Organ Donors-- Pro or Con

One day, while at work, a coworker of mine started to discuss his days as an EMT. As expected he began telling stories about his days of clinicals and started describing some of the gruesome things he had endured. As we continued to talk he began to speak about cases with organ donors. One particular story that has stayed with me for a while involves the life of an organ donor that was taken advantage of. He proceeded in telling me about a fatal motorcycle accident that occurred, he then went on to describe the steps that were taken to try and save this individual’s life (i.e. CPR and AED stimulation), he continued by explaining to me that once they had “tried” every outlet they began to ask if the individual was a organ donor. Once they had confirmation that this particular individual was an organ donor, their priority became to save not the individual but the organ. I understand that it is important to try and preserve precious organs, as I am a organ donor myself, however, I do not believe that the life of a human being should become second priority at any moment during recovering a life. At any rate, they tried reviving this individual once again before cutting him open and luckily it was a success. Upon arriving at the hospital, this individual’s heart rate was steady and he was being monitored closely.

After hearing this story I began thinking; Are organ donors taken advantage of because of the deed they pledge when they place “organ donor” on there driver license? Should EMT’s produce less effort when saving a life on an organ donor?

I was completely taken back when I heard this story and I now have tainted views of some EMTs. As an organ donor, you pledge to give your organ away upon complete effort in saving a life. It should in no way encourage giving less effort because of an opportunity to recover organs. Honestly, with regards to this particular incident, I hope that it was a one-time occurrence, otherwise, it has officially become a sad day in medicine.

Religion and Healthcare

In healthcare, physicians are faced with ethical dilemmas in their everyday lives. Physicians are viewed as advisors and healers; however, there are cases where morale and ethics come into play. At times physicians are faced with patients who may practice different religions than them. In a situation where a patient’s beliefs interfere with their treatment, is it ethical for a physician to sway the patients’ decisions? For example, within the beliefs practiced by Jehovah witness’s it is highly discouraged to ingest any blood; therefore, this religion does not practice the act of blood transfusions. If a patient of this religion has no other option but this treatment to save a life, as a physician, do you intervene and persuade this individual to perform an act outside the beliefs of their religion? Although this answer may seem apparent, when do you draw the line as a physician in allowing patients to make the right decision?

Religion is a very touchy topic that I believe should not be discussed outside of a religious setting. Physicians have the duty to ensure that all patients are cared for to the best of their ability and knowledge. It should be noted that although physicians do have the right to inform patients of their options, they do not have the right to discourage the patients religious beliefs. This issue is a tough one, if I were in the role as a physcian, I, myself would not know how to handle a situation such as this.

Rural v Urban Ethics

All across the country we encounter different codes of ethics and ways of life. However, in healthcare it becomes more complicated. Once accustomed to a particular way of life, it is hard to adjust to anything outside of what is considered the norm. As a healthcare professional, should it be considered ethical to bring a particular set of views and norms into a setting where these norms are anything but "normal"? After reading a selection from our required text I began to think about rural v urban civilizations. Healthcare in these two civilizations differ dramatically. For example, in an urban community racial and ethnic diversity spread beyond the city; however, rural communities continue to share common values, such as self-reliance, independence and cultural perspectives that influence healthcare practices in their regions. Although urban communities may have a enhanced outlook on future outcomes and beneficial strategies, should one interrupt a particular lifestyle to invoke these thoughts? Furthermore, rural healthcare organizations encounter distinct economic challenges. For example, the number of patients living below the poverty level is higher than in most metropolitan areas, while per capita income is lower. Once again, should fundraising and other tactical financial strategies be advised in a setting where one may practice the complete opposite? Lastly, across the county, many rural communites have limited access to – or simply nonexistent- healthcare organizations to healthcare professionals, including nurses, social workers, and mental health professionals. Should encouragement of more healthcare professionals and services be suggested in a community where they may have substitutes?

Overall, it can be thought of as a polite gesture to advise and suggest new ways to effectively deliver healthcare; however, because these two societies dramatically differ it can also be considered an insult. These beliefs plagued my mind as I thought of multiple ways the rural community could improve their form of healthcare, but who am I to suggest a change in culture in an environment where they have been accustomed to these norms. In all honesty, we could probably take some suggestions from the rural community and implement them into our current system. These communities exemplify the different areas and beliefs that this country embodies. Though we may consider ourselves a very commercialized and urbanized country, there are still areas in which we have left untouched. I do believe that it may be best to leave rural areas as is, because at some point in this crazy shuffle of healthcare we will need to revert back to the basics of health.

Incentives.... or not?

OK! Although incentives may seem like a pretty black and white topic, I feel as though it could be debated. In another HSA class that I am currently taking we were assigned to discuss our views on incentives. When I first took a look at the assignment I thought that it would be a no brainer but after reading my classmates responses I started thinking; Should incentives be used to encourage production of quality work?? Although many people would say yes, for the obvious reasons; such as motivation of work and better outcomes, I tend to disagree. Some say that for individuals who lack motivation incentive is a perfect way to get them moving in their area of work. I, however, tend to disagree. A friend of mine who works in a nearby hospital as a registration representative is the perfect example of how incentives can go wrong. Registration representatives are given goals to meet (i. e payment collection) in a specific time period. Although they may get their goals achieved it has been reported that during this process the amount of quality delivered to the patients has declined, through telephone calls to the patients demanding payment for services rendered the representatives can come off as harsh, rude and unforgiving towards patients who may have spent their last dollar. The patients then complain to the corporate hospital offices along with spreading this information to neighbors and potiental patients, thereby leaving the hospital with a bad reputation. This in effect places a bad name on the healthcare organization which can then lead to a decline in profit for that organization.

Then again..... Incentives can also be used in a manner in which they help the organization achieve awards ( i.e Joint Commission recognition and Quality awards). They may also help to motivate individuals and produce outcomes that may have not be produced without the incentive. They can also convince future employees to work for your organizations by informing them of the incentives are provided. For example, Florida Hospital provides a sign on bonus of $2500 dollars for new Graduate Nurses, pending an agreement to work with the organization for 12 months. This incentive no only motivates the employee but it also provides job security for the employee.

I am beside myself on incentives being used to encourage quality work. Should we implement incentives with hopes that it doesn't have a reverse effect? or Should we leave it up to the individual to decide the level of intensity they put into their work?