Over servicing is unkind, unnecessary and unethical
An eighty nine year old man ended up in the Emergency Department of his nearest hospital, gasping for air. Chest X Rays showed an accumulation of fluid in his lungs.
Doctors diagnosed a widespread vessel disease, also called peripheral vascular disease, and regurgitation caused by a poorly functioning heart valve.
The man knew the end of his life was approaching.
He considered ceasing all medical treatments and just accepting morphine and palliative care. However his wife insisted that he go to a private cardiologist to review his case and see if surgery was possible.
‘Doctors can perform wonders’ she insisted. ‘You have got private insurance, why don’t you use it?’
Informed consent means giving people a realistic picture of risks versus benefits
The heart specialist stated that he could fix the man’s problems with open heart surgery.
‘With a coronary artery bypass grafts and a valve replacement, you’ll return to a normal life’.
The man finally agreed. Within a few days he was booked in for open heart surgery in a private hospital.
After the operation, his wife came to visit him in the hospital. Instead of recovering well, her husband was agitated and crying.
‘Take me home’ he told his wife. ‘I’m going to die. Let me go in peace’.
The wife brushed aside his concerns and urged him to be positive.
A few days later the man went into cardiac arrest. Deprived of adequate blood flow, his kidneys failed.
Private surgical patients can end up in public hospitals if they need emergency treatments
Despite performing complex surgical procedures the private hospital did not have the resources to manage unstable patients. The man was promptly transferred via ambulance to an Intensive Care Unit in a public hospital.
Nursing and medical staff there expressed private frustration that an elderly man with a serious medical history had been given open heart surgery.
His wife didn’t understand why he had been taken out of the plush private hospital and put in a noisy, busy public hospital.
The man’s adult children all came to see him. They were shocked and distressed to see their father intubated and attached to a noisy, beeping ventilator machine.
Dialysis was started. Cardiac drugs were given intravenously, to try and centralise blood flow to vital organs and increase the pumping action of the man’s heart.
Intensive Care is noisy, invasive and distressing
These drugs also decreased the blood flow to his hands and feet. Over the next few weeks his feet became blue from lack of blood flow. Toe ulcers started to develop.
His wife, children and grandchildren could not communicate with him.
He was being kept in a dream like state, on sedatives, cardiac drugs. His bed was surrounded by noisy machines, ventilators, dialysis, drug and fluid pumps.
The final vision the family had, was of the tracheostomy tapes holding in the breathing tube, cutting into his white face. His fingernails were dirty. He lay unwashed and half naked in a narrow hospital bed, surrounded by the beeping noise of machines.
Six weeks after open heart surgery in the private hospital, the man died in a public Intensive Care Unit.
His funeral was unhappy. Instead of remembering a life well lived, the family fought over whether he should have been given such aggressive treatment at the end of his life.
© Wikihospitals 2014