Bioethics Blogs

Contemplation in Action: Reflective Habits in Clinical Care

By Karen Spear-Ellinwood

I began professional life as a lawyer, representing people accused of violent crimes, most having failed to graduate high school, if they made it there at all. I realized that while a lack of education accounted for a great deal of crime, the more dangerous affliction was a failure to reflect before acting.

After 13 years, I became an educator. I started in middle school. I constructed debates on history, legal and social issues, on weighing the potential harm of perceived ills and their perceived remedies. The sorts of subjects that forced reflection and self-awareness.

I told my eighth graders that lawyers never make decisions without reflecting on what’s likely to happen and what might happen. Lawyers had to know the law and they had to figure out how to apply it, sometimes while encountering unanticipated circumstances. I assigned these eighth graders to argue the side of the debate with which they vehemently disagreed. They had to stretch their perspective, I told them. See this issue from someone else’s perspective to reconsider their own position. They might not change their mind but they would understand the issue and themselves better…

Doctors and lawyers need to reflect in making decisions based upon the evidence. Rarely does anyone hand us all the evidence we need. We must look for it – an investigatory process that demands attention to detail and objective, self-awareness of knowledge, skill and bias, and reflection in planning and doing.

Many schools recognize the value of reflection in clinical practice and incorporate opportunities for it in undergraduate medical education programs.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.