When ethical behavior is taught in medical courses, it is assumed that the people we are instructing already have a set of morals that have been handed down to them, and that those morals are generally good.
Good morals I define as a desire to preserve personal honor, preserve the dignity and sacredness of human life, respect the personal boundaries and belongings of others, etc, and to act in a way that is right and always erring in the desire to do the right thing. Understanding how morals effect behavior is called ethics. The terms “morals” and “ethics” are not well understood by the layman, so it is a common misconception that they are the same thing.
So frequently lately there have been awful stories in the news about those in emergency services who breach those morals and act in a way that is not ethical. Taking pictures of patients in compromising positions, speaking in a way in public that would degrade others, stealing the property of those we are sworn (usually but not always) to protect, and generally acting in a way that would breach their trust of us, are just to name a few instances where negative morals have ruined careers and by extension, lives.
We live and work in a society that is seemingly out of control. We should know, we are on the front lines of it. Crimes that were unspeakable and carried a serious stigma are now more and more common place, to the point they lose the stigma.
How does my commentary on the state of society relate to emergency services? Well, we are part of it. We were talking on EMS Garage a few weeks ago regarding an EMS LT in FDNY that got canned for posting derogatory comments to Twitter. I made the comment when we discussing teaching “electronic ethics” to students that we have to assume that the people that we are teaching have a translatable set of morals that mold well to our collective ethos. Increasingly this is not the case. In a society that teaches that everything is relative, we are failing to provide a steady guidepost as “pillars of the community.” People that were the standard are now no longer the standard.
The reply to my comment was that maybe we need to be more selective in who the industry as a whole allows to “make it.” I believe that we can’t legislate morals in terms of rules and regulations, but gone are the days of people knowing what is right and what is wrong so we are forced, as organizations to legislate. Invariably, we end up legislating every aspect of a person’s workday. This is where we transition from trusting our people with knowing what to do, to trusting them with nothing. A workplace without trust in our line of work is, in my experience, not a place worth working in.
Can we teach morals and ethical behaviors? Maybe. I believe that organizations should have the right to define was is and what is not procedurally correct, but to undo what a person has been taught all their life about what is right and re-define right and wrong to them is outside of our scope of practice. I believe that the people we bring in should already be able to join our collective ethos.