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Facelift Acupuncture: fact or fallacy/ethics and judgement

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Chris,

 

I'll raise your two cents.

 

I don't choose what I will do or not do for patients once I have committed to

their service, my initial qualms were around the cosmetic service itself, and

its overall value to the patient considering the expense and time generally

involved. My initial take on the work was that it was superficial but useful as

an entre to things that would be useful in the long term. As I have explored it

as an ethical issue, and in practice, I find it useful on more levels than I had

initially thought. The initial statement that you seem to find objectionable

frames my internal debate, not some judgment that I lay on patients who seek out

services for cosmetic issues. And while I will fully admit to being prejudiced

against many of the cosmetic and aesthetic tendencies of our society I believe I

have found a way to render services that are pertinent and useful.

 

You are a practitioner: would you accommodate a healthy thin woman who wants to

loose weight and will pay any price? Perform potentially useful, if painful and

repeated needle treatments to breast tissue to augment breast size (knowing that

the alternative is a fairly crude maiming implant procedure)? Would you stop if

the patient was crying and screaming but begged you to keep going? There are

choices to be made in the administration of treatments, and just because a

patient wants something and we can do something doesn't always mean that we

should or that it is a good idea. Your judgment as a practitioner of medicine is

part of that person's process. We don't just vend treatments at a quarter per

needle, we make decisions about the work that we feel called to and ultimately

make decisions about what we can and can't offer to patients, and if we don't

maintain an integrity around that we come to a slippery slope of following the

patients whimsy.

 

It is an interesting conflict, between what one knows to be true from a medical

perspective and the desires of a patient. One aspect of Western medicine that

has always annoyed me is its hubris and paternalism. But as I spend more time

treating patients I find more and more that they want advice, and they want

something concrete and if I don't stick out the course of that treatment then I

am useless to them, so I have to believe I am right. In your model it would seem

that patients have to be the captain of their ship, at all time and in all ways.

I know this might not be a popular idea, but there are patients who don't have

the guts to dog it out sometimes, and part of the role of practitioners is to

follow what they know is right. To keep informing the patient, but to not bend

when they twist, as their xie qi will often see ways of maintaining its hold

through manipulation of emotion. In this society, part of the role of medicine

is taking responsibility for the ill, giving them hope, propping them up. At

certain points you are obliged to provide them with your opinion, and if you

don't have one you are letting them down. I'm not judging the patient, but I am

making a medical judgment, and I assume that when I enter into a convent with a

person, my end of which is getting them better, I'm obliged to see that through.

If they choose to back out at some point that's there own thing, again, no

judgment about the person, that's where they are.

 

As a rule I find there is a lot of feel-goodery in our field. I don't think it

is wrong or bad, but as has been mentioned recently in this forum or CHA there

is really only a certain amount of hand stroking that is clinically useful. We

are not psychotherapists, spiritual counselors, shamen, priests (unless you are

one of those things, in which case you are what you are and that's fine too) we

are acupuncturists and herbalists, and as such we have a medicine that works

more or less well for a lot of problems, some somatic, some spiritual. We have

to make judgments about what is right and wrong for our patients when we

initiate treatment, and if we fold when a patients pattern decides to take a

swipe at us we might as well pack our tents and move on.

 

My only interest when I'm working with someone is their care. I chose my life

and the type of work I do in order to feel fulfilled and happy, but if I can't

offer what a patient wants, or the medicine I know is ineffective, or I think

they are hurting themselves or wasting time and their money I'm obligated to do

what I think is right, and sometimes the best service is no service at all.

 

Please keep in mind these are my ethical standards, which I do not regard as

universal, but they work for me. Ultimately it is a personal issue for each of

us as practitioners to have a way of dealing with our patients that allows them

to get the most out of what we are doing, and us to be satisfied with our work

at the end of the day. If either end of that balance isn't held up then we

either burn out or we burn our patients and I would rather that neither of those

things happen in my case. I always support the choices of the patients who come

to see me, but the choice that they made and I will always support is that they

are seeking my discernment and skill, because when it comes down to it, that is

all I have to offer. It obliges me to look as deeply as I can and do what I

think is right, and that, by definition, is judgment. I'm not sorry if that

offends you, you have every right to be offended by whatever you feel like and I

don't judge you for that.

 

Take care,

 

Par Scott

 

-

Musiclear

Chinese Medicine

Friday, June 15, 2007 1:09 PM

Re: Facelift Acupuncture: fact or fallacy?

 

 

 

In a message dated 6/15/2007 12:54:59 PM Eastern Daylight Time,

parufus writes:

 

I agree. I actually spent a lot of time thinking about ethics when I started

doing the facial work. There are some cynical ways of looking at it: people

will happily pay money and invest time and energy in looking different, while

they will not take care of their health with nearly the same fervor.

However, once you get people in for superficial things you can take care of

deeper

stuff at the same time, in fact, if you want to do a good job with the

cosmetic you have to clear up internal issues. To that end I thought it more

or

less reasonable and ethical to offer the services.

 

The opening statement in this last post is amazing to me. The question that

comes to my mind is who are any of us to have any judgment at all about the

personal choices of another?

 

Who are we to determine what any individual needs for their own life?

 

Who are any of us to determine what is superficial and what is not for

another?

 

Who are we to think we can know what is or is not on the path of a

persons awakening?

 

I think it would be wise to spend less time worrying about another

persons choice for their life and more time how to support them in their

choices.

 

My 2 cents,

 

Chris

 

 

 

************************************** See what's free at http://www.aol.com.

 

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Wow, that is a long reply. Thanks for all the thought that went into it.

 

My replay may come across simple in some areas. I am not intending to

belittle in any way. It is early and I was traveling for a couple days, so I

hope this comes out coherent. We will see.

 

I have come to find that many people tend to think they know what is

best for others or the direction others should choose for their life. Then

based on that knowing or belief, become personally involved in the others

decision, if that decision doesn't correspond to what they think the other

should

do. I know this from my own intimate experience of previously " knowing " what

others should do for their own progress in their life.

 

I now consider the belief stated above as pure folly. My current

understanding is that no matter how absurd a persons decisions seems to be to

us...... we have no real authority to judge the appropriateness of their

decision.

 

This idea may come across a ridiculous to many and I am sure that many

here could come up with examples of how a decision that another made caused

them untold harm and how if they had chosen differently, things would have

worked out differently. I am absolutely sure that based on the values and

goals

of the observer, that would be true.

 

My point here is that the observer has no real grip on the true course

and meaning of another's life, and based on that idea, has no real

understanding of what is an appropriate choice for another.

 

(Please don't come back with stories of Hitler and murder or anything

else like that. This commentary is directed specifically at what are

apparently more mundane choices in life like, face lifts and who to date ect.)

 

Another idea is, even if we did have divine perception and truly could

understand what would be " best " for another, why allow ourselves to falter in

our own peace by the decisions of another? (I am not suggesting that Par

lost his peace over the face lift discussion. This is a rhetorical question.)

 

OK, there will be additional comments to follow in the body of Par's

post if you would care to read further.

 

All the best and many blessings,

 

Chris

 

 

In a message dated 6/15/2007 11:01:33 PM Eastern Daylight Time,

parufus writes:

 

 

 

 

Chris,

 

I'll raise your two cents.

 

I don't choose what I will do or not do for patients once I have committed

to their service, my initial qualms were around the cosmetic service itself,

and its overall value to the patient considering the expense and time

generally involved.

 

 

Were you considering not servicing new clients that were asking for face

lifts based on financial cost of the face lift program? Why have a quam

which is described by Webster as; " a feeling of uneasiness about a point

especially of conscience or propriety " . This would appear to me to be personal

involvement in the decision by another that cause some level of judgment and

" dis

ease " in yourself.

 

I am suggestion a possible option for the therapist is to make sure the

client is clear about the cost, time and likely outcome without losing ones own

peace and carry out the wishes of the patient gratefully.

 

 

 

My initial take on the work was that it was superficial but useful as an

entre to things that would be useful in the long term. As I have explored it as

an ethical issue, and in practice, I find it useful on more levels than I had

initially thought.

 

My question here is, " How can you know the out come of the patients

decision? " We do not know the course of anthers life nor where the decision

they

make today will bring them tomorrow.

The initial statement that you seem to find objectionable frames my internal

debate, not some judgment that I lay on patients who seek out services for

cosmetic issues. And while I will fully admit to being prejudiced against many

of the cosmetic and aesthetic tendencies of our society

 

This may come across simplistic, but has great relevance to me. Why allow

prejudice in your life? I can understand a desire for people to witness their

true beauty and peace, but prejudice has judgment in it's definition.

 

I believe I have found a way to render services that are pertinent and

useful.

 

 

 

 

 

At this point in my reply you may summize that in my view, your

understanding of " rendering services that are pertinent and useful " are based

on " your "

value system and what " you " think is important to the client.

Again..... are you really in a position to discern that?

 

 

 

You are a practitioner: would you accommodate a healthy thin woman who wants

to loose weight and will pay any price? Perform potentially useful, if

painful and repeated needle treatments to breast tissue to augment breast size

(knowing that the alternative is a fairly crude maiming implant procedure)?

Would you stop if the patient was crying and screaming but begged you to keep

going? There are choices to be made in the administration of treatments, and

just because a patient wants something and we can do something doesn't always

mean that we should or that it is a good idea.

 

 

Are you absolutely sure about that?????

 

What if after a life of self deprecating and then doing the painful

procedure described above, the client became awakened to the feeling that she

really

wants to take care of herself and her feelings about herself are more

important than the image that she had thought others wanted from her. What if

the

pain and suffering from the treatment created a new awareness that propelled

her into a magnificent life of self empowerment that may have taken years

longer if you talked her out of the treatment.

 

 

To take that thought further, what if that same women, after you talked her

out of her own choice decided she really didn't have the ability to think for

her self, went into an emotional spiral because she never gets what she

wants and decides to end her life.

 

 

Who are you to decide where a person is in their development and what they

need to progress?

 

 

 

 

 

Your judgment as a practitioner of medicine is part of that person's

process. We don't just vend treatments at a quarter per needle, we make

decisions

about the work that we feel called to and ultimately make decisions about what

we can and can't offer to patients, and if we don't maintain an integrity

around that we come to a slippery slope of following the patients whimsy.

 

 

 

 

See above comment.

 

 

 

 

 

 

It is an interesting conflict, between what one knows to be true from a

medical perspective and the desires of a patient. One aspect of Western

medicine

that has always annoyed me is its hubris and paternalism. But as I spend more

time treating patients I find more and more that they want advice,

 

I agree with this. If a person is asking for guidance, it is imperative

that we give it to them. If we have a belief that the client is potentially

going in a hurtful direction, I believe it is important to give them the

fullest

picture of our understanding about what they are deciding. After we have

done that without personal bias, I believe we cannot judge them for their

decision nor deny treatment based on their decision and maintain our own

integrity.

 

 

and they want something concrete and if I don't stick out the course of that

treatment then I am useless to them, so I have to believe I am right.

 

 

 

Now that is a slippery slope if I ever saw one. Watch out for believing

that your right. It tends to get people in more trouble than they know.

 

 

 

 

In your model it would seem that patients have to be the captain of their

ship, at all time and in all ways.

 

Based on my last comment, I hope you see that we are responsible for a

relationship with the patient not telling them what they whould do.

 

 

I know this might not be a popular idea, but there are patients who don't

have the guts to dog it out sometimes, and part of the role of practitioners is

to follow what they know is right. To keep informing the patient, but to not

bend when they twist, as their xie qi will often see ways of maintaining its

hold through manipulation of emotion. In this society, part of the role of

medicine is taking responsibility for the ill, giving them hope, propping them

up.

 

Holy smokes!!!!

 

I could not be in more disagreement with that thought. Unless the

patient has openly given you parental permission over their life, we are never,

ever to take responsibility for another's thoughts or actions.

 

I believe your desire to do so comes from a strong desire to help others

and that is an admirable desire, but to take over another's decisions and

personal path because of your belief is IMHO totally wrong.

 

 

 

 

At certain points you are obliged to provide them with your opinion,

 

I agree.

 

 

 

and if you don't have one you are letting them down.

 

If you cannot be honest when you don't have an answer, then you are in

trouble. I would offer to do the best I can to find them an answer though.

 

 

I'm not judging the patient, but I am making a medical judgment,

 

 

 

That is a fine line I am not going into right now.

 

and I assume that when I enter into a convent with a person, my end of which

is getting them better, I'm obliged to see that through.

 

And you may realize by now that you may not really know why they are with

you and that getting better may be different from treating the actual physical

pathology presented to you.

 

 

If they choose to back out at some point that's there own thing, again, no

judgment about the person, that's where they are.

 

As a rule I find there is a lot of feel-goodery in our field. I don't think

it is wrong or bad, but as has been mentioned recently in this forum or CHA

there is really only a certain amount of hand stroking that is clinically

useful. We are not psychotherapists, spiritual counselors, shamen, priests

(unless you are one of those things, in which case you are what you are and

that's

fine too) we are acupuncturists and herbalists, and as such we have a

medicine that works more or less well for a lot of problems, some somatic, some

spiritual. We have to make judgments about what is right and wrong for our

patients when we initiate treatment, and if we fold when a patients pattern

decides

to take a swipe at us we might as well pack our tents and move on.

 

 

See previous comments.

 

 

My only interest when I'm working with someone is their care. I chose my

life and the type of work I do in order to feel fulfilled and happy,

but if I can't offer what a patient wants, or the medicine I know is

ineffective, or I think they are hurting themselves or wasting time and their

money

I'm obligated to do what I think is right, and sometimes the best service is

no service at all.

 

 

Take a look at this from another view. Have you ever seen a patient being

treated by a western medical doctor, suggested they look at a modification to

that treatment and heard, " Oh, no. My doctor would never agree to that. "

 

If not, I have....a lot. It has been a challenge to me in the past, to have

at my disposal a treatment that would truly help another move past some

physical problem only to be stopped by " the expert " medical physician because,

" They think they knew better. "

 

I believe in the Doctors mind, he does know better. They have been to

school. They know what they were trained to know. They know what is best

based on their experience. See any parallels here?

 

No matter how deeply we believe we know the best course of action, there

are always things we cannot know about any situation that may make our

" truth " impudent.

 

 

Ok So that about raps it up for me.

 

 

 

Hope you have a great day,

 

 

Chris

 

 

 

Please keep in mind these are my ethical standards, which I do not regard as

universal, but they work for me. Ultimately it is a personal issue for each

of us as practitioners to have a way of dealing with our patients that allows

them to get the most out of what we are doing, and us to be satisfied with

our work at the end of the day. If either end of that balance isn't held up

then we either burn out or we burn our patients and I would rather that neither

of those things happen in my case. I always support the choices of the

patients who come to see me, but the choice that they made and I will always

support is that they are seeking my discernment and skill, because when it

comes

down to it, that is all I have to offer. It obliges me to look as deeply as I

can and do what I think is right, and that, by definition, is judgment. I'm

not sorry if that offends you, you have every right to be offended by whatever

you feel like and I don't judge you for that.

 

Take care,

 

Par Scott

 

-

_Musiclear_ (Musiclear)

_Traditional_Traditional_<WBRTraditional_Tra_

(Chinese Medicine )

Friday, June 15, 2007 1:09 PM

Re: Facelift Acupuncture: fact or fallacy?

 

In a message dated 6/15/2007 12:54:59 PM Eastern Daylight Time,

_parufus_ (parufus) writes:

 

I agree. I actually spent a lot of time thinking about ethics when I started

doing the facial work. There are some cynical ways of looking at it: people

will happily pay money and invest time and energy in looking different,

while

they will not take care of their health with nearly the same fervor.

However, once you get people in for superficial things you can take care of

deeper

stuff at the same time, in fact, if you want to do a good job with the

cosmetic you have to clear up internal issues. To that end I thought it more

or

less reasonable and ethical to offer the services.

 

The opening statement in this last post is amazing to me. The question that

comes to my mind is who are any of us to have any judgment at all about the

personal choices of another?

 

Who are we to determine what any individual needs for their own life?

 

Who are any of us to determine what is superficial and what is not for

another?

 

Who are we to think we can know what is or is not on the path of a

persons awakening?

 

I think it would be wise to spend less time worrying about another

persons choice for their life and more time how to support them in their

choices.

 

My 2 cents,

 

Chris

 

 

 

 

 

 

************************************** See what's free at http://www.aol.com.

 

 

 

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I agree, we cannot in any meaningful way manage the lives of others, we can only

choose a role to play ourselves and have integrity in that role, and we will

draw or repel the people who respond to it. The critical part of that is to

maintain our own integrity. It often strikes me when I'm treating a long term

patient that they have decided, on some level, to be a person who's neck gets

stiff because of work. The majority of the people that I work with for pain

relief are with me for a short period and they go away feeling better, a few go

away unhappy, and some just end up being around for a long time. I have a couple

patients I have worked on for about a decade now, and they are remarkably

consistent in their presentation. I have repeatedly offered them choices around

self care, etc. which are mostly ignored. At this point I fit into their life in

some way, and they value that, and that is fine by me.

 

People are going to go where they want to, and I look at my role as facilitating

some of those movements. But to imply that I'm obligated to assist people in

doing things that I think are crap or not useful for them doesn't work for me.

I'm obligated to offer them my best judgment and skill because that is what they

are paying me for, and if that doesn't work for them I make it clear I can't

help them, and I will help them look for other resources, or try to reframe what

I do so they can use it. If someone isn't happy with what I do I'm not going to

put on a different hat to make them happy. Part of my job is to make judgments

about their life and how they can change it to be more comfortable and less

dis-eased.

 

It is obvious that we are not omniscient and consequentially we must work with

people based on our observations and the questions that we ask. We make a lot of

judgments for people based on their intakes. One common example of this is work

or married life. We often interview patients regarding their work and home life,

and when we detect substantial frustration around either of those issues we will

often treat them to release that stagnation, and frequently that precipitously

spills over into people quitting their jobs (at least 5 times for me) or getting

a divorce (3 that I know of) or breaking up with a partner of some sort (another

half dozen at least). We are manipulating these situations in many subtle and

not so subtle ways; by selecting and bringing up the issues during conversation

in treatment we focus intent, and then by moving the stagnation we release a

burst of energy in that direction. I'm reasonably sure that in some cases if the

treatment was addressed to somatic problems related to stagnation the patient

would probably feel better and go on in the same ecology, perhaps improving the

situation with their new mood and affect. More often than not these radical

changes are a positive experience and people move on, but after the first couple

of times this happened I realized later the source of frustration was not always

going to be what we talked about, people unconsciously transfer emotional loci

all the time. For example, a person with deep inner frustration about the course

of their life may lay the whole thing off on a spouse who is actually reasonably

supportive but not being communicated with. In that case a breakup does nothing

for them and chances are they will start the pattern over again with another

person. I'm obliged to ask myself: if I disrupt the ecology of their life is

that a useful thing? Then I usually have to ask them a lot of questions about

the situation and decide to go quick or slow, determine if they are going to be

crushed by a change, or if they are resilient enough to pass through it without

rebounding into some crummy headspace... I have no desire to take responsibility

for the outcome of other people's choices when they might not really understand

what they are getting into. The informed part of informed consent only goes so

far.

 

One of my concerns about TCM in general is the popular notion that we can really

do no harm. Medicine always changes situations, pushing things one way or the

other, and we are obliged to be vigilant about how we present our services and

make sure that what we are doing is appropriate to the situation, and that is

another judgment. My problem with your argument is that it sounds like you feel

bad about things that have happened in the past and because of that you've

decided to simply give up a portion of critical thought as it applies to your

work. We are obliged to judge peoples choices and behavior because that is the

service that we offer. We asses them across a broad spectrum and attempt to

change them to be more in line with what our medicine considers health. Perhaps

there is an ideal practitioner out there, who is an empty vessel and just brings

whatever is needed. I have enough to do successfully keeping my own sentiments

and issues out of a picture. That is what allows me to stay in a place where my

emotional needs don't get bound up with the case, and to not judge the person

personally, but only asses the facts that I know, and act accordingly. Pardon my

amateur psychologizing and please don't consider this an ad hominem attack, if

you are expressing pain or disappointment around something that happened I feel

for you, but I don't agree with where that has apparently brought you.

 

Take care,

 

Par

 

 

 

 

 

 

 

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Par Scott,

 

Beautifully put! Actually this was what I was coming at in the first place

:D ....Must work on my English - and my patience in writing posts :)

 

.....It all comes down to our integrity and as such to our choices..... it is

not being judgemental it is being compassionate not to buckle to clearly

excessice unhealthy desires and our own ego (Evil Qi) and commit to support

what is healthy and right (Upright Qi)!

 

Kindly,

 

Thomas Sorensen

 

 

 

2007/6/16, Par Scott <parufus:

>

> Chris,

>

> I'll raise your two cents.

>

> I don't choose what I will do or not do for patients once I have committed

> to their service, my initial qualms were around the cosmetic service itself,

> and its overall value to the patient considering the expense and time

> generally involved. My initial take on the work was that it was superficial

> but useful as an entre to things that would be useful in the long term. As I

> have explored it as an ethical issue, and in practice, I find it useful on

> more levels than I had initially thought. The initial statement that you

> seem to find objectionable frames my internal debate, not some judgment that

> I lay on patients who seek out services for cosmetic issues. And while I

> will fully admit to being prejudiced against many of the cosmetic and

> aesthetic tendencies of our society I believe I have found a way to render

> services that are pertinent and useful.

>

> You are a practitioner: would you accommodate a healthy thin woman who

> wants to loose weight and will pay any price? Perform potentially useful, if

> painful and repeated needle treatments to breast tissue to augment breast

> size (knowing that the alternative is a fairly crude maiming implant

> procedure)? Would you stop if the patient was crying and screaming but

> begged you to keep going? There are choices to be made in the administration

> of treatments, and just because a patient wants something and we can do

> something doesn't always mean that we should or that it is a good idea. Your

> judgment as a practitioner of medicine is part of that person's process. We

> don't just vend treatments at a quarter per needle, we make decisions about

> the work that we feel called to and ultimately make decisions about what we

> can and can't offer to patients, and if we don't maintain an integrity

> around that we come to a slippery slope of following the patients whimsy.

>

> It is an interesting conflict, between what one knows to be true from a

> medical perspective and the desires of a patient. One aspect of Western

> medicine that has always annoyed me is its hubris and paternalism. But as I

> spend more time treating patients I find more and more that they want

> advice, and they want something concrete and if I don't stick out the course

> of that treatment then I am useless to them, so I have to believe I am

> right. In your model it would seem that patients have to be the captain of

> their ship, at all time and in all ways. I know this might not be a popular

> idea, but there are patients who don't have the guts to dog it out

> sometimes, and part of the role of practitioners is to follow what they know

> is right. To keep informing the patient, but to not bend when they twist, as

> their xie qi will often see ways of maintaining its hold through

> manipulation of emotion. In this society, part of the role of medicine is

> taking responsibility for the ill, giving them hope, propping them up. At

> certain points you are obliged to provide them with your opinion, and if you

> don't have one you are letting them down. I'm not judging the patient, but I

> am making a medical judgment, and I assume that when I enter into a convent

> with a person, my end of which is getting them better, I'm obliged to see

> that through. If they choose to back out at some point that's there own

> thing, again, no judgment about the person, that's where they are.

>

> As a rule I find there is a lot of feel-goodery in our field. I don't

> think it is wrong or bad, but as has been mentioned recently in this forum

> or CHA there is really only a certain amount of hand stroking that is

> clinically useful. We are not psychotherapists, spiritual counselors,

> shamen, priests (unless you are one of those things, in which case you are

> what you are and that's fine too) we are acupuncturists and herbalists, and

> as such we have a medicine that works more or less well for a lot of

> problems, some somatic, some spiritual. We have to make judgments about what

> is right and wrong for our patients when we initiate treatment, and if we

> fold when a patients pattern decides to take a swipe at us we might as well

> pack our tents and move on.

>

> My only interest when I'm working with someone is their care. I chose my

> life and the type of work I do in order to feel fulfilled and happy, but if

> I can't offer what a patient wants, or the medicine I know is ineffective,

> or I think they are hurting themselves or wasting time and their money I'm

> obligated to do what I think is right, and sometimes the best service is no

> service at all.

>

> Please keep in mind these are my ethical standards, which I do not regard

> as universal, but they work for me. Ultimately it is a personal issue for

> each of us as practitioners to have a way of dealing with our patients that

> allows them to get the most out of what we are doing, and us to be satisfied

> with our work at the end of the day. If either end of that balance isn't

> held up then we either burn out or we burn our patients and I would rather

> that neither of those things happen in my case. I always support the choices

> of the patients who come to see me, but the choice that they made and I will

> always support is that they are seeking my discernment and skill, because

> when it comes down to it, that is all I have to offer. It obliges me to look

> as deeply as I can and do what I think is right, and that, by definition, is

> judgment. I'm not sorry if that offends you, you have every right to be

> offended by whatever you feel like and I don't judge you for that.

>

> Take care,

>

> Par Scott

>

> -

> Musiclear <Musiclear%40aol.com>

> To:

Chinese Medicine <Chinese Medicine%40yaho\

ogroups.com>

> Friday, June 15, 2007 1:09 PM

> Re: Facelift Acupuncture: fact or fallacy?

>

> In a message dated 6/15/2007 12:54:59 PM Eastern Daylight Time,

> parufus <parufus%40earthlink.net> writes:

>

> I agree. I actually spent a lot of time thinking about ethics when I

> started

> doing the facial work. There are some cynical ways of looking at it:

> people

> will happily pay money and invest time and energy in looking different,

> while

> they will not take care of their health with nearly the same fervor.

> However, once you get people in for superficial things you can take care

> of deeper

> stuff at the same time, in fact, if you want to do a good job with the

> cosmetic you have to clear up internal issues. To that end I thought it

> more or

> less reasonable and ethical to offer the services.

>

> The opening statement in this last post is amazing to me. The question

> that

> comes to my mind is who are any of us to have any judgment at all about

> the

> personal choices of another?

>

> Who are we to determine what any individual needs for their own life?

>

> Who are any of us to determine what is superficial and what is not for

> another?

>

> Who are we to think we can know what is or is not on the path of a

> persons awakening?

>

> I think it would be wise to spend less time worrying about another

> persons choice for their life and more time how to support them in their

> choices.

>

> My 2 cents,

>

> Chris

>

> ************************************** See what's free at

> http://www.aol.com.

>

>

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Hi Par,

 

Sorry it took so long to write back. Been busy.

Basically I was responding to your statement that seemed like you were

saying we get to take responsibility for our patients choices and if that

choice

is something we know won't help them, then we get to tell them " NO " .

I may have gotten carried away a bit in my attempt to use parts of your

other post to show you where it seemed like you were taking a personal choice

away from your patients.

I don't have pain surrounding this. I was trying to draw a parallel

between the western folks " Knowing they have THE answer " and the possibility of

your going down a similar road with the things I saw you write.

In the end, I believe you heart is in the right place as it is your desire

to help people the best you know how.

I was trying to encourage you to examine the idea of whether or not anyone

can know what is best for another. I have seen many a " bad " choice in a

person’s life ultimately end up being a principle choice that created a major

life shift in philosophy that was very positive.

By taking a choice away from a patient, you may be taking a learning

experience away from them also which would potentially change the direction of

their

life for the better.

I know this concept may be way out there for some and I am not saying we

should tailor our treatments to the whim of the patient. I do think it is

important to think long and hard before denying any treatment based on our

judgment of what the patient needs if it is different from what the patient

wants.

To sum up, I believe a persons right to choose, even badly, is extremely

important in the development of life. I think it is dangerous for the western

guys to demand certain treatment protocols and although as an industry, we are

a potent healing force, I am suggesting that if we put ourselves in the

position of " knowing " what is " best " for another, then we may end up being as

dangerous as any other profession that takes freedom of choice away.

Do with it what you may.

Just my 2 cents.

All the best,

Chris

 

 

 

 

 

In a message dated 6/17/2007 10:18:18 PM Eastern Daylight Time,

parufus writes:

 

 

 

 

I agree, we cannot in any meaningful way manage the lives of others, we can

only choose a role to play ourselves and have integrity in that role, and we

will draw or repel the people who respond to it. The critical part of that is

to maintain our own integrity. It often strikes me when I'm treating a long

term patient that they have decided, on some level, to be a person who's neck

gets stiff because of work. The majority of the people that I work with for

pain relief are with me for a short period and they go away feeling better, a

few go away unhappy, and some just end up being around for a long time. I

have a couple patients I have worked on for about a decade now, and they are

remarkably consistent in their presentation. I have repeatedly offered them

choices around self care, etc. which are mostly ignored. At this point I fit

into their life in some way, and they value that, and that is fine by me.

 

People are going to go where they want to, and I look at my role as

facilitating some of those movements. But to imply that I'm obligated to assist

people in doing things that I think are crap or not useful for them doesn't

work

for me. I'm obligated to offer them my best judgment and skill because that is

what they are paying me for, and if that doesn't work for them I make it

clear I can't help them, and I will help them look for other resources, or try

to reframe what I do so they can use it. If someone isn't happy with what I do

I'm not going to put on a different hat to make them happy. Part of my job

is to make judgments about their life and how they can change it to be more

comfortable and less dis-eased.

 

It is obvious that we are not omniscient and consequentially we must work

with people based on our observations and the questions that we ask. We make a

lot of judgments for people based on their intakes. One common example of

this is work or married life. We often interview patients regarding their work

and home life, and when we detect substantial frustration around either of

those issues we will often treat them to release that stagnation, and

frequently

that precipitously spills over into people quitting their jobs (at least 5

times for me) or getting a divorce (3 that I know of) or breaking up with a

partner of some sort (another half dozen at least). We are manipulating these

situations in many subtle and not so subtle ways; by selecting and bringing up

the issues during conversation in treatment we focus intent, and then by

moving the stagnation we release a burst of energy in that direction. I'm

reasonably sure that in some cases if the treatment was addressed to somatic

problems related to stagnation the patient would probably feel better and go on

in

the same ecology, perhaps improving the situation with their new mood and

affect. More often than not these radical changes are a positive experience and

people move on, but after the first couple of times this happened I realized

later the source of frustration was not always going to be what we talked

about, people unconsciously transfer emotional loci all the time. For example,

a

person with deep inner frustration about the course of their life may lay

the whole thing off on a spouse who is actually reasonably supportive but not

being communicated with. In that case a breakup does nothing for them and

chances are they will start the pattern over again with another person. I'm

obliged to ask myself: if I disrupt the ecology of their life is that a useful

thing? Then I usually have to ask them a lot of questions about the situation

and decide to go quick or slow, determine if they are going to be crushed by a

change, or if they are resilient enough to pass through it without rebounding

into some crummy headspace... I have no desire to take responsibility for

the outcome of other people's choices when they might not really understand

what they are getting into. The informed part of informed consent only goes so

far.

 

One of my concerns about TCM in general is the popular notion that we can

really do no harm. Medicine always changes situations, pushing things one way

or the other, and we are obliged to be vigilant about how we present our

services and make sure that what we are doing is appropriate to the situation,

and

that is another judgment. My problem with your argument is that it sounds

like you feel bad about things that have happened in the past and because of

that you've decided to simply give up a portion of critical thought as it

applies to your work. We are obliged to judge peoples choices and behavior

because

that is the service that we offer. We asses them across a broad spectrum and

attempt to change them to be more in line with what our medicine considers

health. Perhaps there is an ideal practitioner out there, who is an empty

vessel and just brings whatever is needed. I have enough to do successfully

keeping my own sentiments and issues out of a picture. That is what allows me

to

stay in a place where my emotional needs don't get bound up with the case, and

to not judge the person personally, but only asses the facts that I know,

and act accordingly. Pardon my amateur psychologizing and please don't consider

this an ad hominem attack, if you are expressing pain or disappointment

around something that happened I feel for you, but I don't agree with where

that

has apparently brought you.

 

Take care,

 

Par

 

 

 

 

 

 

 

 

 

************************************** See what's free at http://www.aol.com.

 

 

 

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