GESTIÓN EN SALUD PÚBLICA: BioEdge: Memo to hospitals: prison wardens do not own their prisoners

domingo, 17 de marzo de 2019

BioEdge: Memo to hospitals: prison wardens do not own their prisoners

BioEdge: Memo to hospitals: prison wardens do not own their prisoners

Bioedge

Memo to hospitals: prison wardens do not own their prisoners

by Michael Cook | 17 Mar 2019 |

Big Stock Photos

Hospitals should check whether a person issuing a do-not-resuscitate (DNR) order has been authorised to do so. This seems to be the hard lesson to be learned from a lawsuit against the warden of St Clair Correctional Facility in Alabama.

On January 6, 2014, a prisoner, Marquette F. Cummings, Jr, was stabbed in the eye by another inmate. He was airlifted to University of Alabama at Birmingham Hospital, in a critical condition.

Although the hospital told Mr Cummings’s mother that her son only had 10% of his brain capacity, she thought that he was responding to simple commands like “blink if you can hear me”.

Even though family members were present at the hospital, the prison warden, Carter Davenport, instructed doctors not to take “heroic measures” to save Mr Cummings life. The hospital thereupon issued a DNR order. Later on, ignoring protests from the prisoner’s family, Mr Davenport ordered that he be removed from life support. Hospital staff told the family that because the State had legal custody of Mr Cummings, whether or not he should die was the warden’s decision. Mr Cummings died on January 7.

Ms Gaines and Cummings’s estate filed a lawsuit against Mr Davenport, alleging he had showed deliberate indifference to Mr Cummings’s medical needs and that he did not have the authority to issue a DNR order.

This seems to have succeeded. “Nothing in the [Alabama] Act empowered Davenport, as a prison warden, to act as the surrogate of a dying inmate,” the Eleventh Circuit Court of Appeals wrote in a decision last October. “The Act is fatal to Davenport’s defense of qualified immunity.” (The case was only reported earlier this month).

Michael Cook is editor of BioEdge

A California family was outraged recently when their grandfather was told that he had very little time to live by a "robot", or rather, what the media described as a robot. In fact, it was a teleconference screen mounted on a robot lectern. I don't suppose that the distinction makes much difference. The elderly man's children and grandchildren were horrified by the cold detachment of the procedure.

The hospital apologised, of course, but the incident is symptomatic of the impersonality which pervades our culture. Prodded on by our love affair with technology, human relations are being reduced to formal interactions. It may be overstating it to say that competence in face-to-face contact is a dying art -- but something is changing. To have a dozen Facebook "friends", for instance, is hardly the same as having a dozen friends.

But an even more -- I was thinking of inserting the word "sinister" but I won't -- application is the reduction of human sexuality to the twin and separable functions of recreation and reproduction. In an article below, British IVF pioneer Simon Fishel predicts that robots will handle the whole process of conception, from harvesting gametes to transferring embryos.

It seems to me that defending humane relationships will be one of the key challenges to bioethics in the coming decades.