Topics Ethics

Question In roles where individuals have a lot of responsibility (e.g. the direct protection of others) how can the idea of a 'learning curve' be tolerated? It seems to me that there are always situations in which people, like doctors or soldiers, must make judgement calls, but if such decisions - though rational and educated - don't achieve the desired outcome (e.g a patient dies, a fellow soldier is put in harm's way), how can the decision makers tolerate having made them? Are there certain roles (like being an emergency room doctor or president) in which the individual filling that role has to accept that despite their best efforts they are very likely to cause others harm or to contribute to it? Is that a risk that just goes with the job?

Accepted:
June 20, 2013

Comments

This is a timely question, since medical residencies typically begin on July 1, so we will soon have some new MDs starting the learning curve! If we don't permit the inexperienced to treat patients we will not be able to train the next generation. To keep saving lives, then, we will have to tolerate some harm. Computer and other kinds of simulation used for training purposes can avoid some of this harm. Patients keep going to training hospitals, presumably because the learning curve harm is compensated for by the skilled supervision that residents get from attending physicians. But yes, physicians in training (and even those already qualified) do have to accept that they will cause some harm. A classic book to read about this is Charles Bosk's Forgive and Remember.