quarta-feira, 7 de setembro de 2016

Fairness and Justice

At one of my general blocks I was referred to treat a patient who was a prisoner. When I got to know more about him and his background it hurt me to know that he was a thief and was guilty of many cases but also guilty of drug dealing in one of the low socio-economic areas in Cape Town. He was a young patient in his late 20’s. As a physiotherapy student to learn to adopt this “habit” of observing people, their body language, the way they speak, the way they think and their response to you as the physio. I could not help assuming the worst about this patient. I built thoughts in my mind where I wanted to ask him “why do you sell drugs”, “what makes it okay for you to take from others” or “why  are you destroying the community”. The reason why I felt this hatred and bias towards him was because he gave me the feeling that he would continue to do what he did as a criminal after being released from prison. I felt that he didn’t  deserve to receive the best services from me. I felt that it is unfair of me to treat someone who is contributing to the communities problems, specifically drugs. I felt that this patient was not willing to change.

This was where my moral ethics to treat a patient holistically was tested. As morality in ethics is understood to be the belief of an individual of what is right and wrong and is influenced by culture, religion, social demands/status etc. Morally I was responsible to treat this patient with the best of my ability, like with any other patient. However, my social status, culture, religion and beliefs of right and wrong  played a big role in the treatment, attitude and behavior I had towards him.

According to Velasquez, Andre, Shanks, & Meyer (2014)  justice and fairness are closely related. Justice is related to rightness, fairness and often has been used with regard to an ability to judge without reference to one’s feelings or interests. Based on justice I was able to judge this patient but my own morals influenced my thinking. Fairness is the ability to make judgments that are not too general but specific to a particular case. To me at the time based on myself as a person (not a physiotherapy student)  I was being fair to not treat this patient the way I would with other patients because to me he did not deserve it. When I mention ‘treat’ I refer to my overall approach to him. However, based on health care/services and professionalism/patients rights in health care delivery, it  is my responsibility to treat the patient to the best of my ability (with fairness). This does not necessarily mean I had to create a “good” relationship with him. All I needed to do was follow my professional protocols according to physiotherapy and treat this patient holistically.


Velasquez, M., Andre, C., Shanks, T., & Meyer, M. J. (2014). Justice and Fairness – Ethical Decision Making – Ethics Resources – Markkula Center for Applied Ethics – Santa Clara University. Retrieved from https://www.scu.edu/ethics/ethics-resources/ethical-decision-making/justice-and-fairness/

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