3B.2 Ethical reflection

To reflect profoundly on number of fundamental ethical and political themes

As health advocates, OBGYN professionals responsibly use their expertise and influence to advance the health and well-being of individual patients, communities, and populations. By doing so they recognize their duty and ability to improve the overall health of their patients and the society they serve. Communities and societies need physicians’ special expertise to identify and collaboratively address broad health issues and the determinants of health. At this level, health advocacy involves efforts to change specific practices or policies on behalf of those served. Framed in this multi-level way, health advocacy is an essential and fundamental component of health promotion. Health advocacy is appropriately expressed both by individual and collective actions of physicians in influencing public health and policy.

On a more individual level, health advocates reflect on, take a stance and participate in public discussions on:

·      The value perspective of humanities; how do we think about themes like health, disease and care? Which criteria do we use for evaluation?

·      The power perspective: who determines the answers to the above mentioned questions, who the distribution of means on which grounds? Which role play sex, age, cultural, religious background? Do patients and professionals use the same criteria and

·      The scientific perspective; do we use a rational or an empirical scientific stance, a natural or social sciences perspective? What are the leading scientific principles in a postmodern age with many paradigms?


The answers on this kind of questions is closely related to what we in OBGYN see as the ‘meaning of our professional life, the purposes of treatment and therewith which criteria we use as quality indicators. Do we really take Quality of life serious or are we still sticking to mortality and  morbidity? Do we take personal growth (like in paediatrics) and social participation (like in rehabilitation medicine) as outcome goals? Or even more revolutionary: do we use inspiration as an aim, e.g. when looking at  professional collaboration in multidisciplinary teams? Overlooking these questions it is clear that OBGYN is a domain which is characterized by a pluralistic value framework. Inherent to pluralism are interfering or even  conflicting value frameworks. In chapter x on the request for labia reduction the autonomy of the individual patient may sand opposed to the medical ethical principle of ‘primam non nocere’ (do not harm).  

Working in this field requires highly developed ethical and reflective skills. The quality and use of these skills will be discussed in more detail here.


Marieke; werk jij dit verder uit?

Wellicht handig om dit op te hangen aan:

·      Dilemma’s, voortkomend uit contrasterende waarden(kaders)

·      Reflectie, moreel beraad, intervisie, standpunt beroepsvereniging etc als technieken om antwoorden te vinden die individuele denkkader te boven gaan.

·      Onderscheid tussen discussie om standpunten (inzake waarheidsvragen) helder te krijgen en dialoog om onderliggende waarden en normen op te sporen en ‘verstehen’. 

Zie ELO: Reflectie: Specifieke methodieken (http://reflectie.ahmas.nl/modules/pagesahmas/php/view.php?id=37295&rev=-1