“Before you make fun of a patient, make sure their cell phone recorder is turned off.”
– Chuck Gallagher, Ethics Speaker and Consultant (2015)
This is a story with just a little bit of age on it, but I have the feeling that it occurs so often (maybe even as you read this), that it will be “evergreen” until physicians and nurses challenge themselves with ethical training.
Man showing tongue upside down .
The original article, appearing in the Washington Post (June 24, 2015) by writer Tom Jackman is entitled: “A surgical team mocks a sedated patient — and it’s all recorded.”
The procedure, a routine colonoscopy was conducted in Reston, Virginia. The patient decided (quite rationally, I might add), that he would be so “druggy” after coming out of surgery that he would record the instructions and the observations of his gastroenterologist following the procedure. I guess in his nervousness, he turned the smartphone recording app on before the procedure began and without realizing it, it ran through the entire procedure.
A funny thing happened when he began to listen to the recording: the team “mocked and insulted him” as soon as they knocked him into semi-consciousness. Here, for example, is what the medical professional who claims to be an anesthesiologist said:
“After five minutes of talking to you in pre-op, I wanted to punch you in the face and man you up a little bit.”
Then during the procedure:
“When a medical assistant noted the man had a rash, the anesthesiologist warned her not to touch it, saying she might get ‘some syphilis on your arm or something,’ then added, ‘it’s probably tuberculosis in the penis, so you’ll be all right.’” The assistant also called him a retard.
The cost of stupidity
The team has probably done hundreds of colonoscopies and so I understand the old concept of familiarity breeding contempt. Nevertheless, they were conducting a medical procedure on a patient; they are not changing tires in a tire store or mixing buckets of paint at Home Depot. According to the article, their mockery of the poor guy continued almost non-stop:
“So the man sued the two doctors and their practices for defamation and medical malpractice and, last week, after a three-day trial, a Fairfax County jury ordered the anesthesiologist and her practice to pay him $500,000.”
The anesthesiologist has been fired, but the patient’s suit was in part successful because the physician in charge of the procedure did nothing to discourage her idiotic comments.
“Court documents state (Doctor) Shah also made some insulting remarks — ‘As long as it’s not Ebola, you’re okay,’ Shah was recorded saying during the rash discussion.”
What was really idiotic is that the patient was even mocked for going to a college that was once an all-women’s school. They “wondered aloud” if the patient was gay, a completely nonsensical and inappropriate comment.
Then the genius anesthesiologist said, “I’m going to mark ‘hemorrhoids’ even though we don’t see them and probably won’t,” and did write a diagnosis of hemorrhoids on the man’s chart, which the lawsuit said was a falsification of medical records.”
There is little doubt in my ethical mind that the team ran this kind of commentary on nearly every patient they treated. Who would have known otherwise? In their minds it was harmless, and as long as they “did their job,” no one was hurt. Of that point, I am not certain.
Malicious intent
The first thing to establish or rather to re-establish, is to stress that as a society we have lost huge chunks of what was once considered “privacy.” You have to assume that you are always under surveillance and that you are frequently being recorded. It can be a good thing – or bad. In this case, it was a good thing for the patient.
The anesthesiologist had “problems” with the patient and her attitude was hostile and unprofessional. I might also add unethical and arrogant. The fact that she went out of her way to make a notation on the chart of a condition that didn’t exist was downright stupid. Worse, the physician in charge did nothing to prevent her from doing it.
Whatever issues they perceived the patient as having; nervousness, fear, feelings of shyness, shame or any combination of those responses, was far less serious than the lack of ethics and unprofessional attitude of the team.
I wonder if the patient had an issue or a concern that could have affected the procedure, if the anesthesiologist would have even heard it.
I have long called for on-going ethical training as a requirement for a renewal of licensure. It is my belief that poor ethics of this nature is not stable, it “cascades.” That is, it gets worse over time. At what juncture does a lack of ethics give way to a lack of compassion and missing a sign of trouble?
It is an ethical issue worth exploring.
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