What?
During class, I found myself struggling to get to grips with working through some of the ethical dilemmas that were posed. Its quite difficult to uncouple yourself from knee-jerk reactions of "well of course x is the right thing to do!". I'm sure everyone thinks they "already know" human rights before they start examining them in contexts such as these. To be honest, I'm scratching my head to think I've been in the healthcare for seven years, and its never come up to frame ethical dilemmas in this way before
So what?
There are very few cases in which "knee-jerk" reactions are in keeping with the consensus on the most ethical way to move forward in a dilemma. It would be incredibly foolish to rely on these going forward. Quite frankly I have never been party to ethically difficult circumstances during my work in private, general practice, or managerial sectors, but I most certainly will in secondary care. The first pillar of advanced practice asks us to manage complexity using critical thinking. In order to be able to deliver high-quality care in these contexts, I should be well prepared to examine the proposed decisions, of both myself and my colleagues, during difficult circumstances
Now what?
Working through the class, I found the use of toolkits was really helping me to critically examine whether or not decisions were in service user's best interest in the context of their human rights. It helped me to step away from those knee-jerks of "well everyone knows...", and really examine things step by step. I found the exercise that helped me the most was to use the British Institute of Human Rights flowchart (designed for EoL dilemmas) to examine whether "best interest" (in terms of upholding human rights) was maintained when comparing different decisions. I decided to try using this flowchart across some non-EoL dilemmas to try and get a better understanding of how to critically assess other difficult decisions.
To my surprise, in addition to helping me feel more comfortable with examining these dilemmas, some extra points came up after using the flowchart in this way. Firstly, was that a decision could still be "right" in terms of upholding service user's human rights, but it may still be discriminatory. This was particularly pertinent to me in the examination of Pretty v. UK. 2002, which lead me on to the second surprise point: that in the UK, the "right to live" absolutely and categorically excludes any "right to die". This has been a quietly burning passion of mine since the the painful loss of a family member very dear to me to MND in 2019. Examining Diane Pretty's case has most certainly stoked this flame, and the ethics of assisted suicide is something I would very much like to explore further.