My work in medical ethics informed my conception of how to live a happy, meaningful life.
The principles of medical ethics – autonomy (respect for the individual’s choice), beneficence (to do good), nonmaleficence (to do no harm) and justice (to be fair) – form the foundation of medical practice.
In the ten years that I consulted on some of the most challenging ethical situations at our hospital, where family members and hospital staff were struggling to make the best decisions for a patient who no longer was able to make autonomous decisions.
I began each consultation by affirming our common goal: to bring to the table all that we know about the medical situation and to seek the best solutions for this loved one and patient from that individual’s perspective – to hear how this person found meaning in life and to make decisions aligned with what he or she would have chosen – in essence, to hear the patient’s voice.
I also emphasized the importance of the principles of medical ethics. They are not mere philosophical principles to be taken off a dusty bookshelf for bedtime reading or madly scrambled for in an ethical emergency. Because they underlie all that we do, these principles should serve as the moral compass guiding our daily work.
I used to say that the road to hell (or ICU) was paved by clinical practice guidelines. If we blindly react to a medical condition with the usual protocols of assessment and intervention, we can make the wrong decisions for an individual.
All that we do in healthcare – our investigations, our treatments, including surgery and medications – are tools. Medical ethics guides us in choosing which of these tools are appropriate for an individual’s situation.
We must first consider our goals of care, and of course, the patient’s voice is paramount. We need to know what the patient would choose from their unique perspective and sense of meaning.
Your happiness exercise for today: In our lives, we will each face difficult situations where we must make the right choices. When we haven’t made the best choices – perhaps we didn’t take the time to consider our moral principles or we were just reacting to life, we eventually must confront them.
What do you believe in? What are your most important ethical principles? Write them down. Put them in your wallet – in the front of your wallet. As you go through your day, look at them often, and affirm that in what you say and how you act, you are respecting who you are and what you believe in.
What are your goals, your megagoals, your life goals? Take some time this week to write these down and stick them on your bathroom mirror. In the morning, ask yourself how you plan to move towards your goals during the day. In the evening, reflect on your progress towards them.
These are two of the keys to a meaningful and happy life: live in accordance with your greatest values and move towards your greatest dreams.