Who you callin' fiduciary?

Over Christmas break, while spending time with my family, my mom retold a story about me as a little kid. At the church we grew up in, every year around Christmas-time, we would have a party in the basement. You remember the church basement get-togethers, right? That universal church basement smell from countless pot luck dinners over the years. The linoleum tile floors. The Sunday school story boards made out of felt. Etc.

Anyway, every year this particular Christmas party was easily the most anticipated of the church basement gatherings - at least to us kids. Because we all knew inevitably during the evening, Santa would make an appearance. At some predetermined time, we would all gather around, be really quiet and listen for the reindeer hooves above us on the roof. Sure enough, always on schedule, there would be a loud trampling/stomping sound upstairs, and shortly after Santa would enter through the doorway, lugging a red sack full of presents - one for each kid in attendance. We would then each take our turn to sit on Santa's lap, with everyone else watching, and proceed to tell him that "Yes, we had been a good child that year" and describe what we wanted for Christmas. Most normal kids were asking for normal kid things - you know, remote control cars, action figures, dolls, video games. When my turn came I went up and took my place on his lap. Hair neatly combed, with the face of an angel, perfect child as I was, I plainly explained to Santa how good I had been that year. And when he asked me what I wanted, my response was, "I want a dictionary and a warm sweater." I'm not sure if my parents were proud or embarassed. And looking back, I suppose I'm thankful that my friends were still too young to understand the concept of "nerd" or "brown-noser".

I think I got a dictionary that year. (The warm sweater, I'm not sure about.) And boy oh boy, did it sure pay off. I would later be crowned back-to-back Adams County Spelling Bee Runner-up in 4th and 5th grade - both years finishing behind Katie Frink (my despised spelling bee arch nemesis...we would later date in middle school). Even today I still enjoy learning words. Last year I signed up for Merriam-Webster Online's "Word of the Day" emails. Everyday they send me a different, usually obscure, word with a definition and history about its origin. That way, not only do I get to learn a new word everyday, I also get the excitement of at least one new email in my inbox everyday (kind of like having a really smart imaginary friend). Almost everyday in school (certainly at least once a week) I come across a word I don't know and I honestly get a little kick out of looking up the definition.

My point in this whole blog entry was to just tell you about an interesting word I came across yesterday when studying medical ethics: fiduciary. From Wikipedia: "A fiduciary is a person who occupies a position of trust in relation to someone else such that he is required to act for the latter's benefit within the scope of that relationship." From M-W: "held or founded in trust or confidence" (adj. form). Usually it is used in the context of finances, business, or law. But in this case it is used as: In the physician-patient relationship, the physician is a fiduciary. I like the sense of confidence and trust reciprocated with obligation and responsibility to do what is right that the word conveys. It falls under the realm of the medico-ethical principle of beneficence.

In medical ethics we have been learning about 4 guiding principles:

1) Beneficence: act in the patient's best interest.
2) Nonmaleficence: do no harm.
3) Autonomy: respect the patient as an individual and honor their preferences and decisions.
4) Justice: treat each patient with fairness and impartiality.

What if we applied these same principles to everyone everyday, not just within the physician-patient relationship? I guess you could sum it up as "Love your neighbor as yourself."