nepotism or favouritism in the member care community. And let’s not confuse professional roles and responsibilities with personal preferences and gain that produce conflicts of interest, not to mention envy and resentment.
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3. Reproducing Knowledge/Skills.
We provide services but we also try to multiply our services reesponsibly. In fact, as member care practitioners we try to multiply ourselves—our competencies as well as our character. Training in many contexts can thus also involve "imparting our own lives" (I Thes. 2: 8). This is a special privlege and responsibility to be taken very seriously. It also requires accountability. “Let not many of you become teachers knowing that as such you shall receive a stricter judgement” (James 3:1).
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One additional application is to mention that it is especially challenging to offer instruction well in light of the diversity of the member care world and mission/aid settings. One example among many: how to intervene in a “troubled” family/team setting in which the parent/team leader is seen as being rigid and authoritarian by some members and as exercising firm, caring authority by others? These types of sitautions certainly "stretch" our own experiential and practice boundaries. Good member care practice often requires going beyond the familiar (or with reference to the Oath, we go beyond the family of our senior teachers) in order to embrace the diverse. We have to cross sectors and disciplines, genders and generations, in addition to crossing cultures. Have a look at the material from the World Federation of Mental Health, prepared for World Mental Health Day 2007: Mental Health in a Changing World: The Impact of Culture and Diversity
http://wfmh.org/COVERS/2007WMHDAY.jpg
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Final Thought
An important part of our member care practice involves responsibly: a) respecting other practitioners, b) relating to other practitioners, and c) reproducing other practitioners. Can we really read all of these responsibilities into the second section of the Hippocratic Oath? Well, yes, in a general way. Without overstepping our interpretive bounds, we can build upon our Greek predecessors. We can use this part of the Oath as a further springboard to help us consider how we want to practice responsibly.
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Reflection and Discussion
1. Is there a senior colleague with whom you regularly relate? Do you have any special type of agreed-upon relationship?
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2. Are there member care workers who look to you as being something like a senior colleague, and consult with you for help?
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3. Who are your closest colleagues? How close are you to their family members?
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4. What are the pros and cons of member care workers who link personal and professional relationships together?
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5. In what ways are you reproducing your knowledge and skills within your sphere of influence? What thoughts do you have about training (i.e. responsible multiplication) in light of the diversity of caregivers/settings?

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