Confronting Subconscious Bias: Ethics in the Pediatric Emergency Department

Physicians are only human. Upon graduating from medical school, physicians take an oath declaring veracity and fidelity toward our patients. We are told to lay aside negative feelings toward patients in exchange for integrity, truth, honor, and compassion. The idea is simple, but following through on it is quite a challenge. Pediatric emergency medicine physicians generally have rapid focused patient interactions, yet even in these brief encounters, instantaneous and subconscious reactions to difficult patients occur. Difficult patients are those who raise negative feelings within the clinician such as anxiety, frustration, guilt, and dislike. Recognition of these reactions and emotions will help physicians understand more about themselves, and assist in interacting more favorably with challenging patients. It is common for doctors to attempt to suppress their human reactions to maintain clinical objectivity, yet these reactions facilitate a better doctor-patient relationship. Allowing ourselves to yield to our emotions help the patient realize that the physician is a human being.