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• W2306970281 abstract "IN her editorial on the teaching and development of moral reasoning skills (VR, August 1, 2015, pp 122-123), Liz Mossop states: ‘We must be careful that veterinary ethics teaching is not just the delivery of theory. Ethical theory should perhaps be viewed as a toolkit to enhance reasoning skills, just as many theories taught at veterinary school are a scaffold on which to develop knowledge and skills. The use of an ethical matrix to map stakeholders and their interests in the patient to the major ethical theories is important, and this case-based approach should encourage students to move from “preconventional” reasoning to a higher level of “postconventional” reasoning where critical thinking and moral principles are key (May 2013). Students must be encouraged to develop a more formal process of considering the ethical aspects of a case, rather than just following their gut instinct or using senior clinicians as role models, who may or may not demonstrate effective moral reasoning (May 2013).’ There is evidence that using ‘gut instinct’ is useful in clinical decision making (van den Bruel and others 2012, Iqbal and others 2015). There is one major proviso. Clinicians, as they say to themselves, ‘I am going to use my gut instinct to help me on this’ must also ask themselves ‘are there any emotional inputs I possess that are now influencing my “gut instinct” opinion?’. If the answer is ‘Yes’ then they have to ask ‘Can I remove them?’. If the emotional aspect is absent or can be removed then I suggest ‘using gut instinct’ can be an excellent tool. All one may be doing is allowing one's subconscious brain to assist in decision making (ironically, in a conscious way). Ethical decisions in a clinical setting can be demanding, so one would be well advised to use as much of the brain as possible. Therefore, I think we should be careful in downplaying the value of gut instinct. In my view one role of veterinary education is to give the students a ‘library’ of data and thought patterns placed in their brain – and the first part of the paragraph quoted above suggests that. This library can then be accessed from the Type 1 domain, very much in the way that the article by Professor May (2013) suggests and possibly by other pathways. I was in practice for over 20 years and I still respected and listened to my own gut instinct (as well as using formal clinical reasoning), and I had great respect for the gut instinct of those who had been in practice for many years. For example, with regard to farm work in Scotland, it was not at all uncommon to make a decision based on gut instinct using mainly the Type 1 domain, then much later over a cup of tea, discuss with the other practitioners how, if one had had the time and had used the Type 2 domain, one would have used focused step-by-step deliberation and formal reasoning processes to reach a conclusion. Interestingly, this second conclusion was in the vast majority of instances the same conclusion as the ‘gut instinct’. This was ordinary practitioners performing on a regular basis an informal assessment of thinking processes and detecting the value of using ‘gut instinct’. Ethics of course was an important component of the process." @default.
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• W2306970281 date "2015-09-01" @default.
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• W2306970281 title "Gut instinct and clinical decision making" @default.
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• W2306970281 doi "https://doi.org/10.1136/vr.h4703" @default.
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