The golden rule: A cornerstone in the ethical care of patients - DVM
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The golden rule: A cornerstone in the ethical care of patients


We must strive to continually maintain a level of contemporary professional competence that would allow us to provide the quality of medical care that we would desire if we were the patients in similar circumstances. To paraphrase the words of Dr. Donald G. Low, this will help us to practice 30 to 40 years of veterinary medicine in our professional lifetimes, rather than repeat one year 30 to 40 times. In context of the golden rule, we should ask ourselves, "If a member of my family or I was faced with a life-threatening illness, would I have confidence in a physician with study habits comparable to mine?"

  • Corollary 2

There is a difference between knowledge and wisdom. Knowledge consists of our familiarity with facts. In contrast, wisdom consists of acquiring a combination of knowledge and understanding that enables us to successfully apply the facts. If we have knowledge but have not learned to properly apply it, we lack wisdom. In context of the practice of veterinary medicine, being wise implies continued effort to acquire sufficient depth of knowledge and breadth of understanding to provide us with the wisdom that will benefit our patients. By expending time, effort, and resources to learn and earn a living, we are applying the golden rule.

  • Corollary 3

To put knowledge and wisdom into practice emphasizes the importance of practicality. But our commitment to practicality should not be misdirected. Practicality may be a virtue provided we do not hide behind it as an excuse for ignorance.

  • Corollary 4

There is a difference between unanswered questions and unquestioned answers. Even if hundreds of experts unknowingly make incorrect statements, they are still incorrect statements. Repetition does not transform errors into facts.

  • Corollary 5

The axiom "it is never too late to learn" is conceptually true. In practice, however, some things can be learned too late to be of optimum value. For example, if we learn about fatal adverse consequences associated with various diagnostic and therapeutic techniques after they occur in our patients, we have learned vital information too late to benefit those patients. This is sometimes called learning in the school of hard knocks (i.e. by experiencing difficulties first hand). Although experience is an effective teacher, she is often a tough one for the ignorant. Why? She gives the test first, and the lesson afterwards. Therefore, to minimize learning by the method of experiencing unwanted consequences of our mistakes, we must seek opportunities to learn in a timely fashion. Keeping in mind that "almost right" is still wrong, we must also be discriminating about what we learn, and how and where we learn it. Why? Because it takes just as much effort to learn useless facts as it does to learn useful ones. Those who become wise are most likely to learn lessons from the mistakes of others (i.e. they are teachable); those who choose to be ignorant often learn too late from their own. Whereas pride is often increased by ignorance and makes us prone to mistakes, humility will keep us from becoming overconfident and will help us to benefit from the experiences and counsel of others.

Rule II

Formulate diagnostic plans as if we were the patients:

Consider the following corollaries of Rule No. 2.

  • Corollary 1

A well-defined problem is half solved. However, in defining patients' problems, we must use care not to consider the significance of observations as synonymous with the significance of interpretations. Why? Because, observations and interpretations represent distinctly separate facets of diagnosis. Although either observations or interpretations may be erroneous, in our experience misinterpretation of a correct observation is the most common pattern of error. If misinterpreted observations are accepted as facts, the result may be misdiagnosis leading to ineffective or even contraindicated therapy. This is indeed ironical since the patient may then be in a worse condition as a result of having visited us in our roles as doctors.

  • Corollary 2


Source: DVM360 MAGAZINE,
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