The other day I was listening to Good Morning America while getting ready for work and heard of a story that made me cringe. The report involved a woman who actually died on the floor of an emergency room while waiting for care in Los Angeles, CA. Edith Rodriguez, mother of three, arrived at the ER feeling sick and vomiting blood. For over 45 minutes, Rodriguez lay on the ER floor while staff members ignored her. From surveillance videos, one can even see a janitor sweeping the floor around Rodriguez. The woman’s boyfriend called 911 from within the inner-city hospital and was told by the dispatcher that he (and paramedics) could do nothing for him due to the fact that the man’s girlfriend was already in a hospital. A bystander also called 911 for help and was told by another 911 dispatcher that there was nothing he could do for her. In fact, the dispatcher stated “I cannot do anything for you for the quality of the hospital. It is not an emergency. It is not an emergency ma'am” (The Associated Press, 2007). The man actually argued with the caller over whether or not Rodriguez’s situation was an emergency. Toward the end of the conversation, the caller told the dispatcher that God should strike him dead as a result of his actions. The dispatcher replied, “No, negative ma'am, you're the one” (The Associated Press, 2007). Shortly after the call, Edith Rodriguez died on the floor of an ER from a perforated bowel that could have been easily treated. To view this article in more detail, please go to http://abcnews.go.com/US/WireStory?id=3273647&page=1
How could this happen to a patient who sought care from a hospital in her time of need? Clearly, the patient was in severe pain and hospital staff could visibly see her vomiting blood. Who is to blame in this situation? Ironically, the Chief Medical Officer of the hospital has been absent from work since this story was reported to the public. Is the hospital staff to blame for Ms. Rodriguez’s death in that they did nothing to help her and simply ignored her? Perhaps the 911 dispatchers are to blame for not taking the calls seriously and choosing not to send an ambulance for the sick woman so that she could be transported to another facility. In this type of scenario, who would receive the appropriate disciplinary action? How does one go about deciding who is to blame in this case? Does the hospital have an Ethics committee to decide such cases? Will the Chief Medical Officer be held accountable or will it be the staff members on duty that day? What reasons will be provided for not giving Rodriguez the appropriate care? How does the hospital “prioritize” patients when they first enter the ER? Is there a particular system in place for seeing ER patients based on their condition? If so, what are the requirements?
According to the story this is not the first time such an incident has happened at the hospital. Apparently, the hospital has encountered similar problems in the past in regard to not treating patients appropriately. In my opinion, allowing this hospital to continue operating would be unethical, not to mention dangerous for the patients who choose to go there for care. After reading this story, I immediately thought to myself, “should someone in this case be charged for the murder of Edith Rodriguez’s death?” If so, how would this affect the hospital’s staff, the deceased patient’s boyfriend and family, the organization’s stakeholders and the community? If staff members could be charged with murder in this case, would it change how hospitals operated their ERs? Would it change how healthcare workers treated their patients? Would situations like the one above be less likely to occur if such laws and/or actions were put into place for healthcare organizations? Unfortunately, for Edith Rodriguez, such laws and/or disciplinary actions will be of no help. Perhaps some type of compensation will be awarded to her family for the lack of treatment she received. As future healthcare managers, what can we do in order to prevent such tragic occurrences and unethical behavior from happening? What can be done to reduce wait times within our nation's ER department? How can we better train our employees to react appropriately to patients when pressed for time and/or space?
References
The Associated Press (2007, June 13). 911 Dispatchers Denied Dying Woman Help. Retrieved June 13, 2007, from http://abcnews.go.com/US/WireStory?id=3273647&page=1
Thursday, June 14, 2007
Thursday, June 7, 2007
Blog 4: Will America be Sick over Michael Moore’s Sicko?
In response to David Moses’s recent blog concerning Michael Moore’s new documentary, “Sicko”, I too felt compelled to write about this politically charged movie. The premise of the documentary involves taking a close look at the many flaws found within America’s healthcare system. More specifically, Moore investigates the inner-workings of our healthcare system and brings to light an array of problematic issues such as access to care, unaffordable healthcare coverage and powerful managed care organizations. He also gives insight into the world of healthcare through other peoples’ eyes and experiences such as political entities, healthcare workers, and of course the patients. In one interview with a mother, Moore discovers that her infant died because she could not receive medical care (Grover, 2007). Similar heartbreaking stories can be found throughout the documentary from a number of patients that were interviewed.
For many of us working in healthcare, Moore’s documentary may come as a breath of fresh air. As healthcare workers (and students studying health services administration), we are exposed to the inner-workings of a healthcare organization each and every day. We are able to see the political battles that take place over finances and patients, the unethical practices that occur between healthcare personnel and patients, medical errors, the controlling nature of managed care companies and the coverage gaps found within health insurance. Most importantly, we are able to see the effects that these elements have on the patient. Many of us in the field hope to see universal healthcare coverage and complete access within the next few years. Many political figures have tried for such coverage and access in the past but have failed miserably. Perhaps next year’s elections (along with “Sicko”) will bring fresh ideas to the table on improving America’s fragmented healthcare system.
According to Hofmann and Nelson (2001), “In the midst of the politics, it is too easy to forget that healthcare is a good and service prerequisite for the well-being of all human beings.” As one of the most powerful and so-called wealthy nations in the world, why is it so difficult to provide reasonable medical care at an affordable price for our nation’s citizens? Why does America still not consider it a basic right for all of its citizens to have equal access to healthcare (Hofmann & Nelson, 2001)? Perhaps just too many “hands are in the pot.” Managed care organizations want their cut, hospitals want to see the bottom line increase, stakeholders want fuller pockets, doctors and nurses want bigger and better salaries/incentive programs and the list goes on and on. There must be a way to reduce the cost of medical care and improve access for everyone. It should be the right of each American to have affordable coverage and convenient access to a system that was originally created to help take care of people and save lives; not fill the pockets of greedy stakeholders and politicians.
Hopefully Michael Moore will shed some much-needed light on the state of today’s healthcare system. Political entities, health authorities, managed care companies, and healthcare organizations in general should brace for the possible large-scale impact this documentary may have on America. Look at the ramifications and outcomes associated with Morgan Spurlocks’s documentary on the fast food industry, “Super Size Me.” This eye-opening movie not only pushed schools to incorporate healthier meal options during lunch (in addition to increasing physical education time) but ultimately caused McDonalds as well as other fast food restaurants to now post nutritional information and ingredients on food packaging. McDonald’s also created the “Adult Happy Meal” and offered healthier alternatives in their happy meals for children. “Super Size Me” created enough awareness within the fast food community for action to actually take place. With any luck, Michael Moore’s documentary “Sicko” will do the same. Our country’s healthcare system desperately needs attention. If Michael Moore can draw enough awareness to this issue and turn up the heat on today’s political figures, than perhaps our nation’s fragmented healthcare system can begin to repair its fragile state.
References
Grover, R. (2007, June 4). Michael Moore Wants to Reform Healthcare. Retrieved on
June 7, 2007, from http://news.yahoo.com/s/bw/20070604/bs_bw/jun2007db20070604109406;_ylt=AgeaZ2tQjvqxrVXrAq1i9fzq188F
Hofmann, P. & Nelson, W. (2001). Managing Ethically: An Executive’s Guide. Chicago: Health Administration Press.
For many of us working in healthcare, Moore’s documentary may come as a breath of fresh air. As healthcare workers (and students studying health services administration), we are exposed to the inner-workings of a healthcare organization each and every day. We are able to see the political battles that take place over finances and patients, the unethical practices that occur between healthcare personnel and patients, medical errors, the controlling nature of managed care companies and the coverage gaps found within health insurance. Most importantly, we are able to see the effects that these elements have on the patient. Many of us in the field hope to see universal healthcare coverage and complete access within the next few years. Many political figures have tried for such coverage and access in the past but have failed miserably. Perhaps next year’s elections (along with “Sicko”) will bring fresh ideas to the table on improving America’s fragmented healthcare system.
According to Hofmann and Nelson (2001), “In the midst of the politics, it is too easy to forget that healthcare is a good and service prerequisite for the well-being of all human beings.” As one of the most powerful and so-called wealthy nations in the world, why is it so difficult to provide reasonable medical care at an affordable price for our nation’s citizens? Why does America still not consider it a basic right for all of its citizens to have equal access to healthcare (Hofmann & Nelson, 2001)? Perhaps just too many “hands are in the pot.” Managed care organizations want their cut, hospitals want to see the bottom line increase, stakeholders want fuller pockets, doctors and nurses want bigger and better salaries/incentive programs and the list goes on and on. There must be a way to reduce the cost of medical care and improve access for everyone. It should be the right of each American to have affordable coverage and convenient access to a system that was originally created to help take care of people and save lives; not fill the pockets of greedy stakeholders and politicians.
Hopefully Michael Moore will shed some much-needed light on the state of today’s healthcare system. Political entities, health authorities, managed care companies, and healthcare organizations in general should brace for the possible large-scale impact this documentary may have on America. Look at the ramifications and outcomes associated with Morgan Spurlocks’s documentary on the fast food industry, “Super Size Me.” This eye-opening movie not only pushed schools to incorporate healthier meal options during lunch (in addition to increasing physical education time) but ultimately caused McDonalds as well as other fast food restaurants to now post nutritional information and ingredients on food packaging. McDonald’s also created the “Adult Happy Meal” and offered healthier alternatives in their happy meals for children. “Super Size Me” created enough awareness within the fast food community for action to actually take place. With any luck, Michael Moore’s documentary “Sicko” will do the same. Our country’s healthcare system desperately needs attention. If Michael Moore can draw enough awareness to this issue and turn up the heat on today’s political figures, than perhaps our nation’s fragmented healthcare system can begin to repair its fragile state.
References
Grover, R. (2007, June 4). Michael Moore Wants to Reform Healthcare. Retrieved on
June 7, 2007, from http://news.yahoo.com/s/bw/20070604/bs_bw/jun2007db20070604109406;_ylt=AgeaZ2tQjvqxrVXrAq1i9fzq188F
Hofmann, P. & Nelson, W. (2001). Managing Ethically: An Executive’s Guide. Chicago: Health Administration Press.
Blog 3: The Dr. Death Debate
Picture yourself as a terminally ill person or someone living with a chronic and painful disease. Perhaps the disease is so debilitating that you are not able to perform every day functions such as taking a shower or making your bed. Maybe you are constantly feeling nauseated from weekly chemotherapy treatments and are so fatigued that even brushing your teeth becomes a chore. Even worse, your psychological condition is going down hill with each passing day. The thought of slowly dying and living with excruciating pain severely affects your mental state and you slip even deeper into depression. Perhaps you have no support during this difficult time. Maybe there is no one in your life to help you function and you ultimately find yourself going through each day alone and afraid. However, what if there was a way to escape the pain and psychological torment for good? What if you could choose to end your life in a less painful process than what your disease had in store for you? Would the idea of a medical professional assisting you with such a procedure seem appealing when faced with dying a slow and painful death? Is it your right as a human being to choose whether or not you want to live or die? Would the idea of “assisted suicide” even be ethical in the field of healthcare? There are thousands of people each day that are diagnosed with and/or are living with terminal and debilitating diseases. How many of these individuals have contemplated “assisted suicide?” According to Dr. Jack Kevorkian, more people than what one might think may want such assistance when it comes to ending their life.
As many of you know, Dr. Jack Kevorkian was released from prison a few days ago after serving an eight year sentence for helping end the life of a man with Lou Gehrig's disease. Kevorkian had also assisted with ending the lives of 130 people throughout the 90s (Hoffman, 2007). During this time, Kevorkian often challenged prosecutors (and the law) to charge him with a crime or make assisted suicide legal. Finally, he was convicted with second degree murder for helping end the life of Thomas Youk, a 52 year old man suffering from Lou Gehrig’s disease. When released from prison, Kevorkian was embraced by many supporters including his legal assistant, Ruth Holmes. According to Ms. Holmes in regard to Jack Kevorkian’s history of assisted suicides, “This should be a matter that is handled as a fundamental human right that is between the patient, the doctor, his family and his God” (Hoffman, 2007). Dr. Kevorkian has two years of parole to complete and during this time he is forbidden to assist anyone with dying. However, news reports claim that Dr. Kevorkian still believes that people have the right to die. Reports also suggest that the doctor will in fact continue to assist with ending the lives of ill patients after his parole is over in 2009.
The result of the above news has stirred up more controversy on whether or not human beings have the right to end their life if ill and/or in pain. Now, if a patient is residing in an actual hospital while suffering, the patient and his/her caregivers/family have the right to make a life-ending decision. If a patient’s treatment is found not to work, treatment may be withdrawn in an effort to stop the patient from suffering. Why is this not the case when an individual is suffering in the privacy of his/her own home and not in a hospital? How can members of a hospital staff legally withdrawal treatment from a patient (and thus resulting in a patient’s death) but individuals in their homes cannot legally end their lives if severely ill? Is not withdrawing treatment from a patient essentially helping them end their lives? Would this not be considered “assisted suicide” in some sense? Was Dr. Jack Kevorkian acting like other medical professionals when asked by a patient to “withdrawal” their treatment and help end their suffering? Was Kevorkian really acting that much different than medical professionals dealing with an ill patient within a hospital? Was Kevorkian really just acting in the best interest of the patient? Do not medical professionals at hospitals do the same?
According to Hofmann and Nelson (2001), “answering specific questions will help to determine when a treatment may be withheld or withdrawn [from a patient]: 1) Is it too painful? 2) Is it too physically damaging? 3) Is it psychologically repugnant to the patient? 4) Does it suppress too greatly the patient’s mental capacity? 5) Is the expense prohibitive?” Cannot these questions be applied to patients suffering at home? If so, why is it illegal for patients to end their lives if assisted by a medical professional? Is this act not the same situation that occurs within hospitals everyday with terminally ill patients? If assisted suicide was deemed legal in the U.S., how would such a law affect healthcare organizations? How would it affect the mindset of the general population? Would assisted suicide ever be tolerated in this country or is such an act just too unethical?
An ethical debate of this magnitude will most likely continue to be ongoing for many years to come. Perhaps human beings will never reach a decision and will continue to “agree to disagree.” In any event, it is my opinion that a human being should have control over his/her life under any circumstance. I do in fact see the similarities between what Dr. Jack Kevorkian did and what trained medical staff practice everyday. What distinguishes these two entities? Are clearer laws and/or regulations needed to define the two practices? Who is able to evaluate such ethical dilemmas and make a change if needed? The above questions may never be answered and for the purpose of today’s discussion serve as just “food for thought.” How do you all feel about the issue over whether or not to end a person’s life due to extreme suffering? Is it right or wrong? Feel free to leave me comments!
As many of you know, Dr. Jack Kevorkian was released from prison a few days ago after serving an eight year sentence for helping end the life of a man with Lou Gehrig's disease. Kevorkian had also assisted with ending the lives of 130 people throughout the 90s (Hoffman, 2007). During this time, Kevorkian often challenged prosecutors (and the law) to charge him with a crime or make assisted suicide legal. Finally, he was convicted with second degree murder for helping end the life of Thomas Youk, a 52 year old man suffering from Lou Gehrig’s disease. When released from prison, Kevorkian was embraced by many supporters including his legal assistant, Ruth Holmes. According to Ms. Holmes in regard to Jack Kevorkian’s history of assisted suicides, “This should be a matter that is handled as a fundamental human right that is between the patient, the doctor, his family and his God” (Hoffman, 2007). Dr. Kevorkian has two years of parole to complete and during this time he is forbidden to assist anyone with dying. However, news reports claim that Dr. Kevorkian still believes that people have the right to die. Reports also suggest that the doctor will in fact continue to assist with ending the lives of ill patients after his parole is over in 2009.
The result of the above news has stirred up more controversy on whether or not human beings have the right to end their life if ill and/or in pain. Now, if a patient is residing in an actual hospital while suffering, the patient and his/her caregivers/family have the right to make a life-ending decision. If a patient’s treatment is found not to work, treatment may be withdrawn in an effort to stop the patient from suffering. Why is this not the case when an individual is suffering in the privacy of his/her own home and not in a hospital? How can members of a hospital staff legally withdrawal treatment from a patient (and thus resulting in a patient’s death) but individuals in their homes cannot legally end their lives if severely ill? Is not withdrawing treatment from a patient essentially helping them end their lives? Would this not be considered “assisted suicide” in some sense? Was Dr. Jack Kevorkian acting like other medical professionals when asked by a patient to “withdrawal” their treatment and help end their suffering? Was Kevorkian really acting that much different than medical professionals dealing with an ill patient within a hospital? Was Kevorkian really just acting in the best interest of the patient? Do not medical professionals at hospitals do the same?
According to Hofmann and Nelson (2001), “answering specific questions will help to determine when a treatment may be withheld or withdrawn [from a patient]: 1) Is it too painful? 2) Is it too physically damaging? 3) Is it psychologically repugnant to the patient? 4) Does it suppress too greatly the patient’s mental capacity? 5) Is the expense prohibitive?” Cannot these questions be applied to patients suffering at home? If so, why is it illegal for patients to end their lives if assisted by a medical professional? Is this act not the same situation that occurs within hospitals everyday with terminally ill patients? If assisted suicide was deemed legal in the U.S., how would such a law affect healthcare organizations? How would it affect the mindset of the general population? Would assisted suicide ever be tolerated in this country or is such an act just too unethical?
An ethical debate of this magnitude will most likely continue to be ongoing for many years to come. Perhaps human beings will never reach a decision and will continue to “agree to disagree.” In any event, it is my opinion that a human being should have control over his/her life under any circumstance. I do in fact see the similarities between what Dr. Jack Kevorkian did and what trained medical staff practice everyday. What distinguishes these two entities? Are clearer laws and/or regulations needed to define the two practices? Who is able to evaluate such ethical dilemmas and make a change if needed? The above questions may never be answered and for the purpose of today’s discussion serve as just “food for thought.” How do you all feel about the issue over whether or not to end a person’s life due to extreme suffering? Is it right or wrong? Feel free to leave me comments!
References
Hofmann, P. & Nelson, W. (2001). Managing Ethically: An Executive’s Guide. Chicago:
Health Administration Press.
Hofmann, K. (2007, June 1). Kevorkian Leaves Prison After 8 Years. Retrived June 1, 2007,
from http://abcnews.go.com/US/WireStory?id=3233593&page=1
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