It was a long time ago, the same galaxy. It was shortly after September 11th, and I was working on the dialysis unit in Butte, Montana. Yeah, the name looks like butt, insert Beavis and Butthead laugh here. Everyone was in a dark-assed mood. Lower Manhattan was still in chaos, and we were still coming to grips with the towers falling. We hurt as a nation because honestly, we aren’t used to having terror attacks on our soil unless you count Columbine, Oklahoma City…Yeah, this was an outside source, and it got a lot of attention. So how does this deal with healthcare, Nursie poo?
Well, shortly after the attacks, our intelligence agencies figured out that it was Al Qaeda led by Osama bin Laden, America’s newest face of evil. Public enemy number one hiding in Afghanistan. So, the US went into Afghanistan with the intent of finding him. We were the same information society that we are today, inundated with all kinds of news about everything Osama related. In this deluge of info, we discovered that he had End Stage Renal disease. The only treatment for ESRD is dialysis or transplant. He needed this to survive. This brought out mixed emotions, and eventually, the ethical question came up. What if you had to treat him?
Well, one nurse on the unit, I’ll call her Jackie, said she would, “fix it, so it was the last run he ever had.” I stepped back, stunned. When the natural, “excuse me,” came out of my mouth she very confidently repeated herself. Ok, I get we were all shocked about the event less than 2 weeks before. We had been attacked like we never had been before unless you count Columbine, Oklahoma City…
Finally, I asked, “why would you have that right?” and “how can you justify it ethically?” She said that she could do it and it wouldn’t matter. The people would be on her side for such a public takedown of a terrorist. She indicated she did have to be ethical in this situation. When I asked why she indicated that it was because he was an evil person and should be punished. Yeah? Punished by who? Certainly not her as judge and jury. She then started on a tangent about how it was a holy war against Christianity, and of course, I was lost in the absolute, bat crappery of her argument. How is she the “chosen one?”
While the people on the unit did agree that they would treat him, they also said that they would call the authorities. That’s sound behavior. Like ethical people who know how to do their job as a professional, specifically, medical professionals who can put their prejudices and beliefs aside to treat someone who is ill.
Okay, so why this long run Nursie poo? Ethics, plain and simple. You want us to be ethical when we provide care for you. You want us to use an acceptable and honest treatment. You want us to provide care that is based on the most recent and current evidence for treatment of disease processes. You want us to “do no harm.” Jackie missed that train. She was extremely upset when I called her out on this, to the point she was an impossible harridan to work with after that. She thought I was supporting the terrorists, even though her behavior and ideas showed that she was more in line with them than I was.
No, Jackie, I was supporting human life. It was not my place then or now to use my medical knowledge to harm someone, or ever. Yes, even in a physician-assisted suicide role. While I have no issue that it should be allowed, I am not sure that I could assist that process because of my own issues with death and dying. It’s not the fact that a dignified death was going to occur, but I would refer that person to someone who would give my patient what I feel to be the best care they could receive besides mine.
When I treat someone, I always look for the best practices, the meds or treatments that will work for them financially, the treatments that will help them maintain quality of life, and most importantly a plan they agree on. When you and your primary care practitioner work together on your treatment plan, there is a far better chance that it will be successful. I would not and do not look for things that would purposefully harm people, treat in a manner that was not supported by current evidence, or try to work against the patient. I’m not Jackie, and thankfully, Jackie only aspired to be a part-time staff nurse so she could participate more actively in her church, bless her heart, cause lord knows she needs more Jesus in her life…
Well, it seems that the flu finally reared its ugly head here. Time to see how that plays out.