Healthcare professional

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“A grown single man who still lives with his family wakes up one morning to find that he has become a bug. This leads to his being isolated from his shamefaced family. His father drives him out of a room by throwing apples at him. One lodges in his backside and rots there; the resulting infection kills him. A family ashamed of their single son. He’s a dung beetle. The apple (sin) infects his posterior,” brothersjuddotcom. This quotation of The Metamorphosis, by Franz Kafka summarizes Gregor Samsa’s undercover homosexuality. Many aspects of Kafka’s real life are foreshadowed through his short story, The Metamorphosis. It concludes to the one single possible factor, Gregor/Franz is gay.

Beginning with the title of the short story, The Metamorphosis it can be inferred that Gregor went through a change. The dictionary term for metamorphosis means a marked change in appearance, character, condition, or function. Gregor really went through a character change of homosexuality, and used the beetle to symbolize his sexuality. A beetle is a perfect use of symbolism towards his intimate feelings.

Being homosexual was not accepted in his era, therefore choosing an insect, especially one that is not liked, even possible despised by the majority of the population was a perfect fit. “It may symbolize the empty, insignificant, and outcast life that Gregor leads as a traveling sales lackey. Or perhaps it symbolizes the degraded nature of modern existence in general, or bourgeois life in particular…Or Kafka’s low opinion of himself as imagined through his father’s eyes,” SparkNotes.

Gregor could have had aids. Focusing in closely on the text, noticing that no one every states what exactly Gregor looks like, it is more then likely that he could have been very sick. During the early 1900’s aids wasn’t educated thus when society is ignorant to something different, they fear it. Gregor could have been dieing from the beginning of the story. “And during Gregor’s speech he did not stand still for a minute but, without letting Gregor out of his sight, backed toward the door, yet very gradually, as if there were some secret prohibition against leaving the room. He was already in the foyer, and from the sudden movement with which he took his last step from the living room, one might have thought he had just burned the sole of his foot” Kafka 16-17. Why would the manager run away from a big helpless bug lying on his back?

A bug with legs so tiny that he couldn’t even flip himself over. This is because Gregor wasn’t a bug at all. Gregor must have looked differently, but most likely looked sick. In most aids cases the person has white spots on him. Gregor could have possibly had these, which scared his manager away. Gregor’s mother did indeed run towards him with outstretched arms. It just isn’t common for a woman to fun open handed towards an insect. How would she know it was her Gregor if he was physically changed into an insect? If he were a beetle wouldn’t she think that the insect ate Gregor? It’s just not physically possible for a human to turn into a beetle over night. Gregor had a disease; a disease that wasn’t known during that time and this disease is at fault for all of his disfunctionings.

I have chosen this title because during my time studying for IPE and from the lectures I have received on the correct conduct of healthcare professionals, I feel that patient-centeredness encompasses the moral, social and legal expectations of a doctor, as well as including effective communication skills and the emphasis on ethical responsibilities. I feel that you cannot look at communication skills in medicine without looking at the ethical reasons as to why we have to interact with patients in this way and that ethics directs us in focusing on the needs and well being of the patient as well as respecting their autonomy. In this essay I will be writing about my findings from research into consent, capacity, confidentiality and the patient-doctor dynamic, and exploring how all of these areas require excellent communication skills and high regard for ethical duties, and finally how all of the factors together work to achieve the patient-centred approach to medicine.

Consent

The reasons that consent is necessary in the healthcare environment are that the healthcare team must be protected from litigation should the procedure fail to achieve the desired results. Another important reason is that patients have the right to access the full information about their treatment, what it involves, the expected recovery time, the benefits of the treatment and other treatment options available. The idea that mutualistic relationships between doctors and patients is important here and the idea of promoting a belief in equal political, social and civil rights for all, empowering patients and involving them in their care is central to the patient centred approach and consent allows the patient to understand their illness more and be more instrumental in their treatment.

The issue of consent overlaps with that of adequate communication between the healthcare professional and the patient and ethics, and the emphasis on the patient centred approach. There are procedures that have minimal risk attached such as taking a blood sample or blood pressure where the patient is only required to give verbal consent, in the case of healthcare professionals this is called implied consent as the care given is easy to understand and administer. In this instance, the patient would roll up their sleeve when a nurse states she needs to take a blood sample. It is the responsibility of the doctor to explain any procedures that require written/documented consent. This involves making sure that the patient understands sufficiently the procedure, its aims and its effects, and the risks in carrying out this procedure.

Regardless of whether or not the patient consents to this treatment, the doctor has a duty to respect the autonomy of the patient, listen and respond to the patients concerns and questions and avoid the entrance into a paternalistic role. The healthcare team must also allow a suitable time period for reflection, offer support to the patient if the information is distressing and offer support to the patient when they have made a decision about their treatment.

Another of the main principles behind this is the doctors upholding of beneficence for the patient, that is holding their interests at the highest priority, and also non-maleficence, which means that above all else the doctor must not harm the patient in any way what so ever. The latter may conflict with the patients choice, if they chose to withhold consent for the optimal treatment, however, the law maintains that respect for patient autonomy is more important and we must respect the beliefs, values and choices of the individual involved. In contrast to this, pressuring the patient into a treatment which the healthcare team think the patient should have may also harm the patient, if they denied treatments on religious or personal grounds for example.

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David from Healtheappointments:

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