An account of how a large Catholic medical center has lost its way. Go to to see recent updates.

Tuesday, March 14, 2006

Ethics Committee at OSF

Ethics Committee at OSF

The American Medical Association’s representative of the Ethics Standards Group sent me a copy of relevant opinions from the AMA’s Code of Medical Ethics.

During the fall of 2001, I had spoken to Dr. Gerald McShane, Director of the Ethics Committee at OSF-Corporate, regarding my opinion of the conflict of interest at OSF and its relationship with Advanced Medical Transport. Dr. McShane advised me at the time that he did not think that OSF’s ethics committee should be consulted regarding this. He just did not feel it was an appropriate topic to be brought up as an ethical issue. I thought it was appropriate for many reasons. I spoke to Joseph Piccione, Corporate Ethicist at OSF, about the same issue, and he stated that I was mandated to bring up the issue. When I wrote five OSF Corporate leaders about what I regarded was a serious conflict of interest (OSF-AMT)in May, 2002, I never received an answer from anyone.

In the Spring of 2004, a former Haitian Hearts patient, Willie Fortune, needed to come back to OSF for pacemaker surgery. Haitian Hearts offered OSF-SFMC full charges for Willie’s surgery. He was dying and needed the surgery. He was denied. I asked Mr. Piccione to take this patient abandonment to the ethics committee at OSF for formal review. I never heard whether Willie’s abandonment was even discussed by the ethics committee at OSF and never heard from anyone on ther ethics committee besides Piccione who said he was pretty helpless to do anything. (How could he be as “Corporate Ethicist”?)

So the OSF ethics committee didn’t really help out when they were needed. The issues they needed to discuss were very close to home–too close to discuss openly and without bias.

Some recommendations to OSF regarding ethics committees from the AMA may include the following from the AMA literature:

1. Generally, the function of the ethics committee should be to consider and assist in resolving unusual, complicated ethical problems involving issues that affect the care and treatment of patients within the health care institution. This would been a potential help for Willie and the thousands of people in the Peoria area who dial 911 each year.

2. Ethics committee members should not have other responsibilities that are likely to prove incompatible with their duties as members of the ethics committee. This would be to avoid conflict of interest with members of the ethics committee. Dr. McShane told me that Keith Steffen sat on the ethics committee, thus he did not think it was appropriate to bring up AMT. I also asked Dr. McShane for my impending termination and Keith’s management style in his office to be brought up to the OSF ethics committee . McShane discouraged this also due to Steffen’s presence. Maybe Keith Steffen should not be on the ethics committee. Piccione and McShane sat on the Diocesan Haitian Hearts committee and were not helpful, in my opinion, regarding the survival of Haitian Hearts at OSF. Therefore, I don’t see how Willie would get a “fair hearing” with Piccione, McShane, and Steffen on the ethics committee. (I am not sure if Steffen is still on the committee or not, but McShane told me he was when we talked in 2001.) It seems Willie took low priority or no priority in the Catholic medical center that speaks substantially about “respect for life”.

3. When a religious order operates a medical center, the mission statements should be taken into consideration in the committee’s recommendations. Respect for life, taking care of the poor and marginalized should be important to the OSF ethics committee…that is, if they will discuss the topic.

Below is an article written by Joe Piccione in InterBusiness news in 2002. In 2005, Jackson Jean-Baptiste, a Haitian Hearts patient was denied care at OSF and died. In 2004, Willie Fortune, a Haitian Hearts patient was denied care at OSF, but survived after he was operated emergently at Vanderbilt for a failed pacemaker. I have never heard from the ethics committee at OSF after multiple requests during the past six years.

Welcome to InterBusiness Issues

Saint Francis Medical Center
Joseph Piccione
June 2002

Ethics a Mainstay in Health Care

When people hear the word "ethics" they tend to think in negative terms. That is too narrow of a perspective, but with the recent Enron and Arthur Andersen debacle it is easy to understand why that negative view persists.

In classical Greek philosophy, ethics was considered a positive good to be attained and aChieved; for example, doing good in a good way made for happy people. Ethics is about good character and good decisions. Health care in the West is rooted in the Hippocratic tradition with its sense of duty, but also its professional fulfillment.

Living in today's pluralist society doesn't foster a common ethical theory. More collaboration is needed before there is consensus on norms, values, and happiness. For example, the Catholic Church and likewise, Catholic health care, does not support any form of assisted suicide. Yet the state of Oregon passed a law legalizing physician-assisted suicide, not making it ethical, but making it legal in that state.

All health care, regardless of the sponsoring organization, values human dignity. In fact, the five hospitals in the tri-County area all follow and support the standards of the Joint Commission of Accredited Healthcare Organizations. On the very first page of the Standards Manual, the Commission notes, "Patients have a fundamental right to considerate care that safeguards their personal dignity and respects their cultural, psychosocial, and spiritual values." The first page ends with "managing the hospital's relationships with patients and the public in an ethical manner."

Jim Moore, OSF Healthcare System CEO, frequently states in presentations health care is the second most regulated area behind nuclear power plants. There are many checks and balances to make certain rules and regulations are followed by those of us in health care so we always do what is right. Recently, there has been a proliferation of newly-formed compliance departments in hospitals and corporate offices of health care systems to further ensure adherence to the vast number of rules and regulations (state and federal) under which health care entities operate.

The Health Insurance Portability and Accountability Act was passed by Congress and will have many positive impacts on patients and providers; chief among them are specific mandates regarding patient confidentiality which compliance departments and many others in health care are actively planning to address in time for implementation by April 2003.

Another forum to ensure we in health care do what is right is the ethics committee. All hospitals have an ethics committee which can be accessed by patients, family members, and care providers to foster patient involvement or to discuss a concern or question. Maintaining and enhancing human dignity is one of the major guiding principles of ethics committees and health care in general.

Ethics is both ancient and contemporary, and continues to be an active mainstay in health care today. Ethics has an abiding place in health care-primarily among the professionals who encounter persons at times of their vulnerability.


Did Mr. Piccione really believe what he wrote?

Please see post below Peoria City Council---February, 2006. In this post I wrote Dr. McShane again about presenting to the ethics committee regarding the ambulance monopoly in Peoria. Dr. McShane did not respond again.

1 comment:

fedUP in Peoria said...

where ARE these so called "ethics"? in their pocketbooks?

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