Monday 21 September 2009

Member Care and the Hippocratic Oath, Part 10—Summary

Hippocrates as Historical Precedent:
Roots and Responsibilities
The Hippocratic Oath in Greek and Latin.

La saeta lanza
fasta un cierto fito,
y la letra alcanza
desde Burgos a Egipto.
Sem Tob, 14th century, Spain
Darts hit their mark when carefully thrown
Writings go far when skilfully sown.
This is our 10th and final discussion of the Hippocratic Oath. As the above moral proverb indicates (and many thanks to you Sem Tob for your universally-wise rhymes!), the truth in skilfully written words, such as those in the Hippocratic Oath, span across continents, generations, centuries, and health disciplines. The ethical core for health practitioners in the Oath, arguably, is unprecedented as a historical foundation of good practice.
Just one case in point among many is the current version of the American Psychology’s Ethical Principles for Psychologists and Code of Conduct (2002). This code like its “cousin codes” in related health sciences, is replete with what can only be called by this point in our discussions, "hippocratisms.” Smile. Meander through the Introduction and the Preamble, and then on to the General Principles and then Ethical Standards sections and you will quickly bump into such familiar concepts/commitments as doing no harm, responsibility, competence, confidentiality, and yes, even not having sex with clients etc. Check it out at:  The Hippocratic foundation is there (along with other items such as justice, integrity, and rights along with more specific, contemporary standards involving things like psychological testing, court testimony, etc.).
Final Application
We want to summarize the 10 core principles that we have covered over the past three plus months. These principles are commitments that are explicitly embedded in the Hippocratic Oath (HO). We want to remember our roots and our responsibilties. These core priciples could be likened to being the 10 commandments for healthcare practitioners. But let’s just call it the “10 HO Commitments”. We also list the first draft of the newly condensed version (10 items now) of the “15 Commitments for Member Care Workers” (from the 2006 article “Five Stones for Member Care: Upgrading Ethical Practice).”
Well, if this does not have your head spinning yet, then this may well do the trick: The 10 Commitments in the Hippocratic Oath will then be referenced to the 10 MCW Commitments (in parentheses)--although note there is definitely not a one-to-one correspondence. Here we go!
10 HO Commitments (for health care workers)
1. Foundational Principle: Accountability to a Higher Power
2. High Standards: Agapeoath for Trans-Practitioners
3. Professional Obligations to Respect, Relate, and Reproduce
4. Hippocratic Heart: Dong Good and Doing No Harm
5. Respecting Human Life: Conception through Completion
6. Growing in Character and Competence
7. Prudence: No Sex with Clients
8. Confidentiality as a Lifestyle
9. Consequences of Good vs Poor Practice
10. Historical Precedents: Roots and Responsibilities
10 MCW Commitments (for member care workers)
1. Ongoing training, personal growth, and self-care. (HO6)
2. Ongoing accountability for my personal/work life, including consulting/supervision. (HO1)
3. Recognizing my strengths/limits and representing my skills/ background accurately. (HO6)
4. Understanding/respecting felt needs, culture, and diversity of those with whom I work. (H03)
5. Working with other colleagues, and making referrals when needed. (HO3)
6. Preventing problems and offering supportive/restorative and at times pro bono services.(HO5)
7. Having high standards in my services and embracing specific ethical guidelines. (HO2)
8. Not imposing my disciplinary/regulatory norms on other MCWs. (H03)
9. Abiding by any legal requirements for offering member care where I reside/practice. (HO9)
10. Growing in my relationship to Christ, the Good Practitioner. (HO1)
Reflection and Discussion
We hope these 10 entries since June have stimulated your thinking about new, old, and creative ways to understand member care. Take some time to identify/review three meaningful concepts for you in particular.
I especially enjoyed the challenge of trying to relate the moral proverbs of Sem Tob and the indigenous artwork of Diego Rivera with member care thinking and the Hippocratic Oath. Perhaps you would like to have a go at some integrative member care work that includes the arts, sciences, and history etc. too.
It has personally been a lot of work and I was not always sure where we would end up. Perhaps the same is true for you. Are you OK for example with the summary in the 10 HO Commitments?
I am tempted to close with yet another gem from the Jewish rabbi Sem Tob in 14th century Spain. However  I want to finish now with something from an anonymous Christian monk in 8th century Ireland. This excerpt from the poem Pangur Ban (White Cat) aptly describes what this integrative journey into "Member Care and the Hippocratic Oath" has been like for me. Like the monk in this poem, I have been hunting at length for the right words to convey my thoughts and I have been keenly aware of how small my wisdom really is. Maybe you have a proverb or short poem that reflects your experience too.
I and Pangur Ban my cat
‘Tis a like task we are at
Hunting mice is his delight
Hunting words I sit all night.

Against the wall he sets his eye
Full and fierce and sharp and sly
Against the wall of knowledge I
All my little wisdom try.

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