tag:blogger.com,1999:blog-7571658.post2513189499699529949..comments2024-03-24T20:02:50.012-07:00Comments on Bioethics Discussion Blog: Patient Dignity (Formerly: Patient Modesty): Volume 94Maurice Bernstein, M.D.http://www.blogger.com/profile/07618638650784869923noreply@blogger.comBlogger175125tag:blogger.com,1999:blog-7571658.post-55728742741760142742019-02-14T11:15:20.555-08:002019-02-14T11:15:20.555-08:00NOTICE: As of today February 14 2019, there will N...NOTICE: As of today February 14 2019, there will NO FURTHER COMMENTS PUBLISHED ON THIS VOLUME. Comments can continue on <a href="https://bioethicsdiscussion.blogspot.com/2019/02/patient-dignity-formerly-patient.html" rel="nofollow"> VOLUME 95.</a><br />..Maurice.Maurice Bernstein, M.D.https://www.blogger.com/profile/07618638650784869923noreply@blogger.comtag:blogger.com,1999:blog-7571658.post-24506088705511944322019-02-14T11:13:40.791-08:002019-02-14T11:13:40.791-08:00Biker: You write,"Somehow long ago the group-...Biker: You write,"Somehow long ago the group-think in healthcare arrived at the conclusion that normal societal norms concerning privacy/modesty/dignity don't apply in healthcare settings."<br /><br />You hit the nail on the head. If I live long enough, I aspire to write a book with the title "Because I Can" and use theories of crime, delinquency, and social deviance to explain the goings on in healthcare. One theory, which has considerable empirical support, is called neutralization theory. It posits that people learn to to violate social norms (folkways, mores, and laws) in the process of interacting with others. They learn (in deviant subcultures or subcultures of deviance), among other things, to neutralize in advance (before they commit their deviant behavior) internal controls (e.g., conscience) and external controls (e.g., the threat of informal and formal sanctions) that generally check deviance. Neutralization theorists posit that controls are neutralized after people learn certain techniques of neutralization. One of several neutralization techniques learned by many if not most healthcare providers can be dubbed "appeal to special status" whereby deviants learn in advance of their deviance that because of their special status, they are entitled to violate the norms of the greater society. Deviants drift in and out of situations which promote deviance. When the deviant provider is at work, s/he engages in her deviant behavior but when he goes home he now follows the straight and narrow.<br /><br />The theory and the evidence suggests that these deviants are at least partially committed to the norms of the greater society. The fact that they drift in an out of deviance suggests that this is the case. But there are more specific examples including, 1) they would not want to be treated that way; 2) they wouldn't want their loved ones to be treated that way; 3) they will avoid circumstance where they would be treated that way (e.g., nurses employing nurse colleagues to keep them covered during preps; providers going to same-sex providers when they need intrusive procedures done); and they don't treat guests in their homes that way (e.g., they don't walk into bedrooms occupied by guests without first knocking).<br /><br />Greater elaboration is needed on my part but I won't do that here. I can do it in the context of challenges to what I've written (which might require some elaboration). I hope what I've written engenders questions that require me to elaborate (e.g., a question regarding the significance of the proposed book's title). You might be inclined to fill in the blanks, give examples, come up with alternative explanations, etc. I look forward to that. -- Ray<br />Ray B.noreply@blogger.comtag:blogger.com,1999:blog-7571658.post-8762208253135663072019-02-14T10:25:42.098-08:002019-02-14T10:25:42.098-08:00JF: I communicated only part of the story. I faile...JF: I communicated only part of the story. I failed to write that the young woman's surgery was for complications associated with Crohns disease. She reported that she was wheeled in a gurney to the prep room along with a young man who was also going to be prepped for surgery. She said that they both saw what I described at about the same time, looked at each other and he shrugged. She said that she had never been more embarrassed in her life and the young man looked embarrassed too. She said that the young man remained in the prep. room as she was wheeled to a cubicle and the curtain closed. She was given a relaxant, prepped, and then anesthetized. Although I did not probe more, I suspect that there were several cubicles that were occupied and the overflow patients were prepped outside of the cubicles. I wish now that I had asked her how long she had to wait (which might signify that she was given the first cubicle that opened up, although there are other explanations), how many cubicles were there,if she had any indication of whether or not the other cubicles were occupied and she was given first dibs on the first opening for whatever reason, etc. It was remiss of me not to have asked these questions. Regarding the nurse's story, she was speaking of a hospital other than the one in which the young lady was treated. She also reported that when nurses at that facility needed surgery, they would generally go elsewhere so as to avoid being exposed to colleagues or they would ask a female colleague to accompany them and make sure that they were not exposed to anyone but those doing the preps. -- RayRay B.noreply@blogger.comtag:blogger.com,1999:blog-7571658.post-87291859022654503182019-02-14T09:57:50.616-08:002019-02-14T09:57:50.616-08:00Ray B
No, no and no. Patients are not left naked ...Ray B<br /><br />No, no and no. Patients are not left naked in masse while being prepped for surgery. That’s just fodder for people to read who have a fetish about that kind of thing. Consider the logistics of a surgical center, not all patients have their surgeries at the same time. You can only have so many surgeons, anesthiologists at one time. Each patient has to be prepped differently, not all patients are the same. Some patients will be intubated while some may have an epidural.<br /><br />Honestly, that is one of the most ridiculous assertions I’ve ever read on this blog. Appreciate that I have over 40 years in healthcare with much experience in the OR. There are so many factors as to why this dosen’t happen and it would take pages and pages for me to explain why, so it’s not worth it. <br /><br />PTAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-7571658.post-60278963653812165122019-02-14T09:29:30.809-08:002019-02-14T09:29:30.809-08:00Continuation
Further investigation also revealed t...<br />Continuation<br />Further investigation also revealed that male patients’ fear of unflattering labels being imputed to them had some validity. Commonplace among healthcare providers is a unique lingo (which supports gallows humor) that contains many pejoratives directed at “bad” patients, among whom are those who complain about being unnecessarily dehumanized. A man who complains about being dehumanized may be symbolically castrated; he is labeled a “crybaby,” a “pussy,” “unmanly” or a P.U. (an “unmanly pussy” with the letters placed backwards to signify contempt) – more child or woman than man. The complaining man may also be typed a N.A.T (as though he were a bug) for “Not a Trooper,” originally a reference to women in labor who complained more than providers thought they should about the pain and discomfort associated with labor and delivery.<br /><br />Male patients, then, were more likely than female patients to be dehumanized, if dehumanized they were less likely than women to complain about it even though they tended to feel worse. Men’s reticence to complain tended not to be due to some masculine self image but to a legitimate fear of stigma, dismissiveness, and malevolent reactions by providers.<br /><br />Our findings may have implications for understanding why men are less likely than women to seek healthcare and why they are more likely than women to delay seeking care until their acute problems become chronic. Conventional wisdom would have us believe that character defects in men account for why they are more reticent than women to seek healthcare. Men’s pigheaded pride, it is believed, accounts for their unwillingness to seek help for illnesses; for them, seeking help is a sign of weakness and dependence on others, character defects that no real man would find desirable. Our findings, however, suggest that the explanation may be more complicated than that. A reasonable hypothesis that may be induced from our findings is that men are more likely than women to balk at seeking care because they are more likely than women to be dehumanized. Put more broadly, the etiology of men's proclivity to eschew treatment may lie less in the character of men and more in the character of a healthcare system that requires men more so than women to weather the indignities of dehumanization. An even more chilling thought is that a pattern of unnecessary dehumanization of male patients may not only help explain why they delay seeking healthcare, it may also play some role in determining their mortality rate due to that delay, a rate that is consistently higher than that of women. Given the focus of researchers on describing and understanding the measurable discrimination against suspect groups (e.g., women and racial/ethnic minorities), tests of these latter two hypotheses may have to be put on hold.<br />Ray B.noreply@blogger.comtag:blogger.com,1999:blog-7571658.post-41943660531320758492019-02-14T09:27:33.109-08:002019-02-14T09:27:33.109-08:00Here is the summary of the study I mentioned in an...Here is the summary of the study I mentioned in an earlier post. I plan to make it the first part of a paper that I will submit to Men's Health or another similar journal. What I'll need help on is placing anecdotes of privacy violations and other indignities into named categories. For example, we can create categories based on a label given to the violator and the circumstances of the violation. You've already given me an idea for one category. Someone wrote about being ambushed. The first category can be dubbed The Ambush (representing the circumstance) and The Bushwacker (the label given to the ambusher). Beneath that rubric, we can list true-to-life anecdotes, of the sort reported by JR. What could we label healthcare providers such as Twana Sparks (Silver City, NM dermatologist) who batter men by touching their genitals without consent or justification? What are some real life examples, other than the antics of Twana Sparks. What can the circumstance be labeled? What about those who play peek-a-boo and the circumstances around those people who play this game? Consumers of popular media like anecdotes. <br /><br />What follows is a summary of the research and its findings. <br /><br />In the early ‘90s, I and nursing students in a research class I taught made a serendipitous discovery. We tested a hypothesis founded on a theoretical proposition: The greater the social distance between subordinate and superordinate peoples (operationalized as patients versus healthcare providers) the greater the likelihood that the former will be dehumanized. Contrary to our expectations, providers tended to be equal opportunity dehumanizers; we failed to find that the relative differences between patients’ and physicians’ statuses significantly influenced the likelihood of unwarranted and unnecessary dehumanization incidences. However, we did find something that was inconsistent with conventional wisdom and which we did not expect to find; viz. male patients were more likely than female patients to be unnecessarily dehumanized and the intensity of this dehumanization was greater for men than for women.<br /> <br />I sought to understand what was going on here, sometimes with the help of students and sometimes using quantitative approaches and at other times qualitative methods. Ultimately, analysis showed that, although men were more likely than women to experience unwarranted dehumanization, they were less likely to say anything about it when it happened. Could it be that dehumanization just didn’t matter to men, as common wisdom would lead us to believe? Nope! Men who were dehumanized tended to feel worse about their treatment than women. Then why were they less likely than women to complain? Was it because, unlike women, their self-image (strong, macho, stoic, in control, etc) precluded complaining about such petty matters? Nope to that too; men who felt badly about how they were treated but didn’t complain tended to fear that, were they to complain, they would be subjected to unflattering labels (e.g., sissy, baby, immature, disturbed, insecure) and sometimes malevolent actions (e.g., refusal to treat, scolding, or verbal/nonverbal confirmation of insidious labels). In fact, the men who reported that they did complain about their dehumanization were more likely than women who complained to report having experienced dismissive or malevolent responses by providers and they were less likely to report that providers honored their requests or demands. -- Ray<br />Continued . . .<br />Ray B.noreply@blogger.comtag:blogger.com,1999:blog-7571658.post-64893560546863425202019-02-14T08:00:35.017-08:002019-02-14T08:00:35.017-08:00Good Morning:
PT. I’ve been looking at state nurs...Good Morning:<br /><br />PT. I’ve been looking at state nursing boards and into fines & sanctions. Most boards have a female majority so I see no chance of any male who gets caught in their web to be treated equally and get a fair shake. <br /><br />I know in my state currently there are nine board members eight of which are women. Seven medical people and one citizen. There are current still 3 positions open, two citizen spots and one LPN spot. I’ve put in for one of the lay positions so as to better equal things out.<br /><br />Fines and sanctions are unbelievable. Female nurses are being sanctioned left and right for alcohol abuse or theft and/or use of drugs.<br /><br />Why are these people allowed to “clean up their act” and come back to work with patients again? These people should be fired and their license permanently revoked. I don’t want them are me or anyone I know.<br /><br />Ray:<br /><br />In regards to the video Biker asked us to look at, Welcome to the PEDESTAL PROJECT. This page was created to assist with the surgical education of practitioners. Please direct all questions to Pedestal42@icloud.com. <br /><br />Maybe pedestal42 will tell ya. From looking at another video in the series, the Knee Scope and Prep video was done at the Sports Medicine and Performance Center at the Children’s Hospital of Philadelphia. Can’t say for sure that the knee prep was done there though.<br /><br />Regards,<br />NTTNTThttps://www.blogger.com/profile/16277382808413575689noreply@blogger.comtag:blogger.com,1999:blog-7571658.post-72551673923689648722019-02-14T07:58:24.751-08:002019-02-14T07:58:24.751-08:00Good Morning:
JR, I read your list of things you ...Good Morning:<br /><br />JR, I read your list of things you want to go over with your elected officials.<br /><br />4. The overuse and use of drugs such as fentanyl to control & make pts. Compliant.<br /><br /><br />Dr. Bernstein, correct me if I’m wrong please.<br /><br />Fentanyl, is just an opioid which is just a very strong pain killer. If I’m correct, fentanyl has nothing to do with making the patient compliant. <br /><br />What causes the patient to be “compliant”, are the benzodiazepines they use along with the pain killer.<br /><br />Benzodiazepines like Midazolam (aka Versed), lorazepam (aka Ativan), and diazepam (aka Valium), are the drugs used in anesthesia. Those are the drugs that doctors and anesthesiologists use that wipe your memory of what happened from the time given until you wake up from your ordeal. The effects these drugs have on the human mind can last for weeks or in some cases the memory lose can be permanent.<br /><br />The other drug worth mentioning is propofol. It’s not a benzodiazepine but is has the same loss of memory that the benzodiazepines have and, it’s a favorite in the operating room to induce and maintain general anesthesia and in outpatient procedures for “conscious sedation”.<br /><br />They use these drugs a lot with colonoscopies so the patient is compliant so they can get them in and out as fast as possible and keep the money train moving. Propofol or a combination of fentanyl for pain and versed (aka midazolam or dazzle), to wipe the memory clean of whatever they did are the drugs of choice.<br /><br />It has always been my belief that drugs like propofol and the benzodiazepines should only be used with complete patient knowledge and approval.<br /><br />That doesn’t happen because neither the doctor nor anesthesiologist tells you what’s being used. If they say anything all they say is “don’t worry, you won’t remember a thing).<br /><br />There has to be other drugs available to the medical community that won’t wipeout a patient’s memory whereby leaving them defenseless if something goes wrong because they can’t remember anything due to what they were given before surgery started. The patient will lose every time.<br /><br />The medical community has a nickname for propofol. It’s referred to as milk of amnesia because of its white milky color and the effect it has on the patient’s memory.<br /><br />These drugs are what helps keeps that veil of secrecy secure for the medical community. They should be outlawed.<br /><br />So, JR I’d speak to your elected officials about tighter restrictions on the use of propofol and the benzodiazepines where surgery and procedures are concerned.<br /><br />Patients should be told while they have a clear head, what drugs are going to be used, what they are for, and what if any side effects they may have. Then let the patient decide if they want to do it or use other drugs.<br /><br />Regards,<br />NTTNTThttps://www.blogger.com/profile/16277382808413575689noreply@blogger.comtag:blogger.com,1999:blog-7571658.post-39400455598492212392019-02-14T05:41:51.673-08:002019-02-14T05:41:51.673-08:00Ray, based on your input and my having thought thi...Ray, based on your input and my having thought this through a bit more I am changing my mind on a couple things.<br /><br />First to answer your question, I don't know anything about that Pedestal Project but was able to see the sports medicine piece was at the Children's Hospital of Philadelphia. The video I had posted wasn't anything I was looking for but rather it was something that popped up when I was looking for something else. It was just a momentary curiosity that caused me to watch it. <br /><br />In my heart of hearts that likes to think well of people I really would prefer the lack of concern for (especially male) patient privacy/modesty/dignity as simply being a culture that doesn't see how disrespectful and inappropriate they are being.<br /><br />Your comments about that group prep is perhaps the proverbial final straw disavowing me of the way I've wanted to see this stuff. I doubt there is any patient literature published anywhere that informs patients they might be lying naked on a table in a room full of other naked patients, and subject to being seen by other patients just entering the room. That is utterly beyond the pale for civilized people.<br /><br />I will add that for things like cardiac caths a patient isn't going to get more than a passing reference to hair clipping and certainly there are no videos out there showing how it is done, nor of the patient lying there needlessly fully exposed while the area is disinfected. When it comes to intimate exposure the healthcare industry is largely silent. As a result patients end up either ambushed when they realize what is happening or they never even knew how disrespectfully they were treated once anesthetized. That the medical industry hides all this info from patients tells me that they know it isn't right but they do it for their convenience nonetheless. <br /><br />It makes me glad I chose to go the no-sedation route for procedures that normally call for sedation. Thus far that has included colonoscopies, an upper endoscopy, and a tranesophageal echocardiogram. None of them were a big deal unsedated. Does anyone know if cardiac caths can be done w/o sedation? Bikerhttps://www.blogger.com/profile/14337739874615826612noreply@blogger.comtag:blogger.com,1999:blog-7571658.post-88010614719360732732019-02-14T05:35:57.976-08:002019-02-14T05:35:57.976-08:00Biker,
We have filed against 2 nurses with the st...Biker,<br /><br />We have filed against 2 nurses with the state AG (here in Indiana they oversee prof. licenses) and they are currently investigating. The Board of Health said they while we have issues the issues that we have are not ones they investigate as they only investigate issues that would result in Medicare revoking a hospital's Medicare payment. As for the Joint Commission, they said they would not investigate as this hospital from hell does not belong to the Joint Commission. I have not filed against the doctors involved--should that be done? There was one monster doctor who said the informed consent had been done and he was the admitting doctor. He does not say he did it or who or when the consent was supposedly done. Then there was the monster who actually did the procedure and he just said consent had been done but again not by who or when. On the actual consent form, 2 of the cath lab heifers signed it 5 minutes after they inputted into the Epic system that consent was on file. There is a wavy line where a doctor is supposed to sign but there is no time associated with that wavy line. That wavy line may also be part of one of the heifer's signature--it is hard to tell. In any case, we will file with whoever we can. Also, we have given the case to an attorney here who does a lot of medical cases. <br /><br />Does anyone here on the board know if a staff member with radiology certification should be present during a PCI? There is not one listed as being present in his file. The four heifers involved are just listed as being RNs with one being a scrub. The scrub was the really vicious looking one who was really mean to him. The radiation concern is another reason why he would not have agreed to this procedure as he has had cancer in the past. We have since found out that the doctor they assigned him was not as experienced as he should have been and the amount of radiation was higher because of his lack of experience.<br /><br />Has anyone seen this site? http://www.easeapplications.com/nurses-perspective-communication-operating-room/<br /><br />The first thing I noticed is a nurse standing there with a cellphone and video on? It is an app. I think that any cell phone should be prohibited from patient care areas especially including the OR or such. I am going to our local chamber of commerce on Friday as our state rep usually goes for the luncheon. She is a wife and mother of 3 sons. Hopefully, I can get her attention about some of these issues. I am preparing my presentation. JR <br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7571658.post-14215643373189305602019-02-13T23:35:37.787-08:002019-02-13T23:35:37.787-08:00Ray,
On the credit page it says you can email them...Ray,<br />On the credit page it says you can email them at Pedestal42@icloud.com I believe. We have shown people this that work in surgery and this is common. They say they just tell people they are only going to expose area needed to make us think we are treated with respect and dignity. One of our friends is a scrub tech. She said there many people that do not have any reason to be there to be in the OR with us when exposed. When several of them were making fun of a woman who was overweight she said she sent them out for bad behavior. Yet, when she found my husband had surgery she was upset and asked why we didn't tell her he was having surgery because she wanted to check him out. And she met it in way I took it. We feel that any surgery where they expose us (which is all) we should be given all same gender support staff if we choose. We after all do get to meet a surgeon and even get second opinions if we don't feel trust in them, so why Not get a full team we are comfortable with. At our hospitals we are not allowed to read the consent. According to them it is a federal law and we have to sign and not make changes as is a contract. Videoing and others present along with photographs is included in the consent. How can this be legal? How can this be informed consent? <br /><br />In our business if I give them one of our contracts and they need to make changes we all sign and initial any changes that that customer needs. Every contract we have can and often needs to be altered. We sign, and date any changes before we complete the transaction.That way the contract is between and agreed upon by both parties. MS KSAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-7571658.post-24136675210803390062019-02-13T21:05:29.285-08:002019-02-13T21:05:29.285-08:00Ray.
Of course he was going to reassure her. As a...Ray. <br />Of course he was going to reassure her. As as long as nobody was interested in seeing her naked body , then she would maybe be covered up or maybe she wouldn't.JFnoreply@blogger.comtag:blogger.com,1999:blog-7571658.post-25003355644815258262019-02-13T18:40:28.779-08:002019-02-13T18:40:28.779-08:00Biker: Can you find any reference to the healthcar...Biker: Can you find any reference to the healthcare organization in which the youtube video on prepping the knee was made? The only reference I see is to the Pedestal Project. I've not found anything that makes sense when I've gone online to track down the Project. The video can be referenced in the paper I wish to write, the first part of which I will post in the next few minutes.<br /><br />Regarding that video, I interviewed a Master's prepared nurse with 20 years experience who taught BSN nursing students. She was also a state representative. She said that typically, patients are left naked en masse while being prepped for surgery. A dozen naked bodies of both sexes may occupy the prep space. Apparently, it's not only healthcare providers who have visual access to these patients but people from many walks of life, even other patients. Regarding the latter, I interviewed a 23-year-old female college student who was flabbergasted when she was wheeled into a prep room to prepare for surgery and saw a bunch of naked anesthetized men, one of whom was getting his pubic hair shaved. She asked the physician who was going to do the surgery on her if she would be treated the same way as the men. According to her, he laughed and said, "No,we will give you your privacy." -- RayRay B.noreply@blogger.comtag:blogger.com,1999:blog-7571658.post-12440724555876239032019-02-13T18:09:21.965-08:002019-02-13T18:09:21.965-08:00JR: Have you filed a complaint with the State Boar...JR: Have you filed a complaint with the State Board of Medicine and the State Board of Nursing? Some states have a Board of Healing Arts. Have you tried to find an attorney? Have you tried to find a media person who might take an interest in your situation? Did you file a complaint with the Joint Commission?<br /><br />If you do all of these things incuding what you've already done, you'll probably find that the typical response is no response. However, you might raise an eyebrow or two. -- Ray<br /><br />Ray B.noreply@blogger.comtag:blogger.com,1999:blog-7571658.post-16083200945537239682019-02-13T17:12:44.932-08:002019-02-13T17:12:44.932-08:00Ray, thanks for the explanation. I posit that most...Ray, thanks for the explanation. I posit that most of the privacy/modesty/dignity violations in healthcare settings are not at anyone's direction but rather because the staff just doesn't care, especially if the patient is a male or is sedated or anesthetized. <br /><br />Somehow long ago the group-think in healthcare arrived at the conclusion that normal societal norms concerning privacy/modesty/dignity don't apply in healthcare settings. That video I posted really does speak volumes in the casualness in which they left that guy exposed, especially given it is being used to train future OR staff. <br /><br />The true disconnect is when healthcare staff almost universally insist that they do respect patient privacy/modesty/dignity. If so that training video would never have been done in the manner it was..... unless they truly don't believe it matters once the patient is sedated or anesthetized. Personally I think it matters even more given patients aren't in a position to defend or advocate for themselves. Bikerhttps://www.blogger.com/profile/14337739874615826612noreply@blogger.comtag:blogger.com,1999:blog-7571658.post-18686516920497521392019-02-13T17:06:03.423-08:002019-02-13T17:06:03.423-08:00Biker: I forgot about my Feb. 12th 11:00pm post. ...Biker: I forgot about my Feb. 12th 11:00pm post. I may be becoming demented or maybe I was half asleep. The analogy is this: We often hope that people who do evil things are outliers -- exceptions to the rule -- when, truth be known, their behavior is replicated many times by many others. Those experts who believed that only 8% or so of subjects would follow Milgram’s orders to the end were among those who believed that only outliers would do such things. They were off by about a factor of 8. I would have to be hard pressed before I agreed with someone who said with authority that it’s only outliers in healthcare who do evil things (including defending the evil doers). How many doctors and nurses participated, directly or indirectly, in the evils that occurred at Abu Ghraib. If you believe Steven Miles, M.D. (“Oath Betrayed: Torture, Medical Complicity and the War of Terror”) the answer is, “All of them.” That’s hardly evidence of outliers. At the same time, however, there is reason to believe, from Milgram’s study, that the people who commit evil acts may, in fact, be outliers – it depends on the situation. He and his colleagues found that only 3% of subjects followed an authority figure’s orders when they had to put the confederate’s hand on electrodes to shock him. At the other end of the continuum, 93% of Milgram’s subjects followed his orders to the end when they played subsidiary roles in the exchange. These findings, among others, are behind Zimbardo’s (who was Milgram’s student) observation that whether or not people participate in evil depends on the “power of the situation.” In some situations, almost all actors will participate in evil while in other situation only a few outliers will do so. -- RayRay B.noreply@blogger.comtag:blogger.com,1999:blog-7571658.post-64848742459031577612019-02-13T14:49:51.698-08:002019-02-13T14:49:51.698-08:00Biker: I don’t reference Milgram’s experiments an...Biker: I don’t reference Milgram’s experiments and other experiments such as Zimbardo’s Stanford prison experiment as analogies. They have been used and continue to be used by academicians to help others understand why people, including “good” people, do evil things and why people put themselves in harm’s way. <br /><br />After the Abu Ghraib debacle was made public, news shows on the major TV stations used both Milgram’s experiments and Zimbardo’s experiment to help explain why the debacle occurred. Phillip Zimbardo was interviewed many times following Abu Ghraib and spoke of the Lucifer effect – why good people do evil things. The experiments have been used to help understand the rise of the Nazis, the Sand Creek massacre, the My Lai massacre, the Tuskegee Syphilis experiment, the outrages of the American eugenics movement, and so on. They can even be used to help explain why a female McDonald’s manager ordered a 17-year-old female McDonald’s employee to strip naked at the orders of what the former believed to be a security officer giving her commands from the main office over the phone. The studies can also be used to understand why the girl truckled to the demands of her boss to strip even though she could have refused to do so. Similarly, the studies can be used to help understand why some healthcare providers do evil things to patients and why most patients let them do it.<br /><br />By the way, Zimbardo was hired by the defense of one of the Abu Ghraib defendants. His function was to get the jury to understand why a soldier (whose name escapes me) who, until he messed up, could have been a poster boy for the armed forces. Zimbardo may have been persuasive, but the jury convicted the soldier anyway and he was sentenced to the max – 10 years. -- Ray<br />Ray B.noreply@blogger.comtag:blogger.com,1999:blog-7571658.post-87792205775306467362019-02-13T14:25:37.991-08:002019-02-13T14:25:37.991-08:00Good Afternoon:
Biker, I saw the video you refere...Good Afternoon:<br /><br />Biker, I saw the video you referenced. Without a doubt in my mind if the patient was a woman, the other females in the room would have made it their number one priority before doing anything else to make sure she's covered up and her dignity was protected from everyone else in the room.<br /><br />The mindset in the medical community is if its a female, cover her up and keep her covered. If its a male, who cares, if we get to it we get to it.<br /><br />Regards,<br />NTTNTThttps://www.blogger.com/profile/16277382808413575689noreply@blogger.comtag:blogger.com,1999:blog-7571658.post-87617470582145599432019-02-13T11:12:06.871-08:002019-02-13T11:12:06.871-08:00JR,
Have the hospital respond to your removal req...JR,<br /><br />Have the hospital respond to your removal request in writing. You then can sue for a violation of your Constitutional right to due process. The fact that a name can NOT be removed means that the system is defective as it does not allow for corrections or one to change their mind.<br /><br /><br /><br />-- Banterings<br /><br /><br /><br />A. Banteringshttps://www.blogger.com/profile/05026455474056909739noreply@blogger.comtag:blogger.com,1999:blog-7571658.post-74948847542538676252019-02-13T08:32:50.530-08:002019-02-13T08:32:50.530-08:00Ray B, if I understand what those experiments were...Ray B, if I understand what those experiments were about they were about people knowingly following orders to inflict pain. I'm not sure that is the best analogy for healthcare. <br /><br />The problem patients face, especially males, is the casualness with which they are left exposed either for staff convenience or simply because they don't think it matters. Here I'm talking about the masses of healthcare staff, not the purposeful voyeurs or sexual predator exceptions.<br /><br />The attached YouTube video speaks volumes about the casualness. This guy is lying there totally exposed and nobody is in a hurry to cover him up. Why? He's under anesthesia and doesn't know he's been left exposed and so presumably the staff thinks it doesn't matter. The leg not being operated on has already been wrapped up which begs the question how long before the start of the video has this guy been lying there exposed? <br /><br />https://www.youtube.com/watch?v=eXWDA5xb1_4<br /><br />I would add that the fact that they were creating this video for educational purposes and still thought leaving the guy exposed was OK speaks volumes for just how casual the thinking is that patient exposure simply doesn't matter to them. I don't know who the audience is that is being trained but they are being taught patient privacy is a non-issue once the patient is sedated or anesthetized. <br /><br />I do wonder if it was a female patient would one of the women in the room have covered her up. Bikerhttps://www.blogger.com/profile/14337739874615826612noreply@blogger.comtag:blogger.com,1999:blog-7571658.post-47655595181582990012019-02-13T04:47:49.368-08:002019-02-13T04:47:49.368-08:00Ray B.
I am with you in doing something. I am go...Ray B.<br /><br />I am with you in doing something. I am going to make an appt. w/ my local state rep and state senator discuss:<br />1. The inequality of intimate care for males and females<br />2. The lack of true Informed Consent<br />3. The use of conscious sedation drugs to selectively erase memories<br />4. The overuse and use of drugs such as fentanyl to control & make pts. compliant<br />5. The falsification of medical records and the lack of complete reporting<br />6. The use of medical information meaning your information is sent everywhere<br />7. The shroud of secrecy that protects the medical community <br /><br />Please anyone, feel free to add to my list as I want a comprehensive platform. Being pro-active is the only way to get things done. <br /><br />I saw on tv this morning about a nurse singing to her female patient in TN and my immediate thought was all my husband got from his female nurse was violated. We are beyond grateful with all they did to harm him that he was able to survive their abuse. Going to the hospital and having encounters with these people should not add to your illness and you should not have to defend yourself from them at such times of crisis. It is time for a change and better treatment for all.<br /><br />I have filed w/ the OCR on HIPAA and freedom of religion/choice violations. I have filed with our state's attorney general's office on the nurse's licenses. I have filed with the State Board of Health about the hospital. I have done reviews on all the doctors and the hospitals involved on places like Yelp. I want everyone to know about these places and people and what they do especially in the cath lab and when men are drugged out of their minds. At least when functioning normally, you have a fighting chance but when they purposely drug you for compliance reasons, you are totally defenseless and at their mercy of which they have non. <br /><br /><br />Medpage did a piece yesterday on HHS wanting to expand EHRs. I think this is a bad idea as most providers you go to do not need your whole history. Also, your social security number no longer needs to be used but is transferred if it is on your EHRs. For cath lab records, my husband's ssn is on just about every form. That is so once it is entered into the NCDR national database for cath lab and chest pain, they can track him forevermore. This was done without his permission. We are now in a battle to have his name, social security number, and information removed. Since he didn't sign the consent form, he didn't agree to this. The hospital from hell says it is too late that they sent his information. I said that's too bad get it deleted as you did not have his permission to do this nor could you have explained a 3 page consent form to a drugged man laying naked, violated, and coerced on your cath lab table while being prepared for said procedure in a room full of nurses, emts, and clerks. Informed consent is not supposed to be done that way. No one has taken credit for saying they actually gave him informed consent which is curious that no one is willing to take responsibility for this dirty deed. Since the procedure records are full of inaccuracies their accounting of the events are suspect as they couldn't remember 2 minutes after the procedure ended what they had actually done. Although it seems like a clear cut case, we know it will be an uphill battle. However, with the discrimination of them thinking he was gay, the blatant invasion of privacy both in his medical records and physical being, the great number of falsifications of his medical records along with their federal violation of freedom of religion/choice of my son and myself, I think we have a case that with persistence can be won. I know that don't care but they do care about the bottom line and that is money and power. The other thing they like doing to patients is exposure and I want to give both hospitals plenty of exposure as they seem to like exposure. JR <br /><br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7571658.post-59016397081759651282019-02-12T21:11:57.923-08:002019-02-12T21:11:57.923-08:00Maurice: I was reading some earlier contributions ...Maurice: I was reading some earlier contributions to volume 94 and noted that several people mentioned outliers. It brought to mind Milgram's mock-shock research whereby subjects believed they were giving dangerous voltage level (over 400 volts)shocks to Milgram's confederate (who was not really being shocked). Before the experiment began, Milgram asked people in the know (psychologists/psychiatrists) what percent of the subjects they thought would follow his orders to shock all the way to the end, they answered somewhere around 8%. In fact, 2/3 of the subjects followed Milgram's orders to the end. Milgram's research was deemed unethical and was never fully replicated. About 10 years ago a psychologist (last name Burger) was challenged to replicate part of Milgram's study because so many people were of the opinion that people were different now. Burger made a few cosmetic changes in the method, received IRB approval, replicated part of Milgram's study and found the same thing that Milgram did. My point, although our faith in human kind may compel us to expect all but a few outliers will do evil things, we are likely to be disappointed when the facts become known. History is ripe with examples. -- Ray B.<br />Ray B.noreply@blogger.comtag:blogger.com,1999:blog-7571658.post-74387076615661143912019-02-12T20:10:21.995-08:002019-02-12T20:10:21.995-08:00Well, we've been describing, analyzing, and co...Well, we've been describing, analyzing, and complaining for years. Let's do something about what we've been describing, analyzing, and complaining about for years. Sociologists who have studied social change tell us that change in a system (e.g., health care system) will not get to first base unless there is some degree of collective dissatisfaction. Martin Luther King observed that collective dissatisfaction is not possible unless people know what's going on. For example, black men who were subjects in the Tuskegee Syphilis experiment did not become disgruntled with their treatment until some upstart physicians and attorneys with solid ethical foundations informed them of what government doctors were up to. So, the first step in fostering collective dissatisfaction if not outrage is to inform people's ignorance regarding the unnecessary indignities that have been and are taking place in healthcare and the differential distribution of ethical/legal violations by gender that are occurring.<br /><br />I recommend that we pool our knowledge and complete a paper to send to a widely read journal designed for public consumption such as Men's Health. Tomorrow, I'll let you know more specifically what I have in mind. -- Ray B.Ray Bnoreply@blogger.comtag:blogger.com,1999:blog-7571658.post-78279433058890292352019-02-11T20:57:24.648-08:002019-02-11T20:57:24.648-08:00Banterings, physician clinicians are not a minorit...Banterings, physician clinicians are not a minority in ethics discussion or arriving at clinical ethics conclusions. There are many active and thought provoking physicians (incidentally, beyond myself) who participate on the multiple clinical ethics listservs, attend clinical ethics meetings, write articles and are essential parts (including chairpersons) of hospital ethics committees. Thus, physician clinicians are active participants and provide input to the discussions of all ethical issues by philosophers, social workers, lawyers and other non-physicians.<br />Clinical physician ethicists do exist and we are communicating with and requested for consults and education by other physicians in medical practice. ..Maurice.<br /><br /> Maurice Bernstein, M.D.https://www.blogger.com/profile/07618638650784869923noreply@blogger.comtag:blogger.com,1999:blog-7571658.post-3820935366977465402019-02-11T16:45:32.152-08:002019-02-11T16:45:32.152-08:00I think most of us non-medical people would be sur...I think most of us non-medical people would be surprised at how much of our information including photos or video taken during surgery is out there. Since it is clear that there is very little respect for patient privacy and/or dignity, it means nothing to them to use us like that. The Informed Consent forms give them the right and even if it didn't, they would assume they have the right.<br /><br />If you haven't been a victim of this medical system, then it is difficult to understand. You don't know what happened to you when you were put "under" and your memories were purposely erased. It is akin to rape and you have no idea how many strangers participated in the fun of your situation. You don't know how cell phones may have pictures of you and to who those pictures have been sent to. <br /><br />Not only for us is what happened during the cath lab an issue but it went on to be an issue when a nurse and at least one other nurse couldn't refrain from laughing and smirking. These same 2 nurses also were alone with a drugged, defenseless man for hours while they purposely isolated him from his family. There was no medical reason why they kept him apart from his family except they could and did. Also, the nurse freely admitted that she exposed him needlessly because she claimed about over 10 years of nursing and being in the Cardiac Critical Care Unit, she somehow did not know how not to expose the genital area when looking a the groin wounds. And to top it off, she was laughing when she said it. It is the knowing that these people who we pay to take care of us during our illnesses are sometimes exploiting us. It is the not knowing everything they did to you while so vulnerable but knowing enough to realize what they did was very, very wrong and sick and you feel defiled. Going to the hospital should not create this feeling but when you have suffered abuse, it does. Now, we look at each and every one of them as a possible sexual predator. We do not have faith in their ability not to do or cause harm. That night he had his heart attack, we were unprepared for all of this other.<br /><br />And for those who say, get over it that they see naked bodies all the time, haven't yet experienced the feeling of total helplessness, betrayal, broken trust, and emotional trauma that was caused. My husband had prostate cancer and is no stranger with his genital area being exposed. However, it was the manner and how they did it. There are respectful ways and there is a way that this hospital of horrors did it. There was no reason for his genital area to be exposed. His groin is not his penis. Even if they needed to sterilize the area which they don't need to as the Covr garment takes care of that, it could have been done quickly and covered. They did not need to strip his clothes off of him without his permission and stuff them into a pink garbage bag (yes, pink for woman power-ironic isn't it?) and leave him totally naked and exposed for over 30 minutes without a blanket or gown in a room full of 4 women, 3 EMTs, and countless techs and others such as a registration lady and possible minister. How in any world is this okay to do? Why does a registration lady need to see his genital area? He didn't get to see hers and she certainly would have been offended if he had mentioned this but she and others shouldn't as being naked doesn't matter or does it?<br /><br />I have decided that I am going to start Twittering as much as I dislike it. I think the hashtag I have decided on is #happens2mentoo. I think the public needs to be made aware that females nurses are predators too. Too often the story is about male nurses. It is not that female nurse do not act inappropriately but rather men don't make their sexual abuse public as they feel they will be victimized more. I am also thinking about #cathlabsRcesspools as my other one so maybe people will become educated as to what really happens at cath labs or has the potential of happening. JR<br /> <br /><br />Anonymousnoreply@blogger.com