Tuesday, August 17, 2010

Cancer Therapy & Privacy Part 3

Part 2 is full. Please continue here. For continuity I will add the last comment from Part 2.


Joel Sherman said...

Taken from Part 2

Art Stump wrote: "In my view it’s not a failing for people to have unquestioning trust in their caregivers and their caregiving institutions. That’s part of the dependency dynamic that envelopes the seriously ill."

I agree, Art. But it's such a fragile trust that a if it's compromised, the result is what you describe in your book. And that trust can then be permanently lost.

As I've written on this and Bernstein's blog -- some of this is how medical professional are socialized to "see." We learn to "see," and we learn to "not see" certain things. Some (many)learned to become immune to nudity and modesty. We see what we think is relevant. For many (s0me?)medical professionals, modesty and nakedness isn't relevent in what they do. The relevent thing is saving or helping the patient, or perhaps "success" (whatever that means for them).
This is where medical education comes in. Not only the academic education, but more importantly the "hidden" or "underground" education -- what they learn in the field from other professionals -- e.g. "This is what they taught you in school, but here's the reality; this is how we do it around here." Sometimes this info is good. Sometimes it's not, but rather just time-saving or cost cutting measures.
Art: Would you get my email from Dr. Sherman and contact me? I'd like to discuss something with you privately.

Anonymous said...

This is a swing of the pendulum. Providers or more acurately the administration pushed the line of modesty's value in the equation and there wasn't much push back, so the pushed it a little further, and a little further to where we are today. providers for all of their admiral intentions become a tool of the administration to provide a means to and end of two often conflicting goals patient care and profits. Offering patients gender choice costs money, providing garments that are more conducive to modesty costs, they compromise patient comfort for the benefit of profits. How else could you explain a hospital gown that everyone knows patients hate for a completly mobile patient, the same gown used for a comatose patient, really, they need the same garment? Its cheaper and easier to provide the I-C-U gown for all than stock different styles to accomodate patients modesty preferences. They make disposable colonoscopy many have been offered one? why? a patients comfort isn't work $3.50...unless we demand it or go where it is provided.

Biker in Vermont said...

This thread is long dormant but it caught my attention being my PSA is slowly rising and I am educating myself a bit on prostate cancer protocols.

In reading through the many posts there was something that nobody ever spoke to. I am thinking that despite the quality care Mr. Stump received, his hospital was in some ways stuck on the 60's as concerns their protocols. The hospital is apparently an old facility if they don't have private changing areas for patients. That being the case, if treating patients with respect was a priority, for $100 they could have privacy screens in a corner of the treatment room, and a couple hooks on the wall to hang clothes. Yet the best they could do is to sometimes have a nurse or tech hold a sheet in front of the patient? A sheet that the nurse could see over while the patient disrobes? Really?

Mr. Stump describes being exposed for his treatments, which of course led to him being in that state when the high school girl was invited in. My understanding is that having the genitals fully exposed is not standard protocol elsewhere. The radiation is not being aimed at the penis or testicles. They can be kept covered. Not covering his genitals with a sheet or towel just speaks to patient privacy simply being a non-consideration there.

When Mr. Stump had his volumetric study and was positioned in stirrups, his genitals were again just left fully exposed. Why? His genitals could have been kept covered with a towel or sheet while they accessed his prostate.

Memorial Hospital clearly was stuck in a time warp as concerns patient privacy, or at least male patient privacy. That the staff were polite and friendly does not equate to their having treated him with respect. The high school girl was just the most blatant example of disrespect is all, but it doesn't seem their protocols were respectful in any aspect of his treatment.

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