Comments on: Mandating medical care?

By: Doc99

Doc99 — Fri, 08 Jan 2010 13:34:43 +0000

“Judge not, that ye be not judged.”
Matt 7:1

“The police acted stupidly.”
President Obama

By: Steve Pitschka

Steve Pitschka — Thu, 07 Jan 2010 22:24:21 +0000

Wow! Legal medicine lives on.

By: TireDoc

TireDoc — Wed, 30 Dec 2009 20:44:36 +0000

Here’s reality people. This whole thing is an unfortunate consequence of our society “having it’s cake and eating it too”. You can’t say to anyone person that because of their training/social stature/moral station they are obliged to enter into a situation where they may later be second-guessed or otherwise held liable for a then unforseen outcome and expect widespread compliance. It’s simply myopic and unrealistic. And to those who would serve as “expert witnesses” on this or other cases you are singularly uninformed on the facts because you were simply NOT THERE, so you couldn’t know the mental state of the EMT’s, you couldn’t know whether other medical professionals were present and did or did not get involved, and you couldn’t know the patient’s state of health at the time of the “collapse”. All you have is hearsay and third person accounts. There are simply too many variables for the opinions of “experts” or anyone else who feels they know what “should have” happened to apply to rational thinking persons. That being said, our unfortunate reality is that we practice in a self-destructive environment where we retrospectively blame, incriminate and punish those whose role is to assist society during the most dire circumstances of our lives, (when the outcome is less than “desirable”- people don’t often say much if the result is neutral or good). The whole silly process is adjudicated by those least equipt to do so impartially, fairly and accurately. With such a horrible chimera of failings in our system, it would be surprising NOT to have individuals who refuse to participate in circumstances which carry the greatest liability. Why are they still part of the “illness management” machine? Had they known things were this messed up they likely would not have entered the field in the first place. The “high minded” in our profession need to wake up and realize our health care system is coding and events such as this are merely a symptom!

By: one__speed

one__speed — Tue, 29 Dec 2009 18:07:46 +0000

It was mentioned above that the two employees were at a coffee shop in the heaadquarters building where they worked as dispatchers for the FDNY.

So we have two people presumeably trained in first aid who may or may not actually be current in the skills needed to assess the patient.

When asked for assistance they recommended that 911 be called so an active crew can be dispatched to the scene. (very appropriate in my opinion)

We don’t know what the patients condition was or even if the assistance of two bystanders (sure, they were wearing uniforms) would have made any difference in the eventual outcome.

And really, how often does a 25 year old pregnant female with a non viable fetus die prehosptial where the intervention of bystanders make any difference what so ever ?

Ian

By: John Cutright

John Cutright — Mon, 28 Dec 2009 12:08:51 +0000

With a limited scope of practice, and no equipment, it’s unlikely that the two EMT’s could have changed the outcome. But the APPEARANCE of indifference makes them an easy target for criticism.

They, correctly, identified the need for a 9-1-1 response, perhaps in the face of their own inadequacies, but failed to provide BLS support. It may have made no difference, but they should have at least tried.

We make attempts to “save” individuals sometimes simply for the sake of family knowing that our efforts are futile. They, at least, should have done the same for the sake of the family. The failure to show a compassionate response is a moral and ethical violation. They should be fired.

By: Francesca

Francesca — Sun, 27 Dec 2009 01:29:07 +0000

alex21 says:
December 24, 2009 at 11:22 pm

I dug out an old article giving a good bird’s eye view of the law and its practice.
The Good Samaritan- by Dr. Leonard Berlin

http://www.ajronline.org/cgi/content/full/177/3/529 Wouldn’t be a problem if it is old as much as it is subjective in favor of removing all moral and legal implications to coincide. Clearly this is a matter that Doctors and lay people will most likely never agree. It’s sad that a Doctor even if wanted to render “good samaritan” aid needs to first worry about getting sued. Pity.

By: Fred Bollhoffer

Fred Bollhoffer — Sat, 26 Dec 2009 22:10:02 +0000

everyone talks about the morally right or wrong, the legally right or wrong.
ever had to defend yourself in court and win?
you will still pay your lawyer, the more you make the more that lawyer costs.
and we aren’t reforming the judicial system,
morally right is lost in this country ,

By: Silence Dogood

Silence Dogood — Fri, 25 Dec 2009 14:56:21 +0000

Can a government mandate certain behavior from its citizens and punish them if they do not conform to the law? Yes and no.
Forcing us to wear seat belts is a no brainer to most of us but there is a subset of the population who sees this as an infringement of their rights. Forcing us to wear clothes when in public is a good idea for most of us, however some people think that this should be their decision to make.
Now, if the government passed an edict that said that all unmarried women who get pregnant will be forced to have abortions…………..now, would the government be right in this case. We tried legislating morality with constitutional prohibitions to the manufacture and consumption of alcohol……and we all know what happened to that bit of social engineering.
So, my point is this……in some cases, government mandates for citizen actions is a good thing; for other government mandates, not so good. Forcing a doctor or a nurse or an EMT to act in a situation when they are not “on duty” would be one of those times where the government may have over reached its power. We can but hope that for the majority, the morality of their action or inaction would be much more determinate than the threat of government sanctions.

By: hawk

hawk — Fri, 25 Dec 2009 05:30:18 +0000

Don and Mystic

I thought I would get a couple of comments like this. I understand what you are saying, but I have known people who have been sued for rendering aid in an emergency, successfully, I might add. If you look at your malpractice, you will see that it likely does not cover you outside of work, and likely not outside of a shift.

If you want to risk everything by rushing to aid somebody, be my guest, but dont judge me based on my desire to not be sued. If you have been in er for 30 years, your practice probably predates residency training, and even in residency we were told not to stop and aid, for the legal reasons more than anything else.

On another note, what if you do stop and give aid, no protective measure, get hep C or AIDS. you are SOL in that case, as disability wont cover you for an injury or condition not sustained at work.

My hope is that one day, we will move past the legal system in this country, to the point where somebody who is highly trained, and who does care (and believe me I do care) is aboe to give care when needed, in whatever circumstance, without the fear of jackpot jury lawsuits. It probably wont be in my lifetime.

By: Francesca

Francesca — Fri, 25 Dec 2009 05:29:06 +0000

Dear “AfellowWhoCanRead”: You make a nice defense team member for Sir Whitecoat. Perhaps I and all others who have derived alternate understanding of Whitecoat’s post not know how to read! Please educate me by example of where exactly is specified Whitecoat’s post states morality in pre-hospital care protocol be spared the legal axe? Perhaps I have indeed projected that I would have hoped an intelligent Emergency Physician such as Sir Whitecoat, would think deeper before posing such a question. The fact that you state: “It is interesting to see how many people who are projecting upon WhiteCoat that which he specifically disavowed within his post.” might suggest that majority reaction is all dumb? I personally believe morals and integrity should not be put aside when it comes to legally mandating disciplinary action on this matter or many others. The fact is this case is based on deficit of moral substance of two EMT’s who did not react as many would have. Maybe I’m nuts but don’t all infractions like these have some foundation which can not set morals aside? I gather one would not have effect without the other. Oh well…just another crazy New Yorker talking so try not get your knickers all tied up in a twist! I talk straight and if someone disagrees, it’s OK. If they do agree that’s OK too! Pity really for Whitecoat or any other professional to have a public blog with comment section needing moderation for damage control on every move if they were unable to handle some back slap talk. Perhaps if Sir Whitecoat thinks I and others who have commented negatively are dumbos he might like to explain position himself. If my reaction is egregious, as you say it is, you “AfellowWhoCanRead”, defense team member of Sir Whitecoat, might submit claim for comment(s) to be removed by Comment Board of Directors. Apologize if have offended which was not my intention. I shoot straight from the hip, with little if any political correctness. Before lambasting my comments please take into consideration that I lack formal education, write run on sentences and dumb as nails. Hope knowing latter might get me some sympathy from a smart “AFellowWhoCanRead” like yourself. It’s Christmas and I wish all who celebrate a merry one.

PS… I’ve written a nice comment before on Whitecoat’s so please know I’m not for or against any particular blog or person!