The Limits (and Horrors) of Technology in the Patient World

The New York Times called attention to a horrific death in a NYC hospital earlier this month. It raised a plethora of issues about our right to privacy, as well as how, when and what types of technology, are appropriate to record patient encounters. And it is a pathetic example that calls our use of technology in healthcare on the carpet.

I won’t use any more adjectives. Here is a description by another blogger whose post called my attention to this, Glenna Crooks, PhD:

According to the stories, without their consent – in fact, without their knowledge – husband and father Mark Chanko was filmed for a national ER reality-show television episode while he received care. Until the segment was aired 16 months later, the family did not know a camera was present, that Mr. Chanko’s death was filmed and that the physician who delivered the news was wearing a microphone when he did.

The hospital argues that since his identity was concealed no consent was needed. Not concealed well enough apparently, since family and acquaintances recognized him and his voice. Can anyone imagine the pain when 16 months later his wife heard him say, “Does my wife know I’m here?” and one of the clinical team say, “Are you ready to pronounce him?”

My heart aches for his family. I agree with their attempts to seek redress from government and accreditation authorities and hope they win.

According to the articles, their pleas rest on claims the hospital violated Mr. Chanko’s privacy and on those grounds, they may not win. The Chanko’s are not the only victims, though. The spirit of privacy protection laws like HIPAA may well become a victim to the letter of those laws and how they are interpreted by attorneys and the courts today.

Read Dr. Crooks’ complete post.

She followed this blog with another that enumerated the policy issues that this kind of invasion invites. I recommend it. Read it here.

Her questions demonstrate the wide range of legal and policy issues raised by this kind of behavior. I imagine years of lawyers’ time spent arguing these issues! But in my heart, this situation requires us to examine deeper issues, such as the dignity of the person and the nature of the doctor-patient relationship. The plethora of policy issues arising from this incident reveal how far we’ve left behind the humanity of the healing exchange. Now society is the arbiter of what some might still argue should be a private, personal and intimate situation – our health, our diseases, our dying.

My mind reels with the policy implications, but my heart hurts for our humanity.

Reality TV is a symptom of how harsh and undignified our culture has become, and nowhere is it more evident than in these most private moments. As I recall journalism school lessons from a time long ago and far away, this case seems to violate a basic premise that we were taught to respect the dignity of private moments, and leave them out of the news. There were certain things that stayed with the family, especially with people who didn’t meet the legal definition of public persons. Sometimes, depending on the situation, common decency required restraint even when people did meet those criteria. Has our Instagram culture made all of us public figures, eschewing legal definitions for all practical purposes? Have we unwittingly – or witlessly! – allowed ourselves to lose our right to privacy by our un-private behaviors?

From a pure health policy perspective, Dr. Crooks raises issues that need to be addressed. One layer deeper, as a human being, you have to ask yourself: How did we get here? I suppose if the state/government is paying the lion’s share of the bills and the health plan bears most of the risk, the piper gets to call the tune. In that case, the payers can require that it is all about the regulations.

As a patient, as the mother of patients, as the partner of a patient, as the daughter of patients, as a family member and friend of patients, I wish we had a healthcare system in which people could be assured that their personal health and well-being was the primary interest of their treatment team.

You know what they say about wishes – if frogs could fly, they wouldn’t womp their butts…


One Response to The Limits (and Horrors) of Technology in the Patient World

  1. Pingback: Health Wonk Review: Super Bowl Edition « Healthcare Economist

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