Thursday, October 4, 2007

Information, Consent, and La Operacion

After watching La Operacion, I was initially torn. I agreed with the idea of disseminating information on birth control and sterilization to those who might not be aware of their choices, especially since prevalence of small family sizes has been linked to a country's economic development. Nevertheless, I had concerns with the ways in which these women were "informed": having the husband sign the papers and make the decisions, not mentioning to women that the surgery is irreversible, etc. Overall, though, I felt the program "meant well" but had too many racist and eugenic overtones for it to be completely morally acceptable. My ambiguity on the subject disappeared after an incident that happened two days ago.

On Monday (incidentally, right after our class) I got a text message from my best friend saying she had food poisoning and wouldn't be able to meet with me later as planned. That night, I got another text message saying that she was in the ER with her sister being treated for dehydration related to the food poisoning. While I was concerned, she told me she was fine and that she would see me the next day. I found out the next morning that she was admitted into the hospital the night before, and I spent all of Tuesday afternoon in her room. No doctor appeared for the 6 hours I was there, and she and I both had no idea why she was still in the hospital. The nurses and technicians continually took blood tests and inserted her with IVs, not really explaining why they were doing anything. When we asked what they were testing for, they just said "food poisoning" or "we're not sure," even though by this time she was eating, walking around, and had not been nauseous for 18 hours. I was outraged that the hospital staff was not disclosing the whole truth to us, and this was a matter as insignificant as food poisoning, nothing as serious as sterilization. While I had read of this chasm between doctors and patients before, I had never truly experienced it. Now, I believe that no treatment (on a small or large scale) is justified without the full and informed consent of the patient involved. My friend is fine; she finally told the staff that she wanted to leave and they let her go. I have no idea why they didn't earlier.

2 comments:

A New View said...

That's really interesting about your friend's situation. I just finished reading a significant portion of And the Band Played On: Politics, People, and the AIDS Epidemic, and the book has mentions multiple times the concept of hiding the truth from a patient. However, the book explains that the doctors were not actually hiding truth from patients; rather, they themselves were trying to figure out what was going on. Is it possible (knock on wood) that your friend could have potentially had soemthing that the doctors didn't want to scare her about? Is it ethical for a doctor to not tell his patients about a hunch he has?

emorycmh said...

While I think you bring up a good point about doctors not being sure, or not wanting to scare the patient, when does it become the right time to the tell the patient. If they want to leave they should know the whole situation. If they're being kept for almost 24 hours for food poisoning, I think it becomes the right time to say, even if it's something as simple as "we need to do a few more tests, there are some things we want to look further into."