ChatGPT, ethics, quality and responsibility
Our personal ethics are sometimes challenged by the tools at our disposal and our desire for efficiency. In our professional lives, we follow practices, methods and procedures that help us to be more efficient and effective. Take the case of ChatGPT, who seems to have all the answers. Let's ask it to talk to us about ethics through 3 concrete cases in a nursing home...
Article taken from the first issue of the Ethics, with you and for you magazine.
“Hi ChatGPT, can you write 3000 characters in 3 paragraphs arguing the importance of ethics in the treatment of serious adverse events in nursing homes. This article should illustrate 3 practical cases, in the case of a resident falling, in the case of a hospitalization and in the case of a suicide.”
This is what the AI replies to me, in less than half a second...
- Ethics plays a crucial role in handling serious adverse events in nursing homes. It is the moral foundation on which the quality of the care provided to residents rests. These facilities are responsible for the well-being and safety of older citizens, and each delicate situation requires an ethical approach to ensure respectful and accountable care. We will explore the importance of ethics in situations involving residents who suffer falls and are hospitalised in nursing homes through two illustrative case studies
- When a resident falls in a nursing home, ethics demand that we provide a comprehensive and respectful response. Implementing rigorous preventive measures, such as adjusting the living environment and careful monitoring, is imperative to minimise the risk of falls. In the event of a fall, ethics guide transparent communication with the resident's family and the resident. Professionals must guarantee appropriate post-fall care while preserving the resident's dignity. This includes a careful review of the care plan, adjustments to daily assistance and open communication about potential changes in the resident's health or mobility.
- Ethics play a fundamental role when hospitalisation becomes necessary. Transparent communication with the family and the resident is imperative. It will allow all parties to understand the need for hospitalisation and its implications. Ethics guide effective coordination between the medical staff and the nursing home during the hospital stay to ensure continuity of care and a smooth return. Any decisions made must take account of the resident's wishes and overall state of health. Ethics also require careful monitoring after a patient returns to the nursing home and appropriate adjustments in the care plan to promote recovery and well-being
- Ethical handling of serious adverse events in nursing homes is essential to ensure residents' safety, dignity and well-being. Observing practical cases of falls and hospitalisations shows that ethics goes beyond protocols and regulations; it involves in-depth reflection on moral responsibility towards the elderly. Nursing home professionals are responsible for creating an environment where old age is lived with dignity, respect and compassion, even in the face of the most difficult challenges.
Should efficiency guide our daily lives?
The four preceding paragraphs, which I fully endorse, explain the links between ethics and the processes for managing undesirable events in nursing homes. They were not written directly by a quality expert, nor by the French National Authority for Health, nor by me, but by ChatGPT, in less than half a second... Of course, this text can be improved: the level of reflection required in a magazine like Ethics with you and for you is a different requirement altogether. Yet, this type of robot will undoubtedly revolutionise our daily lives by freeing us from time-consuming drafting and summarising tasks that seldom have added value. Producing these documents would be a waste of time when a tool does it more quickly, rigorously, and with fewer errors. This should not absolve us from the need to be cautious, as there is a risk of losing the capacity for human vigilance or even competence.
Quality tools are the foundation of our efficiency
Quality tools serve the same purpose as digital devices, enabling us to call on expertise. Protocols and their assessments must help us control our practices, detecting and correcting variations attributable to systemic or human error and, therefore, avoidable. Implementing these processes is essential as we are responsible for following the expected good practices that allow us to guarantee operational control. These approaches are no longer debatable; they are validated and established in all the regulations of the countries where we operate.
However, it can be challenging to apply these procedures to the personalised care and support provided by emeis teams. Unlike the production of manufactured objects, which are defined by specifications and are strictly measurable, our activity involves more than mere compliance. While disregarding quality tools would be a mistake, using only quality tools would be just as bad. Thinking that our know-how and empathy are the only things that ensure we provide the best possible support to our residents, patients, beneficiaries, and their families can only lead to approximations, mistakes and a lack of professionalism. Quality tools become the foundation of efficient work when used with good judgment.
Using quality tools, emphasizing ethics and human values to ensure that our assistance keeps its promises
The use of ChatGPT is not morally reprehensible: it meets a requirement for efficiency and clarity based on impressive expertise, as it mobilises colossal documentation. I fulfil my mission when I use this artificial intelligence to make the right (or even the best) arguments. It also allows us to make more time for relationships and give our professional practice more meaningful. Conversely, one might consider that, in some way, my approach to my responsibilities in good conscience departs from the implicit commitment expected of me in terms of authenticity or even human truth. Indeed, I'm leaning on a third party not as part of a collegial deliberation but in an abstractly technological way.
The use of quality tools should free us from the constraints of providing care per regulations and standards. Quality management, through procedure monitoring and proof of achievement through evaluations, protects us from strictly prescriptive injunctions. It means we are freer to be present in a role that demands our human availability. We need to develop professional practices that consider quality management and involve everyone —including professionals who are far removed from the field—so that the lives of residents, patients, beneficiaries, and their families are addressed as a shared priority when we perform our duties. Ethical approaches encourage us to reflect on our values, principles and actions concerning the dignity, autonomy and vulnerability of the person seeking our care. The same attention applies to processes for managing adverse events so that residents experience ‘old age [...] with dignity, respect and compassion, even in the face of the most difficult challenges’, according to ChatGPT's analysis.
However, we must move beyond this reflection and embody this humane approach and our promise to support the most vulnerable on the field. ChatGPT finds its limits where our human and professional responsibilities must be met responsibly.
