Ethical and Religious Directives - Part Three

Part Three of The Ethical and Religious Directives for Catholic Healthcare Facilities is is entitled, "The Professional – Patient Relationship." To touch into the heart of the material, let’s do some "supposing."

Suppose it’s a weekday evening. You and your family have had dinner, done the dishes and are into your mid-evening activities.

Suppose the phone rings and the caller identifies herself as a pollster doing research on provider-patient issues for a prestigious organization. She wonders if you’d be willing to give her six or seven minutes to answer some questions.

Suppose that because she didn’t call you during your dinner hour, clearly explained her reason for calling, and gave you a real chance to say "no," you decide to cooperate and say, "Sure."

So suppose she asks you to indicate, using a scale of 1 to 10 (10 = totally outraged), how upsetting it would be if you discovered the following health care related information:

—That after several years of seeing a certain physician, you learn that the latter has little genuine concern for you. In this person’s mind you are little more than a meal ticket for the provider and the provider’s family. Response:___

—That in a recent medical situation, when you were quite ill, your physician was less than honest about your situation, failing to share key facts that would have made a difference in what treatment you agreed to. Response:___

—That during the above episode people involved with your care talked about your situation in such a way that it became known in the community and neighbors soon knew the specifics of two decisions you and your family made. Response:___

—That the health care facility you entered to undergo surgery deliberately downplayed the importance of having an Advance Directive. Their reason: "They just complicate matters and tie the hands of our physicians who know what’s best for patients." Response:___

—That that facility takes a similar attitude towards encouraging a patient to identify in advance a representative —someone to make health care decisions as the patient’s surrogate—in the event the patient loses the capacity to make health care decisions. Their reason: "It injects amateurs into complex situations." Response:___

—That the facility’s professionals don’t provide the patient or surrogate all reasonable information about the essential nature of proposed treatments; i.e., they regularly fail to indicate treatment side effects and costs. Response:___

—That the facility has no resources to help patients and families understand the moral/ethical aspects of their situations, nor does it have a code of ethics to guide it in its medical and business operations. Response:___

—That among health care "insiders" in the community, the facility is known to treat people differently, depending on their income and status; i.e., they "can’t do enough" for the prominent and wealthy, but are barely civil to poor people or those with socially discredited conditions. Response:___

—That the patient’s assessment of the benefits and burdens of a proposed treatment is seldom solicited and, if known, is generally ignored by providers. The reason: "We know what’s best for people. We don’t like patients and families deciding what we should or should not do." Response:___

—That when patients, in assessing the benefits and burdens of proposed treatments, are inclined to turn down options that would impose an excessive expense on their family, the facility pressures them to disregard those worries and undertake the recommended option. The facility’s rationale: "Simple economics – we’re here to grow our bottom-line." Response:___

*****

Suppose at this point your caller indicates the interview is complete, and she thanks you for your cooperation as she says, "Good-bye." Chances are most, if not all, of the just-described situations would leave you quite upset.

From time to time violations like these can take place in a professional-patient relationship. But Catholic health care doesn’t want such abuses in institutions it sponsors. For that reason, principles enunciated in Part Three of the ERDs make clear what is and is not expected of us in matters such as the above.

With the above scenarios in mind, read that ERD section and see if every listed abuse isn’t addressed with wisdom and compassion.