We had a discussion in class not to long ago were we talked about the law and ethics of a psychiatrist having a patient whom expressed thoughts of killing someone. We discussed if the psychiatrist should break that confidentiality and tell someone or not. I think that sometimes people can take thoughts way to far, but on the other hand you never know what someone is capable of doing. If I was the psychiatrist on the case I would try to get as much information out of the situation that I could before coming to any conclusions. If I didnt think that person was really out to hurt anyone I wouldn't want to ruin our progess and trust on what could have been a stupid little comment that he/she didnt mean. I mean who hasnt had a thought like that before... well I dont know I could say something if I was really mad but I wouldnt really mean any harm to anyone. It made me think of my best friend in high school and one of her good friends at the time. The friend had sexual relations with her boyfriend or something and they ended up hating eachother. Well my friend, not a harmful person at all, drew a picture of the girl hanging from a tree and it got in the other girls locker somehow. Well my friend was expelled immediately, I was shocked! I mean i guess you never really know what someone is capable of doing and they had to do what was right for the safety of their students, but I thought it was ridiculous I knew this girl couldnt hurt a fly. I was pretty shocked, I thought suspension and counceling maybe, but being expelled wow. I think this relates to our discussion in class just to the simple fact that you just never know and you have to take precautions to every action.
A case study we had this past week was about a medical assistant sending her patients to get a new order for some lab work that needed to be done after she couldnt read the physicians hand writing. When I first read this case I was kind of shocked that their was even an ethical issue in it at all because little things like this happen all the time, whether it be insurance, getting prescription, or records from another place. I didnt think it was their responsibility for things like that, I mean I questioned it in some instances, but never thought anything could be said about it. I mean I do not know how many times I would have a prescription faxed over to the pharmacy and I would wait an excessive amount of time, especially enough for them to get the prescription ready and by the time I got their they never recieved the fax and I had to call the doctor or go and get a handwritten prescription. This really makes me mad because I am obviously upset, I drove all the way up their for a prescription they didnt recieve, and then they want me to do the work to fix the problem, when it wasnt my fault in the first place! :-) Or how about trying to get records from place to place and they make up excuses on why or how its not their responsibility to get them to fax it! Or the calling to the insurance... this one happens alot, the place I go to says in their paperwork I am covered with my insurance, but them something goes wrong and I am not and I have to make a hundred phone calls to make sure I am covered. I could go on and on with little situations like this, but I guess it's life, you have to do what you have to do. Next time I do think that it is their responsibility I will use my knowledge from class to come up with something smart to say and see if they second guess what they are trying to do.
I wanted to discuss how debate #3 went. I think that we did extremely well I think the conversation kept going back and forth with information and I was proud that neither team were stumpt. It was a little hard to debate with people relating situation to their work (whether it be at a hospital or pharmacy) because it made me feel a little stupid! But thats ok! Overall I had alot of fun with it and thought it was a good experience!
Sunday, March 29, 2009
Monday, March 9, 2009
Octamom and Discussions
I have been hearing about the Octamom on my hour drive to school every morning. I didn’t know much about it but kept hearing about artificial insemination for over six kids, I thought wow thats definitely an ethical issue. Being lazy I wrote notes about it and found out more but never posted a blog, then I come to school and what do we talk about... Octamom, man there goes my blog entry. But it is still something I hear about so much and figured hey I can talk about it still, I just won’t have as much to say. I think that this woman cannot be all together psychologically, who in their right mind would put that many kids through what she is. She made a statement about being the only child and always wishing she had siblings, ya but two or three kids in her situation would have been fine. I am so confused where she gets the money for the artificial insemination and for plastic surgery, especially the way the economy is right now. I don’t understand how she got approved for any type of loan. I can’t even get approved for a car under 14 thousand right now and I have good income and a high credit score. Someone has to be behind her in all of this whether it be the media’s support because their making money off of her or something! Not to mention in our class aspect this is ethically and morally wrong. I think that the doctor shouldn’t have been able to do that procedure that many times and I think he should have been stopped somehow someway. I think that the kids in a way should be taken from her but in a way shouldn’t. I don’t know how she is going to afford the needs of the children when she obviously only thinks of her wants. I just wanted to express my opinion on this case because it is taking up so much media and shouldn’t, she shouldn’t be praised and given so much attention for what she is doing.
In class the other day we passed around ethical dilemmas to discuss and I could sit and talk about a lot of them for hours. The first one I remembered was a partner in a clinic going back to his old ways of using drugs. Should he be fired? I don’t think that would be ethically right at all, yes it might be legal due to the drug free work place, but what happen to the oath that everyone took to help others and to do no harm. In this situation even if he is a co-worker, not a patient, you would think as a physician your first instinct would be to help him and do anything you could to help, so you know inside that you tried everything to help, and if it doesn’t work there wouldn’t be any guilt left about it, you can only try so hard. My first step would be to address the issue, I would say look man I can tell you have started using again and you could put your job, life, and/or life of your patients in jeopardy as well. If he didn’t realize and make a suggestion then and there I would refer him to classes or rehab depending on the severity of his usage. He would have to take leave from work to get his act together. Hopefully in that time frame he would realize what he would be loosing and straighten up his act and if not we would take the situation further. Firing someone right off the back would be a horrible thing to do and could involve lawsuits, guilt, and more problems than needed.
Another situation was instance were a perfectly could surgeon got really upset and through a tantrum and flipped a surgical trey. My opinion on this is everyone has their bad day, I have, you have, and I am sure everyone has. The big question is, is how many times has this happened, did she seem to have anger problems with patients or co-workers before, and has she had problems in the past. In this case she hasn’t, she was well known for her good work and professionalism. In my opinion she should be spoken to and asked her problem of why she was having a bad day and what set her off? I would explain to her that it is unacceptable and that if something like that was persistent that following actions would be taken, but I would say that understand mistakes happen and for her to learn from this one and try to do something else to deal with her anger. It is really funny that this exact dilemma was brought up in class because me and my brother were talking about a similar case were he works in Mississippi, not saying hospital names, but a surgeon was performing and the surgical tech kept handing the wrong instruments to the doctor, like this case a perfectly known doctor and a good one at that, he got so angry at her he flipped the trey, broke sterile field by taking off his gloves walked to a desk close by and pulled out an application to waffle house told her to fill it out and get the F*** out of his OR. Nothing happen to this surgeon in this case and yes I believe it is a little different, I believe that performance was uncalled for and some kind of action was needed to be done.
I love how dilemmas and cases can always be pertained to real life situations, that’s what makes this class so interesting to me, IT’S REAL!
In class the other day we passed around ethical dilemmas to discuss and I could sit and talk about a lot of them for hours. The first one I remembered was a partner in a clinic going back to his old ways of using drugs. Should he be fired? I don’t think that would be ethically right at all, yes it might be legal due to the drug free work place, but what happen to the oath that everyone took to help others and to do no harm. In this situation even if he is a co-worker, not a patient, you would think as a physician your first instinct would be to help him and do anything you could to help, so you know inside that you tried everything to help, and if it doesn’t work there wouldn’t be any guilt left about it, you can only try so hard. My first step would be to address the issue, I would say look man I can tell you have started using again and you could put your job, life, and/or life of your patients in jeopardy as well. If he didn’t realize and make a suggestion then and there I would refer him to classes or rehab depending on the severity of his usage. He would have to take leave from work to get his act together. Hopefully in that time frame he would realize what he would be loosing and straighten up his act and if not we would take the situation further. Firing someone right off the back would be a horrible thing to do and could involve lawsuits, guilt, and more problems than needed.
Another situation was instance were a perfectly could surgeon got really upset and through a tantrum and flipped a surgical trey. My opinion on this is everyone has their bad day, I have, you have, and I am sure everyone has. The big question is, is how many times has this happened, did she seem to have anger problems with patients or co-workers before, and has she had problems in the past. In this case she hasn’t, she was well known for her good work and professionalism. In my opinion she should be spoken to and asked her problem of why she was having a bad day and what set her off? I would explain to her that it is unacceptable and that if something like that was persistent that following actions would be taken, but I would say that understand mistakes happen and for her to learn from this one and try to do something else to deal with her anger. It is really funny that this exact dilemma was brought up in class because me and my brother were talking about a similar case were he works in Mississippi, not saying hospital names, but a surgeon was performing and the surgical tech kept handing the wrong instruments to the doctor, like this case a perfectly known doctor and a good one at that, he got so angry at her he flipped the trey, broke sterile field by taking off his gloves walked to a desk close by and pulled out an application to waffle house told her to fill it out and get the F*** out of his OR. Nothing happen to this surgeon in this case and yes I believe it is a little different, I believe that performance was uncalled for and some kind of action was needed to be done.
I love how dilemmas and cases can always be pertained to real life situations, that’s what makes this class so interesting to me, IT’S REAL!
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