DUTY OF CARE

Open your mouth for the mute, for the rights of all who are destitute. Defend the rights of the poor and needy

 - Proverbs 31:8-9

Every day, I and everyone else who drives shares space on the road with other drivers, cyclists, runners, walkers on the sidewalk, and people riding the bus, trams, and trains on the rails. From my home to the clinic I drive a distance of eight kilometers that usually takes fifteen minutes. It's faster than walking, it's more secure to me than riding, and it's easy for me to keep my helmet, my HiViz, my gear and all else in the car instead of lumping it onto a courier bag. It's convenient for me, and necessary for everyone else who drives to work. People usually walk to work when the walk is less than twenty minutes. Any longer than that, people ride their bikes. Beyond that, taking public transport usually gives people a commute time of about an hour. With driving, the average commute time is twenty or so minutes, as per the 2023 survey. From my home to the clinic I might share the road with a hundred or so other road users. I tried counting but it's difficult to keep track of the total number as well as concentrate on not crashing into someone, so I concentrate on driving because that's what I'm expected to do. I share the road with other people who want to get from point A to point B. I share the road with people who want to get to their work and get through that so they can go back home. I share the road with people like me. From my home to the clinic I pass through three suburbs, through six different residential zones, four different postcodes, past two kindergartens, a school, a few bus stops, a shopping precinct, two or three medical clinics, and one of my favourite cafes. I make that drive on a road I've ridden since when I was fifteen years old and going to school. I make that drive past buildings that were there before I was born, and past buildings that will be here long after I go. Everyone around me is making the same journey - their own journey. Everyone around me on the road is driving with the understanding that I'm concentrating on my own journey, that I'm competent to drive and not drunk or gurning, that my car is roadworthy and safe, and that I know what I'm doing. Everyone makes that assumption about me, and I make that assumption about everyone else.

I can only take care of myself. I can make sure my mirrors are adjusted, my tire pressure is up, my bushings are oiled and that I'm doing the right thing. I can make sure I'm obeying the speed limits, using my indicators, maintaining a safe distance from the cars in front of and around me as well as slowing down just a little more than is needed in school zones because you never know when something might happen. I can control myself and control my actions and thereby reduce the risk I pose to other drivers to as low as I can be, but there's still going to be leftover risk. It's residual risk, like the streaks of gravy left on a plate after you mop it up with a slice of bread. There's always something left that I can't chase, can't minimise, can't control. That residual risk multiplies when we think about the points of articulation between myself and other drivers - each of us has residual and leftover risk that we can't ourselves minimise, but by and large we make it to where we're going because we trust each other. Residual risk is owned by a person responsible for it, and we assign it to them with the trust that they'll take care of it. We can only control ourselves, not other people, so we take care of ourselves and trust that other people do the same for themselves and for us. That's how I act on my duty of care as a driver. I take care of myself because I know that other drivers are counting on me to take care of them too.

Duty of Care

As a practitioner, my duty of care to my patients is to make patient care my first concern and to practise safely and effectively. Everything else comes secondary. As a member of the Human Factors and Ergonomics Society of Australia, I have to ensure that the community and clients’ well-being take precedence over my responsibility to sectional or private interests. As a member of the Australian Institute of Occupational Hygienists, my responsibility to worker health takes precedence over responsibilities to commercial, sectional, or private interests. As a member of Engineers Australia, I strive to serve the community ahead of other personal or sectional interests. If the wording on those phrases is a little stilted it's because I copied them directly from their respective codes. I didn't reference because I like to live dangerously, what can I say. In all of those statements, to practise safely and effectively, to engage with the community and clients' best interest, and to protect the health of workers, I have to be a competent practitioner. The Duty of Care I have toward my clients, my patients, and my community is the endpoint of an ecosystem of obligations that I have to fulfil beforehand. Some of those obligations are professional - I obviously need to have the relevant training in what it is that I'm doing so that I can do it competently. Some of those obligations are technical - I need to have insurance as a legal requirement of my practice. Some of those obligations are organisational - I need to have appropriate and legally certified business and billing so I can charge people for work. Some of those obligations relate to me as a person - I need to be sober, of sound mind, physically capable of doing the work, oriented to myself and my tasks, and I need to know when a situation might be getting the better of me and when to step back. Exercising my duty of care to my patients is a matter of satisfying my obligations, but it's not the end.

Caring is an active process. Caring is a decision. Caring is a promise made between myself and the community that I serve that in taking on their concerns I'm going to do my best. To call it a Duty of Care minimises the exchange to the active immediate. The Duty of Care is perpetuative, originative, and dynamic. My Duty of Care isn't just about what happens in the moment in the clinic, it's about how the decision I make in that moment radiates outward as an ambassadorial statement. When I practice as a physiotherapist, an ergonomist, a hygienist, a safety consultant, or even just as a guy, what I do makes waves. My position as a professional means that I can effect change. The change I make happen has to be positive. The person in the clinic, the business I review, the workstation I design, all of these are just reifactive touchpoints where I meet my fulcrum. To exercise my Duty of Care in any context is to have the opportunity to choose to act on what I believe is moral, appropriate, ethical, caring. Caring is an active process. Morals are lived in our modelling. What is Appropriate is met in the middle between I as the practitioner and the client but they get the final say. What is Ethical is instructed by my codes but made real through my doing. The Duty of Care I exercise with those for whom I care is the point at which my mission is made real and brought into the world, and where that mission makes the world a better place for myself and others in it. 

Duty to Care

To be in the world is to struggle against it. To wake, live, work, age, and progress through life is to change as the world grinds down against us. To change is to struggle. We struggle against our society's indifference towards us as individuals. We struggle against the meaninglessness of an individual human life despite the enormity of each of our individual existences. We struggle to make a living wage. We struggle to find accessible accommodation. We struggle to clothe, feed, and house ourselves. We struggle to be decent and upright in a world that repeatedly casts us adrift in a sea of troubles. Everyone is neck deep in it and nobody's doing well. Everyone's on this road together, looking after ourselves as best as we can, ensconced in our vehicles of individual and collective suffering. We're all going through this together and nobody's getting out of this alive. We all have twenty-four hours. We all have the bodies we have. We're all just walking around out here with a pound of shit inside us and a vague sense of our own importance, but we're all just apes on two feet. We're just monkeys that took this whole thing way too far. Each and every person who I see is living the same life I am, just with different features. Some are younger, some are older. Some are men, women, or otherwise. Some are rich, some are poor. Everyone has the same dignity of the soul. To care for a person, a people, a place is to acknowledge that dignity. To enact a Duty of Care is to recognise the thing that needs caring for - that when people bare their pain they're also baring their soul, being vulnerable, opening up as a necessary element of asking for help. Each and everyone one of the people with whom I share roads, sidewalks, pubs, parks, homes, halls, and my community needs, deserves the care that I would expect if I was in pain because really, at the end of the day, they're me too. My community is just me looking back at myself. My community needs me to care.

My community needs me to take care of it because it takes care of me. Just like I take care of myself as best as I can with those things that I have, so to does everyone else. The trust I have that everyone else is going to attend to their care and so give me the space to attend to mine also works in reverse. I assume responsibility for the people around me because they assume responsibility for me. In attending to themselves, they attend to me, in measures large and small. It's as minor as flashing highbeams to let me know I can take right of way. It's as middling as helping me put the bins in when I'm at the clinic. It's as abstracted as a lineman making sure my house and my practice have power. By doing their jobs well, by enacting their duty of care to their work, they make good on their duty of care to me. By engaging with the breakthrough point of concern where they meet the world and the world meets them, and by shaping it with their skill, each decision they make, each word they speak, and each small act adds to a greater perpetuative whole that is so vast as to be all-encompassing. Maybe it's all-embracing. I am nothing without my community, and with me, my community can be more. My Duty of Care is a Duty to Care, to attend with active attention in the things that I do to make sure they model well, that their perpetuative effect is a positive one, and that their value is only grown with time, with curation, with care. My Duty of Care is Care itself, to attend to the world around me and to add to it in the best way I can, through practice, through protection, and through patient care. 

Duty is Care

Each day I work, I have the chance to add something to peoples’ lives that might make their own journey through life a little more bearable, a little less of a struggle. I was born with a brain, a heart, and a soul, and they’re not just for me, they’re for other people as well. To be selfish and to think that I’m the be-all and end-all of this whole show is to deny the responsibility I have toward other people as a participant in a society that has other people in it. To deny that responsibility is to deprive myself of an opportunity to make meaning by protecting the wellbeing of others. My Duty is Care - to actively choose every day and in everything I do to add something to the world around me that supports the health, wellbeing, and dignity of the people in it, because the world does enough to deprive people of those things even without considering those incidences where people are selfish, because they don’t care, because they can’t care, because they choose not to care, or because they don’t know that they can. Care is attention paid to my duties of work. Care is a moment spared for my friends and my community. Care is, after everything else, what I can do. Take away the degrees, take away the car, take away the professional capital, and at the end of the day what I can do is to care, is to choose, because that choice is with me and it comes from somewhere in me that is mine.

If anyone’s come to see me in clinic, you’d know that I have chats with my patients when they come in. I ask how they’re doing, I ask what’s going on, and I ask what’s new. More and more, people seem on edge. Maybe it’s the international situation. Maybe it’s the cost of living and the price of petrol, power, water, rent. Maybe it’s the sense that the world is just moving on and leaving people behind. Maybe it’s because people feel like their communities, their companies, their colleagues and their country doesn’t care about them, doesn’t see them, and they don’t see themselves reflected in the priorities or care of the society in which they exist. This is a profoundly shitty thing because it’s awful to be alienated from the place in which you live and to feel like nobody and nothing cares. I don’t know why this might be happening aside from those reasons I mentioned before. I do know that I’m just me - One Dude in a room and with twenty-four hours, and I have the choice to use what resources I can.

I choose to act in line with my Duty of Care, because my Duty of Care is to choose to Care in everything I do.