Monday, August 31, 2009

Town Hall meetings...

Gosh, it's been a busy summer...

I've been working long hours, like my partners, in our nonprofit medical and dental practice. We're working harder to see more and more underinsured and uninsured patients.

And, I realize that I need to spend some more time updating this blog with comments about the storm which is raging across the US this summer, as seen in the Town Hall meetings.

I'm struck by the question of one of the attendees of the meeting going on this evening, in Bremerton, where this woman asks why she had to develop renal failure to warrant medical insurance coverage. Great question!

So, I'll see if I can address some of the issues that I hear coming up so often in these "discussions." ...

Tuesday, August 4, 2009

Summer Seminar in Clinical Ethics...

I'm out of the office this week, at the Summer Seminar in Clinical Ethics at the University of Washington.

I'm sitting in a large classroom, terraced with desktops in front of a projection screen at the University of Washington School of Medicine. It reminds me of so many hours spent in similar rooms during my own med school classes at the University of Kansas. Some things have changed a bit - projector screen instead of just blackboards, and an electrical outlet next to each chair so that I can plug in my notebook computer and connect to the internet via UW WiFi. Actually, I was the first student at the University of Kansas School of Medicine to bring a full-screen laptop computer to take notes in class, back in 1985. That was a Data General ONE. So, computers have been getting me into trouble for years!

So, I find myself in this classroom, with 150 others from around the country, talking with experts about the concepts of medical ethics. And, what a time to review these concepts...

The first case yesterday brought it into focus for me:

"A homeless man with a history of drug abuse visits his primary care physician. Overall, he states he is doing 'pretty good', but is clearly malnourished. He does not have specific medical complaints, but says what he really needs is a loan of $100 to get a 'roof over my head and some food.'"

So, the question posed to the group was, "Does the doctor have a responsibility to the patient?"

And, this brought things into focus for me because we are so embroiled in rhetoric about healthcare reform that we are losing sight of the big issues...

So, does "the doctor" have a responsibility? Well, YES! As a member of society, we ALL have a responsibility to this man. (Have you heard that story about the Good Samaritan? Try reading the story again: Luke 10:25-37.) One of the scholarly pursuits of ethics is to define the underlying principles which lead to ethical decisions, to "right" choices. And, I find the basis for addressing much of today's debate in the red-letter words of the New Testament.

So, that's why I'm here. That's why I'm working where I do. I hope that those around me can see that basis in the way in which I choose to live.

How did the class respond to the question? I'm afraid they answered in a much narrower way, by saying that the doctor had only a limited responsibility to assist his neighbor. We have our text book for the week, but I'm afraid that many of the class didn't bring the other Book!