Challenging questions and ethical obligations: the ethics of everyday practice > 21 January 2015

James Wilson


What’s in your ethical toolkit? A forum theatre exploring solutions to everyday ethical situations

In the wake of the Mid Staffs (2013) report there were clearly identified markers which combined to create a ‘negative culture’. This included pressure (targets, finance), reaction (fear, low morale), behaviour (unwelcoming, keeping head down) and habituation (tolerance, external reassurance) at all levels within the organisation. As the report pointed out the grisly deficiencies of the professional groups (nursing in particular), it laid out a cautionary tale which inferred that the negative culture that existed in Mid Staffs could be replicated elsewhere. The stories that emerged provide a sobering platform from which to reflect and analyse where pivotal moments occurred and how the culture was allowed to continue. At the heart of it was the observed, recorded and judged conduct of the healthcare professionals who were unable to recognise or halt the warning signs which included:

  • Ignoring patient stories
  • Raised levels of mortality
  • Raised level & poorly handled complaints
  • Oppressed/absent whistle-blowers
  • Finance-led care
  • Staff reductions

A test for educators going forward is to provide tomorrow’s healthcare professional with the tools to gain an awareness when layers are being corrosively stripped from their humanity and deliver learning experiences that face up to this.

“All the world’s a stage and most of us are desperately unrehearsed.”

Prince (2005) reflected the feeling of inadequate practitioner ‘preparedness’ to meet the complex challenges of clinical practice.

Being prepared to practice in a just and ethically sound manner in order to defend against the creation of or navigate your way within a negative culture. These are real challenges faced by staff involved because after all when the name badge and uniform is removed what is left is a human being who often joined the care industry with good intentions.

To facilitate learning opportunities to show stories and encourage participation, an ‘interactive’ method known as forum theatre has been utilised which enables students to dialogue and explore different options for dealing with an issue. In a forum theatre, a play is performed where a central character is watched by the student audience usually committing numerous flaws during the course of their practice. The play often ends in an unsatisfactory or unresolved form. Through the use of a facilitator, dialogue is opened up with the students and they offer invitations to individuals to take to the stage and demonstrate alternative options about how the central character could have performed in the same situation. Forum theatre provides a safe space to enact and observe a range of ideas that can be rehearsed and shared, generating both fellowship and a sense of empowerment (Boal 1992).



(to be confirmed)


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