Research moves us on

This post picks up some of the recent research and papers I’ve been glad to take part in.

These include multi-centre work to study Covid, developing a published research protocol and an early report on the features of long Covid. This involved thinking about how best to measure the (then) uncertain impacts of Covid – before then getting on and doing just that.

Beyond Covid there have been research papers, invited blogs and an invited commentary for the Journal of Medical Ethics. Broadly speaking, they consider how we might make healthcare better, by thinking about areas we might sometimes take for granted.

First, there’s a call for a more imaginative and inclusive approach to disability; one that considers capability and also the often unsaid political issues that constrain disabled people. These ethical issues relate strongly to the clinical work within rehabilitation medicine.

Second, there are two papers that think about how we verify the safety of our healthcare – whether the surgeons who operate on us or the institutions that store and use our personal health data. I make the case that routine videoing of surgery (with patient consent) is now an ethical obligation for surgeons and their institutions. In a further paper, I set out why such verifications don’t undermine or eliminate the need for trust. Rather verifications can build our trust and confidence in our surgeons and our institutions.

Third, there’s an invited commentary on how medical training might be reformed to address the crop of organisational failures that seem to recur. The ideas have been well received as “inspired thinking” in this published response.

Finally, there’s a paper on kindness and how it may have surprising side effects in healthcare. Our choice of whom we’re kind to can foster unfairness and even damage – leaving some left out and putting some in harm’s way. This paper calls for better inclusion, both of the vulnerable but also of the powerful. The latter need to be studied better to see how they get kindness to work for them and theirs. This final point is relevant also to the work on verification and trust. Our choices of who to trust can have wide impact in healthcare – from who we ask to do our surgery – to who gets (over)policed by regulators like the General Medical Council.

Overall, this work recalls the saying that aspects of medicine are a way of thinking, not simply doing. When health problems recur, whether particular illnesses or organisational failures, progress can need some new moves.

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