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Friday, March 03, 2006

Trust in Physicians

Trust In Physicians

Jerome Kassirer, M.D. recently wrote a book entitled “On The Take”. It reports extensively how medicine’s complicity with big business can endanger your health.

In one of the last chapters, Dr. Kassirer quotes Cardinal Joseph Bernardin regarding the topic of trust. Cardinal Bernardin gave a talk to the American Medical Association and gave a description of the covenant that must exist between a doctor and a patient. He explained that this covenant“is grounded in the moral obligations that arise from the nature of the doctor-patient relationship. They are moral obligations—as opposed to legal or contractual obligations—because they are based on fundamental human conepts of right and wrong. While…it is not currently fashionable to think of medicine in terms of morality, moralaity is, in fact, the core of the doctor-patient relationship and the foundation of the medical profession.

“Why do I insist on a moral model as opposed to the economic and contractural models now in vogue? Allow me to describe four key aspects of medicine that give it a moral status and establish a covenantal relationship: First, the reliance of the patient on the doctor. Illness compels a patient to place his or her fate in the hands of a doctor. A patient relies, not only on the technical competence of a doctor, but also on his or her moral compass, on the doctor’s commitment to put the interests of the patient first. Second, the holistic character of medical decisions. A physician is a scientist and a clinician, but as a doctor is and must be more. A doctor is and must be a caretaker of the patient’s person, integrating medical realities into the whole of the patient’s life. A patient looks to his or her doctor as a professional adviser, a guide thorugh some fo life’s most difficult journeys. Third, the social investment in medicine. The power of modern medicine–of each and every doctor–is the result of centuries of science, clinical trials, and public and private investments. Above all, medical science has succeeded because of the faith of people in medicine and in doctors.This faith creates a social debt and is the basis of medicine’s call–its vocation–to serve the common good. Fourth, the personal commitments of doctors. The relationship with a patient creates an immediate, personal, non-transferable fiduciary responsibility to protect that patient’s best interest.

The moral center of the doctor-patient relationship is the very essence of being a doctor. It also defines the outlines of the covenant that exists between physicians and their patients, their profession, and their society. The covenant is a promise that the profession makes–a solemn promise–that it is and will remain true to its moral center. In individual terms, the covenant is the grounds for the public’s continued respect and reliance on the profession of medicine.”

Patients in Peoria need to be able to trust their doctors. Patients that suffer emergencies need to be able to trust that the physicians in charge of the 911 system and ambulances have the system set up with the patient at the central focus and not set up to enhance the best interests of the doctors or the company which they are affilliated. When patients only have minutes to live, the first arriving responder at the scene who is most capable of caring for the patient during this valuable time period, should be able to. The Peoria Fire Department should not have to wait on AMT to arrive or wait until AMT asks them for help to assist the patient (with a breathing tube, for example.) The doctor is charge of this policy, Dr. Rick Miller, needs to change this. What would Dr. Miller want if he were the one with the medical problem?

OSF should not forget Haitian children that need heart surgery. Making them whole again makes all of us more whole. We will help ourselves if we help them. The technology is in Peoria. The money is in Peoria. Haitian Hearts is in Peoria and will gladly do the work that no one else will. The Sisters are in Peoria. The secular leaders of OSF need to think in terms of making society better, not just their bank statements. The Sisters pay their secular leaders enormous salaries. They need to be “good stewards” of the faith and trust the Sisters have placed in them to help the poor and marginalized (including Peoria’s psychiatric patients). The Catholic Diocese of Peoria need to push OSF in the right direction and not fear OSF’s money and influence at local and state levels. Bishop Jenky needs to practice what he preaches from the Catholic pulpits in Peoria. Most importantly, Peoria’s laity need to demand changes and challenge Bishop Jenky and the OSF Sisters to do the right thing, as Cardinal Bernardin was pleading.

1 comment:

NUT with a Consience said...

Dear John Carroll I AM one of those psychriatic patients that has been "marginallized" I have A chronic Bi-Polar disorder. I found it nessecary to "quit" my job after my last Bi-polar episode so I could recover at home under a Drs care since the St. Francis closed their mental health unit. Methodist mental unit is full 99.9% of the time Zeller's is gone. but the same still sick people are here wandering the streets of Peoria in and around St. Francis picking up ciggerette butts and looking for a place to stay during the day.They collect in many places around Peoria even at the Police station where my cousin works.Some people around town think they are just a bunch of "weirdos" on the fringe.But i know many of them from being in the mental ward at OSF {with them} when there was a mental ward.Even the DR that has worked my case over the last 20yrs has left Peoria. I had always felt "lucky" I wasnt one of the people picking up ciggerette butts and wandering the streets I had insurance and a good Dr. that has since left.Now Im the one who lives in fear My present he only deals with the "medication" side of my illness and doesnt deal with any of the Give and take dialologe i at times find neccasary to function with this illness it is not as simple as "find another Dr" Most of the good ones have already left Peoria such was the case with my previous Dr. as well as my insurance has limited my no. of choices the Bi-Polar has "cycled" about every 18 mos for the past 20yrs I managed to keep a job most of the time with the help of the good Dr. I had and knowing St. Francis would be there for me "just in case" holding a job has always aggravated this illness I no longer have the security of a knowing St Francis mental unit was there for me in case I needed it without a good Dr AND a good LOCAL mental health unit available I cant keep a job when My illness cycles and I have NoWHERE to go The public needs to know you cant SIMPLIFY everything the mental health "crisis " Is just that a crisis that has affected every asspect of my life including how I support myself and make a living. I dont want to be a "burden on society" but now that "society has become a burden "on me I have no choice but to either hit the welfare rolls disability or both.

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