Withholding Medical Care From a Bigot and the Dehumanization Movement

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.

About mmjdiary

Professor Marianne Jennings is an emeritus professor of legal and ethical studies from the W.P. Carey School of Business at Arizona State University, retiring in 2011 after 35 years of teaching undergraduate and graduate courses in ethics and the legal environment of business. During her tenure at ASU, she served as director of the Joan and David Lincoln Center for Applied Ethics from 1995-1999. In 2006, she was appointed faculty director for the W.P. Carey Executive MBA Program. She has done consulting work for businesses and professional groups including AICPA, Boeing, Dial Corporation, Edward Jones, Mattel, Motorola, CFA Institute, Southern California Edison, the Institute of Internal Auditors, AIMR, DuPont, AES, Blue Cross Blue Shield, Motorola, Hy-Vee Foods, IBM, Bell Helicopter, Amgen, Raytheon, and VIAD. The sixth edition of her textbook, Case Studies in Business Ethics, was published in February 2011. The ninth edition of her textbook, Business: lts Legal, Ethical and Global Environment was published in January 2011. The 23rd edition of her book, Business Law: Principles and Cases, will be published in January 2013. The tenth edition of her book, Real Estate Law, will also be published in January 2013. Her book, A Business Tale: A Story of Ethics, Choices, Success, and a Very Large Rabbit, a fable about business ethics, was chosen by Library Journal in 2004 as its business book of the year. A Business Tale was also a finalist for two other literary awards for 2004. In 2000 her book on corporate governance was published by the New York Times MBA Pocket Series. Her book on long-term success, Building a Business Through Good Times and Bad: Lessons from Fifteen Companies, Each With a Century of Dividends, was published in October 2002 and has been used by Booz, Allen, Hamilton for its work on business longevity. Her latest book, The Seven Signs of Ethical Collapse was published by St. Martin’s Press in July 2006 and has been a finalist for two book awards. Her weekly columns are syndicated around the country, and her work has appeared in the Wall Street Journal, the Chicago Tribune, the New York Times, Washington Post, and the Reader's Digest. A collection of her essays, Nobody Fixes Real Carrot Sticks Anymore, first published in 1994 is still being published. She has been a commentator on business issues on All Things Considered for National Public Radio. She has served on four boards of directors, including Arizona Public Service (1987-2000), Zealous Capital Corporation, and the Center for Children with Chronic Illness and Disability at the University of Minnesota. She was appointed to the board of advisors for the Institute of Nuclear Power Operators in 2004 and served on the board of trustees for Think Arizona, a public policy think tank. She has appeared on CNBC, CBS This Morning, the Today Show, and CBS Evening News. In 2010 she was named one of the Top 100 Thought Leaders in Business Ethics by Trust Across America. Her books have been translated into four different languages. She received the British Emerald award for authoring one of their top 50 articles in management publications, chosen from over 15,000 articles. Personal: Married since 1976 to Terry H. Jennings, Maricopa County Attorney’s Office Deputy County Attorney; five children: Sarah, Sam, and John, and the late Claire and Hannah Jennings.
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