"The Truth, Whole Truth and Nothing But.." Followed by Words of Comfort
Now here is an Essay from the Hastings Center Report July-August 2012 issue which you can read free and in full by clicking on this LINK which I think brings out a modern and perhaps a common behavior by physicians which clearly is of ethical importance and should be considered by all patients.. The Essay, titled "Comfort Care as Denial of Personhood" by William J. Peace starts with the following abstract.
Comfort care is an ethical good for the patient but should not be used to meet the needs or frustrations of the healthcare providers. Read the Abstract below but then go to the Essay LINK and read the entire Essay. Then return here and present your comments. Do you think that a physician's suggestion for "comfort care" could be premature and actually be an ethical wrong for the patient? ..Maurice.
ABSTRACT
It is 2 a.m. I am very sick. I am not sure how long I have been hospitalized. The last two or three days have been a blur, a parade of procedures and people. I had a bloody debridement for a severe, large, and grossly infected stage four wound-the first wound I have had since I was paralyzed in 1978. I know the next six months or longer are going to be exceedingly difficult. I will be bedbound for months, dependent upon others for the first time in my adult life. As these thoughts are coursing through my mind, a physician I have never met and the registered nurse on duty appear at my door. As they put on their gowns I am weary but hopeful. Surely there is something that can be done to stop the vomiting. The physician examines me with the nurse's help. Like many other hospitalists that have examined me, he is coldly efficient. At some point, he asks the nurse to get a new medication.
What transpired after the nurse exited the room has haunted me. Paralyzed me with fear. The hospitalist asked me if I understood the gravity of my condition. He grimly told me I would be bedbound for at least six months and most likely a year or more. That there was a good chance the wound would never heal. If this happened, I would never sit in my wheelchair. I would never be able to work again. Not close to done, he told me I was looking at a life of complete and utter dependence. He went on to tell me I was on powerful antibiotics that could cause significant organ damage. He informed me I had the right to forego any medication, including the lifesaving antibiotics. If I chose not to continue with the current therapy, I could be made very comfortable. I would feel no pain or discomfort at all. Although not explicitly stated, the message was loud and clear. I can help you die peacefully.
posted by Maurice Bernstein, M.D. @ 9:40:00 PM
3 comments
3 Comments:
Again, the answer lies in the uncomfortable process of reaching to the spirit within the crippled body. I had a chance to interview a delightful girl, perhaps eight years old, with horrible neurological disease, with contractions and spasm. I asked her what she's looking forward to, and she told me she's going on a family trip to Six Flags in Texas.
Tut-tut, I said in my mind, what an insensitive family, to choose recreation that is beyond the reach of such a cripple. Perhaps she could read my thoughts...
Then - she energetically told me that the family was going to Six Flags, not in spite of her, but BECAUSE of her. She loves the big rides, the bigger the roller coaster the better - and her favorite thing is going on rides that make her teenage brother throw up.
So, once again - who the hell am I? I dove into a very enjoyable conversation about roller coasters. I find them fun, too!
Care of the patient is care of the patient, that's all.
What an unfortunate phrase: "the uncomfortable process of reaching to the spirit within the crippled body". Should not all health care professionals be comfortable around the crippled? I know I am quite content with my crippled body. The discomfort identified states nothing about people with a crippled body and much about ableist society that refuses to provide the most basic accommodations required by law for the last two decades. Comments such as this one only reinforce why so many crippled people fear hospitals and the highly educated male and female professionals that populate them.
It is just that the medical provider can have no true empathy with the crippled patient unless the provider him/herself is likewise crippled. Sympathy, yes but no true empathy. In addition the task for the physician to diagnose and treat the present disorder faces, in the physician's mind, a greater challenge because of the patient's chronic disability. I think absence of true empathy and the anticipated challenge can lead to the medical provider's "uncomfortable process" as described by SteveofCaley. ..Maurice.
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