The world is a dangerous and sometimes intolerant place.
The recent atrocity in Paris against the staff of satirical magazine Charlie Hebdo has brought into sharp relief issues that are ever present, and are likely to remain so for the foreseeable future. However, these issues remain largely undiscussed among the professions involved in healthcare.
Across the world, people have spontaneously stood in solidarity with the French and for the principles of tolerance and liberty, saying: “Je suis Charlie”. In a multicultural world, it is only possible for us all to thrive within the bounds of integration and tolerance. Imagine the possibility for human achievement, particularly in healthcare, if society could accommodate and value all of its constituents equally. This is an enlightenment dream and it is worth striving for.
So, how can health professionals contribute our skills to this endeavour? The current unrest is a threat to health and to healthcare and, whenever challenges to health arise, health professionals respond. We only need to look at the selfless response to the ebola crisis as an example of health professionals doing their bit.
Reflecting upon the current state of the world has brought me back to my first professional principles as a nurse and health visitor. Practice is founded on the fundamental ethical principles of beneficence and non-malfeasance, which are two sides of the same coin. These are the active intentions with positive volition to do good and to do no harm: this cannot be achieved by accident.
The four principles that underpin health visiting practice, often revised since their origin in 1977 but still essentially the same, have permeated my entire professional life. They are: the search for health needs; the stimulation of an awareness of health needs; the intention to influence policies affecting health; and enabling health-enhancing activities.
In my reflection on what can be done by health professionals to help the world situation, it strikes me that the four principles of health visiting and the fundamental ethical principles of beneficence and non-malfeasance apply to the situation the world faces, and frame an appropriate response. We face this challenge together, wherever or whoever we are. This is highlighted by the events in Paris.
The health professions are a powerful force for good. Each of us has access to people, every day. The engagement we have with patients and colleagues influences attitudes and opinions and shapes society, and the shape and nature of society is important to all of us. Whatever personal views we may hold, as a professional group we surely have a responsibility to help to shape our society, creating tolerance and integration, modelling this wherever we can and, through this, strive to improve health and health outcomes.
So, should we take on this responsibility? Assuming the answer is yes, some of the many ethical questions that arise are: how do we do this as professionals? How do we embed tolerance of difference and respect for all into all our activity? How do we become aware of our actions as a force for good and a force for change?
As an academic health visitor, I am involved in delivering programmes of education and in designing programmes to create the next generation of professionals who are fit for the future. It seems to me that to do this appropriately, the challenges the world faces today need to be addressed, somehow, within our programmes. Each of us in a small way can contribute to making change. Je suis Charlie, are you?
Carmel Blackie is a principal lecturer at Kingston and St George’s Faculty of Health, Social Care and Education