A healthy outcome

Sam Hazledine.
Sam Hazledine.
''First do no harm.''

This oft-quoted medical ethics phrase is a guiding principle for doctors the world over, ensuring the patient's health and wellbeing is their primary consideration.

Its meaning - if not the actual wording - can be traced back to the Hippocratic Oath, and a version of it is incorporated in the various declarations, statements and codes informing doctors today.

One of the modern interpretations is the Declaration of Geneva, adopted in 1948 by the General Assembly of the World Medical Association, in response to the medical atrocities of Nazi Germany.

The Declaration has been amended four times since - most recently last weekend, to accommodate a clause proposed by Queenstown doctor Sam Hazledine: ''I will attend to my own health, wellbeing and abilities in order to provide care of the highest standard.''

The amendment is ground-breaking and is the satisfactory conclusion of several years of consideration by Dr Hazledine, who had been researching stress among doctors, and its impact on patient care, and believed something needed to change in the medical system but he was unsure exactly what.

His ''lightbulb'' moment apparently came in 2015 when speaking about wellbeing to graduating medical students and he realised the Declaration did not mention doctor health and wellbeing.

He told this newspaper last year his research had shown that ''stress leads to depersonalisation and emotional disconnection from the patient and depersonalisation leads to increases in major medical errors'', and set about lobbying for change.

The medical profession is rewarding but tough. There is an expectation that long hours and long periods of work are part and parcel of the job, and, to some extent, a rite of passage, something previous generations have endured. Relentless pressure on budgets only exacerbates that.

Those who are focused on ''doing no harm'' to their patients, who may also be filling positions in less desirable disciplines or locations and therefore are even more in demand, may find themselves well down the list of anybody's priorities. There is a toll for them and their families.

Revelations this week that nurses in the only acute mental health unit on Auckland's North Shore have been working double shifts of 16 hours and more for months show the problems are not specific to doctors.

Southerners have been concerned about areas where resources are stretched, healthcare is being delayed, and patients suffering as a result.

The strains on the system - those who use it and those who provide the care - are becoming intolerable, by many accounts.

Miraculously, patients still seem to be largely pleased with the service they receive - when they get it. That speaks volumes about the dedication of the country's medical practitioners.

Yet, a system cannot run on goodwill and aspirational words alone. As Dr Hazledine says, his amendment is meaningless unless it is adopted globally and the values become something to live by.

It is hoped that those negotiating our future government composition are aware of Dr Hazledine's global progress and have health concerns as a primary consideration in their thinking too.

Comments

Emotional connection, what nurses and caregivers call 'emotional labour', is stress inducing in itself. While 'depersonalization' is not good, need doctors have emotional investment in patient care?