Doctors Question Use of Dead Or Dying Patients for Training

The Wall Street Journal ^ | Tuesday, November 12, 2002 | PAUL GLADER

[TroutStalker]

Unbeknownst to the vast majority of family members, after a patient dies in the emergency room of many hospitals, a senior physician draws a curtain and supervises young doctors practicing several rounds of emergency medical techniques on the deceased.

In addition, several hospitals permit young doctors to practice on patients who are nearly dead, that is, who are technically still alive, but beyond the help of even extraordinary measures.

[Ditter]

This was kinda shocking when I first read it but if I was already dead it would be OK with me. Just don't bill my insurance co. for it.

[Drango]

Yeah I'd like to think in death, I could give something back. I'm dead...poke away!

[billorites]

"Some believe virtual reality, fiber-optic and mannequin technology will continue to improve as an alternative."

Great. I really want to be treated by a physician who trained by playing with dolls.

[fourdeuce82d]

I'm dead...poke away!

well said, as long as we're not talking about a naughty mortician...

[boris]

I had an "attempted hemorrhoidectomy" in a doctor's office on a Friday afternoon.

Everything was fine until Saturday morning, when I had uncontrollable rectal bleeding.

I stuffed a roll of paper towels into my shorts, sat on another and drove to the emergency room. You'd be amazed at how rapidly they admit you if you are (a) holding a blood-soaked roll of Bounty and (b) making a puddle on the floor.

I was hospitalized for six days. During this period, the fellow who committed the botched operation (and was out of town all weekend) brought groups of medical students around to examine my rectum. "You will not likely see many cases like this," he told them. "Acute gangrenous prolapsed hemorrhoid. Could you please spread your cheeks a little more, Mr. Boris?..."

An educational opportunity. At least I lived. Sort of.

--Boris

[Seruzawa]

Hmmm. If the patient is not dead doesn't that make it murder? I didn't know that doctors had the legal authority to order a procedure that would kill a patient who is still alive under any circumstances.

Well, I guess this is to be expected. After all if it's okay to murder a baby, why not a terminal patient?

I'm not dead yet!

[Pearls Before Swine]

During this period, the fellow who committed the botched operation (and was out of town all weekend) brought groups of medical students around to examine my rectum.

And you let him do this with nary a harsh word? It would be different if he was the surgeon who saved you, rather than the one who fouled you from behind (its basketball season).

[blackbart1]

Your are right if you are dead you wouldn't know it but apparently sometimes the person isn't dead. The absolute lease they should do is get permission. If they don't get it, they shouldn't do anything.

It is surprising this hasn't come out in the open sooner. Wouldn't a coroner be able to tell a body has been fiddled with? This is a scandal in my estimation.

[Bikers4Bush]

Without written permission or verbal from the family they shouldn't be doing anything other than attempting to save the patient, period.

[WilliamWallace1999]

What part of the article said they do things to cause the death? It said they PROLONG life in order to practice after the brain is GONE. Have you ever been with a dying person? It doesn't happen like switching off the lights. The chronically ill slip away in stages. Electrical activity in the heart muscles continues long after blood has ceased to flow. I have used the rubber dummies and animal models in school and nothing compares to the intubation of a human. Endotracheal intubation is one of the most difficult to master parts of resuscitation. It is also the most critical. Without oxygen, you can push drugs and shock away and it won't make a difference. THEY DIE.

[Age of Reason]

Stop reading in the toilet.

[Ditter]

As far as the coroner not knowing, of course he knows this goes on. It probably would look like heroic measures were used to try & save the person. If he had died on the table anyway, how could you tell. My next door neighbor is an MD emergency room specalist at a big hospital, I wonder if she would tell me? Probably not.

[LurkerNoMore!]

...a third of the residents said prolonging the life of patients for practice is appropriate and 16% had done so.

Sickening.

[LurkerNoMore!]

I agree with Biker's reply in #10. Do you?

[mlmr]

I worked in a teaching hospital. An elderly stroke patient who is aphasic is a medical lab rat in a teaching hospital. Do not let you or your relatives in this situation be left alone in one of thos facilities. Also you can refuse to have residents and med students follow or be involved in your case. When you are admitted say you want your attending and the chief resident to care for you but do not permeit others to care for you.

Remeber all residents interns and med students walk around with proceedure check list. You could be their next proceedure...or even worse...their first...

[JudyB1938]

Oh, I don't care. If those kids can learn something on me and save a young persons' life, it'll be worth it. Of course, I might think differently should this actually happen to me.

However, I think the trainees would try to be gentle. They are still in the humanitarian phase.

[mlmr]

I have watched med students practically sitting on an elderly stroke patients chests peering for long minutes at a time at the retinas of these patients. I have literaly had to pull them off of patients. There is some compassion but as I said, these kinds of patients are treated like specimens. And specimens are not treated well.

[WilliamWallace1999]

Absolutely agree with the consent issue. It could be incorporated in the mountain of other crap you have to sign at pre-admits. I would raise an additional question for discussion. If one's care is entirely paid for by the state, does one retain the same autonomy of consent. Does a person not have to give anything back to society in return for the best healthcare in the world.