ETHICAL DILEMMAS IN THE TRAINING OF HEALTH PROFESSIONALS PROF. Midion M. Chidzonga BDS; FFDRCSI; MMedSc (Clin Epid); PGDipIntResEthics; PGDipHPE; MPhil (HS Edu). DEAN, University of Zimbabwe College of Health Sciences Oral and Maxillofacial surgeon

MEDICAL ETHICS, BUSINESS ETHICS, ETC No such thing There is only ethics Different set of ethics, Professional life Spiritual life At home with family Training of health professionals.

ETHICS IS ETHICS To live ethically One standard across the board Not always easy Strive to live and work ethically to achieve greater success.

THE ETHICAL DILEMMA An undesirable or unpleasant choice reaching to a moral principle or practice Do we do the easy thing or the right thing?

KING SOLOMON The ways of right living people glow with light the longer they live the brighter they shine but The road of wrong doing gets darker and darker, travellers can’t see a thing they fall flat on their faces.

CHRISTIANITY: “Whatever you want men to do to you, do also to them.” 2 ISLAM: “No one of you is a believer until he loves for his neighbour what he loves for himself.” 3 JUDAISM: “What is hateful to you, do not do to your fellow man. This is the entire Law; all the rest is commentary.” 4 BUDDHISM: “Hurt not others with that which pains yourself.” 5

HINDUISM: “This is the sum of duty; do naught unto others what you would not have them do unto you.” 6 ZOROASTRIANISM: “Whatever is disagreeable to yourself, do not do unto others.” 7 CONFUCIANISM: “What you do not want done to yourself, do not do to others.” 8 BAHAI: “And if thine eyes be turned towards justice, choose thou for thy neighbour that which thou chooses for thyself.” 9

JAINISM: “A man should wander about treating all creatures as he himself would be treated.” 10 YORUBA PROVERB (Nigeria): “One going to take a pointed stick to pinch a baby bird should first try it on himself to feel how it hurts.” 11

THERE ARE REALLY ONLY TWO IMPORTANT POINTS WHEN IT COMES TO ETHICS. THE FIRST IS A STANDARD TO FOLLOW. THE SECOND IS THE WILL TO FOLLOW IT.

Ethics is how we ought to live and do our business.

TRAINING OF HEALTH PROFESSIONALS Recruitment Training Process

RECRUITMENT Student selection Qualifications High fliers National needs Student numbers

DILEMMAS National needs Versus Facilities Infrastructure Pass rates Colleagues Standards of care to which health workers are trained.

Training Facilitator Student/lecturer ratio Deteriorating infrastructure Low cost of training Dilemmas High pass rate/failure rate Gender issues Lower grades Affordability

Training Failure rates Commitment of trainers Training environmental Facility development Dilemmas Commitment Ill preparedness. Economic development Western standards Production relation to resources Equitable distribution Fair financing

APPROPRIATE TRAINING Training Licensure Continuing education International optimal standards.

SUPPORT FROM THE HEALTH SYSTEM FOR ITS WORKERS Train people and then not support them, basic level Resource intensive training procedures, not available

TEACHING STANDARDS Ethics health care

REFERENCES 1.Proverbs 4: 18-19, The Message 2.Matthew 7: 12 3.The traditions of Mohammed, quoted at 23 September Talmud, Shabbat 31a, quoted in “The University of the Golden Rule in World Religions,” values.com, 23 September values.com

5.Udana-Varga 5, 1, quoted in ibid. 6.Mahabharata 5, 1517, quoted in ibid. 7.Shast-na-shayast 13:29, quoted at 23 September Analects 15:23, quoted at ibid. 9.Epistle to the son of the Wolf, 30, quoted at 23 September

10.Sutrakritanga , quoted at ibid. 11.Ibid. 12.Cash R. Ethical issues in Health work force development. Bulletin of worker health Organisation 2005; 83: ,

Thank you for your time