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A young woman is rushed into hospital by ambulance to the labour ward. She is 28-weeks pregnant and alone. Her waters have broken, and she says she cannot feel the baby moving. The midwives cannot detect a heartbeat. They deliver her baby rapidly and competently. A paediatrician and a medical student are also present. The baby emerges stillborn and grossly deformed, his body bloated and his head misshapen. A dark swelling protrudes from his chest. After rapid delivery of the placenta and checking that the mother is physically stable and comfortable, the baby is whisked away to a side room. The clinical team cluster around the lifeless body, whispering instructions and counter instructions. Horror hangs in the air. Meanwhile, the woman, plump and helpless, lies on the bed-marooned, alone, tears slowly coursing down her cheeks. The student looks up and sees this. She detaches herself from the group and hesitantly approaches the woman. She gently takes the woman's hand lying limply by her side. No words are spoken. The woman squeezes the student's hand in silent gratitude.
Introduction
This narrative is one of many I partook in as a medical student and junior doctor which showed me the unintended harm that doctors and nurses could do to patients in their emotionally laden responses. I witnessed doctors getting angry, blaming or insulting patients, being cold and callous, lying, failing to explain, being patronising or simply not noticing distress or not listening to what patients were telling them. I also witnessed kindness, tolerance, patience and sensitivity. These observations, perhaps oddly, gave me the strong motivation to study and later to teach medical ethics. At that time ethics was not part of the medical school curriculum. We learnt from our role models, from hearing their deliberations, but above all what they said and how they behaved in their encounters with patients, colleagues and students. In the above narrative, one could perhaps fault the clinicians for not carrying out a specific duty or protocol, but what stood out for me was the lack of attentiveness to the woman's desolation and suffering. The shock-disgust even-generated by the abnormal stillborn baby eclipsed their sensitivity towards her plight. Instead they focused on carrying out correct forensic procedures. I have a recollection of...