The New York Times and its “The Ethicist” feature continues to offer its jaw-droppers. This is one example in which the fact that someone asked the question is the stunner. A doc wrote in to explain that a patient he was treating for sepsis was uttering racist and homophobic slurs at staff members.
The doctor had a talk with the patient and outlined the conditions for her treatment. The patient was warned to stop or she would be discharged, against her will if necessary. According to the doc, risk management and the nursing staff were A-OK with this approach.
Thankfully, that patient stopped. However, the doc wanted to know if it would be okay to discharge a patient who did not meet conditions of treatment. The doctor admitted that because the patient had a substance abuse problem releasing her with oral antibiotics would perhaps be a death sentence.
Let’s look at this quasi hypothetical. You have a drug-addled, septic patient who is uttering hurtful things to the staff. And risk management determined that a death sentence was an appropriate response? Could I get a Hippocratic oath here?
Whatever was causing the patient to mouth off, bigotry or medical condition, means you have a person all of us need to rein in. But that’s the point — we don’t impose a death sentence. What the patient was uttering hurt the staff and no one should be faced with that level of verbal abuse. However, the dehumanization of bigots and feeling justified in ending their lives will not fix the underlying hate.
The doc, the nursing staff, and risk management all missed an opportunity to turn the other cheek and humanize the staff — a means for overcoming the damaging hate of bigotry. Had the Barometer been the CMO of the hospital or a risk manager or head of nursing, well, here’s a different approach.
Ask one of the staff members who was verbally and undeservedly hurt to go with you into the patient’s room and say, “This is my colleague and friend. She has worked at this hospital for 15 years. I have watched her save lives. I have seen the loving care she has given to you and so many others. She is one of the finest people I know. Please do not hurt my friend with name-calling or slurs. Treat her with the respect this wonderful human being who has cared for you deserves.” We change hearts and minds when we see humans instead of letting outrage (however well justified) drive our attitudes and decisions.
Instead, the doc and others went to risk management with its processes and procedures, and then to the patient with threats. They dehumanized a patient so that they could impose a death sentence for bad words and worse behavior and feel justified in abandoning the ethical essence of health care.
We give medical care to prisoners, enemy combatants, and POWs who have taken our treasure. Surely we can muster the same compassion for an ill drug addict whose slurs offend.
The solution the medical professionals came up with stopped the behavior. But no heart or mind was changed vis-a-vis the patient. Worse, they introduced dehumanization into their medical care. No good can come from that development.