ISD: first, do no harm

This post is my contribution to the April 2009 Working/Learning blog carnival, hosted by Dave Wilkins at his Social Enterprise blog. 
(I updated this note when Dave’s “host post” appeared on April 30.)

Conversation in a learning chat on Twitter last Thursday included this from Shanta Rohse:

Doctors have “do not harm”
I wish IDers had an equivalent.

I always thought this phrase was part of the Hippocratic Oath, but it’s apparently much more recent. That spoils the analogy a bit, but not the idea of the duties of a learning professional.

The UK’s General Medical Council has published the duties of a doctor. I used those to think about my responsibilities as a learning professional.  Here’s the result:

Learners and clients must be able to trust learning professionals with their time, with their goals, and with their desire to learn. To justify that trust you must show respect for learning and you must:

  • Respect the goals and the business of the clients and learners with whom you deal
  • Protect and promote the right of each person to learn
  • Provide a good standard of practice and care
    • Keep your professional knowledge and skills up to date
    • Recognize and work within the limits of your competence
    • Work with colleagues in the ways that best serve learners’ interests
    • Test your assumptions, question your preferences, and seek evidence to support the effectiveness of approaches to learning
  • Treat learners as individuals and respect their dignity
    • Treat learners politely and considerately
    • Respect learners’ right to confidentiality
  • Work in partnership with your clients
    • Listen to them and respond to their concerns and preferences
    • When you believe their plans or preferences will not accomplish their goals or facilitate learning, provide reasons and alternatives in a collegial, constructive manner
  • Work in partnership with learners
    • Listen to them and respond to their concerns and preferences
    • Give them the information they want or need in a way they can understand
    • Respect their right to reach decisions with you about their learning
    • Support them in managing learning for themselves to improve and maintain their knowledge and skill
  • Be honest and open and act with integrity
    • Act without delay if you have good reason to believe that you or a colleague may be putting patients at risk
    • Never discriminate unfairly against learners or colleagues
    • Never abuse your learners’ trust in you

What are your thoughts?

7 thoughts on “ISD: first, do no harm

  1. Good topic for discussion, Dave. I use these, based on ISPI’s original CPT ethical guidelines:

    1. Base recommendations and actions on an objective needs assessment conducted in partnership with the client.

    2. Define and achieve useful results that can be aligned with both the client organization’s mission, objectives, and positive contributions to society.

    3. Focus on results and consequences of the results. Measure performance based on results, not on procedures performed for the client.

    4. Set clear expectations about the process to be followed and about the expected outcomes.

    5. Serve the client organization with integrity, competence, and objectivity.

    6. Respect and contribute to the legitimate and ethical objectives of the client organization.

    7. Prevent problems from occurring rather than solve problems that could have been predicted and avoided.

  2. Harold, I’ve always liked the concept of the king’s shilling. If as a consultant you take on a client, part of the relationship is accepting that client–not uncritically, but accepting that their goals are their goals, and that they’re entitled to work toward them.

    If you’re the employee of a larger organization, you have less freedom of movement, because you’re already accepting your employer’s shilling. I think you have to make any difficulties known internally, first–e.g., you have personal reservations about the client’s business or focus.

    We could have a whole new blog based on problems people have run into with clients…

  3. Ah yes, several new blogs on that subject alone.

    One of the ways that I differentiate being a consultant from a contractor is that a consultant sometimes has to tell clients what they don’t want to here. Like your physician analogy, doctors have to make the correct diagnosis, not just please their patients.

  4. I’m a big fan of Peter Block’s Flawless Consulting, except perhaps for the ambitious title. He sees three kinds of consultants: the extra pair of hands (here’s the task, do it the way we want), the expert (here, you know this stuff; you do it), and the collaborator.

    Each role is valid if both parties are in agreement. Over the long haul, though, I’ve never had much fun being an extra pair of hands.

  5. Lisa: leave it to a clinical professor to ask that kind of question…

    I’d like to know more what you have in mind. My initial response would be that technology, in general, means “tools with chips.”

    An old form of the Hippocratic Oath said the physician would not “cut for stone” (try to remove gallstones) since that required specialized skill–one origin of surgery, maybe, and aligning with the “limit of competence” in the list above.

    Perhaps that’s technique rather than technology. Today, you’ve got intelligent tools like the gamma knife; the surgeon still needs to keep up her professional knowledge, and still needs to listen to the whole patient.

    Or, in areas like electronic patient records, the technology can reduce error and empower the individual. I read just this weekend about efforts to give individuals more control over their medical records, something that an occasionally paternalistic profession might have trouble with.

    The connection: in the same way that medicine is moving from something done to you to something you manage for yourself, so too professional learning is becoming the way that you take charge of your own growth, not an endless sequence of “contact hours,” CEUs, and content-consumption.

Comments are closed.