Friday, October 25, 2019

Compassion in Medicine~GVEC-~Jan 2020 Number Four


Global Veterinary Ethics Congress
Compassion in Medicine

Donald H DeForge, VMD
Fellow of the Academy of Veterinary Dentistry
Director: Silver Sands Veterinary
Director: Advanced Veterinary Dentistry
1-800-838-3368
DonDeForge100@gmail.com
www.SilverSandsVeterinary.com
AnimalDentistrySolutions.blogspot.com
Jan 2020 #4


The Global Veterinary Ethics Congress [GVEC]
The Human-Animal Bond
The Preservation of the Five Freedoms
Addressing connections between Ethics and the Human-Animal Bond:
Collaborative-Synergistic-Enlightening



Compassion in Medicine   
One Medicine

The Global Veterinary Ethics Congress will be studying Compassion in Veterinary Medicine in the months ahead.  Look at the video below concerning our human brothers and sisters in medicine. Jennifer Dobner in the essay to follow describes where we have been and where we should begin again in a quest for compassion in medicine.  It will only take a few moments to view the video and read the essay.  It is a gift well worth experiencing.

Donald H DeForge, VMD
Acting Chair-The Global Veterinary Ethics Congress



"At the beginning of medicine, when our knowledge was frankly limited or absent, what is it that we were able to provide?" asks Dr. James Doty, a neurosurgeon, who has practiced medicine for more than 30 years. "It was not cure. It was not intervention. The only thing we could provide was care and comfort."
Compassion isn't entirely gone from health care -- those working in the profession are still driven by a desire to ease suffering -- but in practice, it's a tenet that seems to have been lost or pushed aside over time, says Doty, the director and founder of the Center for Compassion and Altruism Research and Education (CCARE) at Stanford University.
"We've become enamored with the technology and the power of science," he says. "Certainly, they've had a huge impact on health and health outcomes. But we also have seen the result of negating that and what we have learned is that there is immense power to demonstrating compassion and caring to individuals who are ill."
Working to put compassion back at the center of health care systems will be the focus of Compassion Week, a joint initiative of CCARE, the Charter for Compassion, and the Tenyin Gyatso Institute, which seeks to instill compassion into the arenas of business and public service.
Dignity Health is a lead sponsor of the week's events that include the 2nd Science of Compassion Conference, the 3rd Empathy and Compassion in Society Conference, the Charter for Compassion Day, a "Living Compassionately" Retreat, a youth gathering, and the inaugural Compassion and Healthcare Conference.
Research has produced ample empirical evidence for proving what should seem obvious: Feeling soothed or cared for through the experience of meaningful social or human connections produces a physiological state in the body that is optimum for healing, Doty says.
The immune system gets a boost. Cortisol levels drop. Blood pressure goes down. Stress and anxiety begin to melt away and a person's mental state improves.
"I always tell people that while science and technology have probably saved millions of lives, the fact of the matter is that kindness and compassion have probably saved more," says Doty.
But it can be hard to hang onto compassion in an industry that has become increasingly complicated and expensive, relies on payment models that reward procedures over wellness care, and moves cautiously around legal and regulatory concerns, Doty and Dignity Health's Heather Walker say.
A pediatric nurse who now runs the Learning Institute Simulation Center at Dignity Health's St. Joseph's Hospital and Medical Center in Phoenix, Walker says she's watched nursing become heavy with requirements for documentation and creates mounds of paperwork.
"What I see lately is that health care is just so task-oriented," says Walker, who chose a career in nursing because she wanted to make a healing connection with others. "Many of those tasks are important, but we are just so focused on the tasks that we sometimes forget the patient because we are busy checking off all the boxes."
Part of Walker's job is to teach compassion skills to health care workers across the spectrum, from nurses and respiratory technicians to medical students and others. To do that, Walker uses a team of hired actors and volunteers to serve as "patients" in simulated situations -- known as the standard patient program -- to measure a health care provider's performance.
What she's watching for: How is the health care worker interacting with the patient? Are they looking the patient in the eye? Are they really listening? Is the patient understanding the information about medications?
"Everybody calls them soft skills, but I think they are hard, harder than just learning the technical stuff," says Walker, who plans to show a video from a simulation during a conference panel discussion.
The simulations include providing students with immediate feedback from their "patients."
Many get heaps of praise, but some are also surprised at how poorly they score on the compassion scale, even when the perceived infractions might seem small in the overall scheme of things.
"Like moving the bedside table closer. It's not a huge thing, but when a patient can't get to it and you leave the room, they're saying, 'wow, that's really rude''," she says. "We have to practice these things every day. I tell my students, what if this was your mother in your bed? Your child? What would you want for them?"
From Walker's perspective restoring compassion -- a touch, a listening ear or an acknowledgment of a patient's frustration or sorrow -- is an important way in which hospitals and other care facilities can differentiate themselves from each other.
Today, patients can readily find satisfaction surveys on the internet and made choices about where to seek treatment.
"As consumers, patients are really looking at whether they feel like they are being listened to," says Walker, who is slated as a presenter on a Wednesday conference panel. "So we really need to put the patient back into the center of health care and make sure we are taking care of the whole patient."
Doty believes the health care system is at an important crossroads that make this the right time for conversation and action around the idea of compassionate care.
"I think a lot of people understand the prices we have paid for ignoring this aspect of health care," he says. "There's an understanding that compassion is not only what defines our humanity but it defines us physicians and health care providers."
It's why, he says, the future of medicine resides in understanding the past and the beginnings of medicine.
Doty hopes conference -- goers will leave the event with a deeper understanding of the power compassion and caring can have on medicine and health care.
"It is fundamentally at its core," he says. "I want them to have a sense of excitement in regaining this part of medical practice and to give them some tools to use within their own environments that will not only support them in terms of resilience but also allow them to better re-engage with those they are caring for."
Salt Lake City-based Jennifer Dobner is an independent award-winning journalist and writer and a regular contributor to Reuters, The New York Times, WebMD, and NBC’s Today Show. Her resume includes stints at newspapers large and small across the western United States, and for seven years she was the lead reporter in the Salt Lake City bureau of The Associated Press. She has written extensively about the Mormon church, criminal justice, politics and health care. Before working in journalism, Dobner worked in sporting event management and media relations for sponsors of professional golf events and for a professional soccer team. Raised in the San Francisco Bay Area, she studied journalism at Fresno State University.








Friday, May 31, 2019

The Global Veterinary Ethics Congress~Principles and Plans of Action



Donald H DeForge, VMD
Chair-Global Veterinary Ethics Congress
"Addressing connections between Ethics and the Human-Animal Bond"
Collaborative-Synergistic-Enlightening

www.SilverSandsVeterinary.com
1-800-838-3368
E-Mail DonDeForge100@gmail.com




Image result for images of the animal kingdom

The Principles of the Global Veterinary Ethics Congress:
1] Integrity, honesty, and truthfulness for the betterment of the Animal Kingodm~~
2] Beneficence: Acts of charity, mercy, and kindness with a strong connotation of doing good with all interactions concerning the Human-Animal Bond~~
3] Respect, Justice, and Integrity within the Five Freedoms~~
4] Veterinarians shall continue to study, apply and advance scientific knowledge, make relevant information available to pet advocates, colleagues, and the public, obtain consultation, and use the talents of other health professionals when indicated as proposed in One Medicine~~
5] There will be on-going review of the techniques in the continued betterment of zoo species; acquatic species; farm animals; service and therapy dogs; and all other members of the Animal Kingdom.


The Epithet:
The epithet of the Global Veterinary Ethics Congress [GVEC] concerns the union of the Human-Animal Bond and Ethics.
It centers on total freedom for all Members of the Animal Kingdom to live a quality~~~ pain-free life!

It cannot be described more clearly than in the words of Dr. Leo Buscaglia. "Only when we give joyfully without thought of gain, can we truly know what love means!"  In three words, the epithet of the Global Veterinary Ethics Congress is UNCONDITIONAL LOVE and CONCERN for the quality of life for all members of the Animal Kingdom.  [See Five Freedoms below]

The Five Freedoms:
"All animals should have the freedom “to stand up, lie down, turn around, groom themselves and stretch their limbs!" This is just the beginning of "The Freedoms" for all members of the Animal Kingdom as a foundation of the Global Veterinary Ethics Congress. 

Fifty years ago, Ruth Harrison, a British woman wrote “Animal Machines” which described intensive livestock and poultry farming practices. The outcry of the British public regarding the information in the book prompted the British Government to appoint a committee to look into the welfare of farm animals.
In 1965, the committee, chaired by Professor Roger Brambell presented the 85 page “Report of the Technical Committee to Enquire into the Welfare of Animals Kept under Intensive Livestock Husbandry Systems” which became known as “The Brambell Report.”
The report stated that animals should have the freedom “to stand up, lie down, turn around, groom themselves and stretch their limbs.” These freedoms became known as “Brambell’s Five Freedoms.”
As a result of the report, the Farm Animal Welfare Advisory Committee was created to monitor the livestock production sector. In 1979, the name was changed to the Farm Animal Welfare Council and by the end of that same year; the Five Freedoms had been codified into the format below.
The welfare of an animal, which includes its physical and mental state, has been defined as the Five Freedoms:
  1. Freedom from Hunger and Thirst: by ready access to fresh water and a diet to maintain full health and vigor.
  2. Freedom from Discomfort: by providing an appropriate environment including shelter and a comfortable resting area.
  3. Freedom from Pain, Injury or Disease: by prevention or rapid diagnosis and treatment
  4. Freedom to Express Normal Behavior: by providing sufficient space, proper facilities and company of the animal’s own kind.
  5. Freedom from Fear and Distress: by ensuring conditions and treatment which avoid mental suffering.

The Five Freedoms are used as the basis for the actions for professional groups; including veterinarians and have been adopted by representative groups internationally including the World Organization for Animal Health and the Royal society for the Prevention of Cruelty to Animals. Most of the Animal Welfare audits developed for implementation on farms and in processing facilities are based on the Five Freedoms.[This article was published by Michigan State University Extension]

The Five Freedoms expand far beyond farm animals.  These same Freedoms apply to all members of the Animal Kingdom.  The Global Veterinary Ethics Congress will create partnerships with associations to enlighten and expand  compassionate care within the Animal Kingdom.

Dr. Leo Bustad The Human-Animal Bond and the Five Freedoms:

Dr. Bustad, Dean of the WSU College of Veterinary Medicine for a decade, was an outstanding educator, scientist and humanitarian, who is internationally recognized for his pioneering work in the field of human-animal interactions.  Among other things he founded the People-Pet Partnership, the first university-based community service program on the human-animal bond and was also co-founder and first Chair of the Delta Society (now Pet Partners).
Herein lies our commitment and responsibility to animal care.

We lost Dr. Bustad in 1998.  If here today, he would want each and every one of us to take a moment each day to enrich ourselves and the Animal Kingdom with a personal focus on the Human-Animal Bond.

Those of us who have been honored with a vocation in veterinary medicine [i.e. nurse;doctor; health care professional; or caretaken of the Animal Kingdom] have the greatest responsibility.

Global Veterinary Ethics Congress follows Buscaglia:
Dr. Buscaglia once said: "Don't spend your precious time asking: why isn't the world a better place?"....it will only be time wasted....The question to ask is: "how can I make it better?".....to that there is an answer!

Come join us as advocates and caretakers of the Animal Kingdom.

The proverb "a journey of a thousand miles begins with a single step" puts forward the notion that, however difficult a task is, you can only complete it if you first start it. [Lao Tzu]

  

Wednesday, May 8, 2019

Artificial Intelligence in Veterinary Medicine -GVEC Blog #2 08May2019


Global Veterinary Ethics Congress 
Blog #2
08May2019
Donald H DeForge, VMD
DonDeForge100@gmail.com
www.SilverSandsVeterinary.com
www.AnimalDentistrySolutions.com





Artificial Intelligence In
Veterinary Medicine
















Artificial intelligence (AI

AI in healthcare is the use of complex algorithms and softwares to estimate human cognition in the analysis of complicated medical data. Specifically, AI is the ability for computer algorithms to approximate conclusions without direct human input.

AI could free up time for Veterinarians

As the average veterinarian appointment time has dwindled AI may be the answer!  Do more machines bring more time for client contact or do they actually distance the veterinarian further from pet advocate contact?
Compassionate care is directly associated with pet advocate contact.  Maybe the machine is the answer to increasing time with each client; answering their questions; and having a more detailed differential diagnosis.
Machines could definitely improve the SOAP Problem Oriented Medical Record.
When veterinarians are queried about not providing a SOAP on each patient the answer immediately is given...."there is not enough time!"  Machines could also clean up clinical records and correlate lab data with clinical assessments allowing expedited reports about patient problems.   Some call this "making time grow"!
Veterinary specialists with AI can now walk away from repetition of procedures and spend more time giving the pet owner options of care based on AI diagnostic interpretations and differentials.   The machine should increase the doctor-patient interaction and not replace it!
Think of the time animal radiologists would save reviewing specific sites identified by AI.
AI could eliminate incomplete radiology reports or inaccurate radiology reports.
This could be extended to cardiology, pathology, and advanced imaging reports.
One reporter discusses AI as a way for specialist to "come out of the basement" and start talking to patients; review results; and share expertise with generalists.  In simple language~"enhancement of care".
Many are skeptical — that’s fair!  
To get there, there are also the privacy and data hurdles to contend with in medical records.  Although not as complex as in human medicine, it still will be an issue.

The majority of AI experts believe that this blend of human experience and digital augmentation will be the natural settling point for AI in healthcare.  Each type of intelligence will bring something to the table, and both will work together to improve the delivery of care.

The answer is there is no answer!  We will move forward but must take the journey in a way in which veterinary medicine will improve the care of the patient without stressing cost factors to the caring pet owners of the world.  It is a very exciting time!

Monday, April 29, 2019

Global Veterinary Ethics Congress [#1]--Ethics-Change-and the Human Animal Bond

The Global Veterinary Ethics Congress [GVEC]
The Human-Animal Bond
The Preservation of the Five Freedoms
Addressing connections between Ethics and the Human-Animal Bond:
Collaborative-Synergistic-Enlightening




Ethics, Change, Good News, and the 

Human-Animal Bond



Bernie Siegel, MD states the following: "Remember the saying ---no news is good news! So why then do we spend so much of our life time reading about or listening to the news? Stop listening to the news before you go to bed, after you wake up, and during the day. Watch how much healthier you feel and the free time that you have." 

Dr. Siegel is correct........ the morning and evening news is inundated with BAD news. Murder, rape, auto accidents, suicide, children killing children, terrorism, war casualties, and babies being tortured are common daily NEWS stories. 

What is the ethical connection between selling bad news; devaluation of the truth; and profit?  There is a major connection!    

We now live in a cyber world where traditional media competes with cable and Internet news.  One can actually listen to the BAD news 24/7 without making any effort.

Why do the young have little fear and only live "today" without considering the consequences of their actions?  

Maybe the answer lies in what Dr. Siegel is saying. They don't focus on the BAD news.  Most of the time they focus on NO news.  Their smart phones are focused on video games and friends activities on social media.

But the rub begins at a later age when youth messaging on social media becomes BAD news.

Bullyism is commonly initiated in social media. The scenario of BAD news leading to pain or even suicide in youth can be traced to hurtful accusations on the Internet.

Siegel states: "The answer is inside you.  The answer's to life's questions lie inside of you. All you need to do is look, listen, and trust."  

Dr. Leo Buscaglia, my mentor and friend, in the 80's stated, "Don't waste your precious time asking why isn't the world a better place....that is time wasted.....the question to ask is....how can I make it better?  To that there is an answer!"

So maybe Siegel is not completely correct.  Maybe we have to filter out the negative....whether it is the BAD in the evening news on your television....and all the negative stories in magazines and newspapers.....or the Internet.

We have to find a way to find the GOOD NEWS. Yes...... there is wonderful GOOD NEWS occurring each and every day of our lives.  Something good can come from every experience of each day.  

The GOOD NEWS can be as simple as making someone else's day happy.  Do not live in tomorrow but live in today.  Do not copy the negativity of others but promote positive thoughts than lead to positive actions. 

You have the freedom to grow in happiness by rejecting the evil that resides in negative and hurtful people.  Buscaglia has captured the magnitude of simplicity when he asks you to consider making the world better by thought, word, and action.


Man's interaction with animal....the Human-Animal Bond....is an example of finding the Good News.  The animal companion provides unconditional love and only asks for sustenance and a small return of this love.  

A pat to the head.....a kind word.....a special treat.....these are the meager returns of love that the companion seeks. That is the lesson of life that goes unnoticed in a fast paced world centered on self, ego, and wealth accumulation. 

YES-it is so simple it goes unnoticed each and every day. The lessons taught through the Human-Animal Bond are much greater than those gained by any television news cast or Internet review of today's top stories.....i.e. politicians berating their competition; one race hating other races; gang killings over drug turf; or road rage death..........These painful acts have no place in the world of man's companionship with animal.  

The Human-Animal Bond is the epitome of peace!
  
From newborn to the geriatric years man and animal are bonded in love. 

Siegel is correct......... the BAD news of reporting contains anger, hurt, and pain.  Unfortunately, we cannot just remove the negativity by turning off a television, computer, or smart phone.  

We are part of the world that is reflected in "stories that sell"! We can separate ourselves each day by seeking out the elements of the Human-Animal Bond and actuating them in our daily lives with the smallest act of caring.  




You will find refreshing moments become refreshing hours.  People seek out "Happy Hours" each day to escape from their lives.  

Natural intoxication can be found when we realize the secret of happiness lies right in front of our eyes and is only one step; one smile; one positive comment; or one caring action away.

You can become the teacher and the mentor of happiness!

First, you must learn to live in the moment.....just as the child who has not been corrupted by life's negativity.  You must reverse your life to a time when happiness was an ice cream cone shared with a friend or a walk in the park seeking the wonders of all of nature.


Is this impossible? Dedicate yourself to change.....make use of your talents not for profit or gain but to make this world.....your part of the universe....a better and happier place to live.

Once you do that you can then turn on the evening news....see Internet encapsulations of world problems and not become anxiety challenged.  

The "tuning in" to the positive will allow you to reject the negative and make you a stronger person.  You can change yourself and the lives of others. Begin the journey today!  Reflect on this message and believe!

VETERINARY HOSPICE

 Global Veterinary Ethics Congress GlobalVeterinaryEthicsCongress.blogspot.com Donald H DeForge, VMD Veterinary Hospice End of Life Care for...