First Do No Harm of Lisa Belkin chronicles some of the events in Hermann Hospital in Houston, Texas prior to 1993 (Belkin312). The premise of the book is three years of research in the hospital day-to-day operations while working with New York Times journalist. In the end, the book recollects chronicle of cases in the developments of the health care sector and the relative moral decisions. Belkin poses as an observer in the ethics committee as she talks to the members, families, patients, and doctors. Most of the speakers allow the use of real names in the publication of the book to suggest discretion and empathy. The ethics committee has to formulate decisions an illustration that there are no right answers, no perfect happy conclusions, or easy answers. Some of the events express the effect of moral care in health care that focuses on the patient’s conditions. Belkin has the satisfaction of minimal duty in the contemporary health care in the field of ethics. In her book, doctors and patients make impossible choices at the hospital. According to the author, one has a moral duty to do well that will derive satisfaction in the nursing profession. Some of the positive reflections of the book are that it offers insights to laypersons and health care professions. The criticism of the book relate to the cultural perspective concerning the health care and ethics that the book reinforces unintentionally. At the beginning and at the end of a fifteen year old Patrick Dismuke that suffers from Hirsch sprung disease. Patrick defies the ill condition since he survives on IV nutrients for fifteen years as he continues to battle infections associated with a line that feeds the heart. Other cases mentioned include seven-month neonate, a newborn baby suffering from meningomyelocele, a 97 old woman suffering from dementia and stroke, a paralyzed 65 year old trauma victim near to die, and a teenager suffering from short bowel syndrome (Belkin 322).
Hermann Hospital is a tertiary care hospital that attracts the critical injured. The hospital has limited fund since no one compensates the patients this leads to the care providers facing hardships as well as treatment decisions. Belkin chronicles the struggles faced by the hospital ethics committee. The hospital ethics committee consists of social workers, clinicians, few administrators, spiritual advisors, nurses, an attorney, and two non-medical professions from other professionals not related to the field of health care. The function of the ethics committee is to stipulate the ethics policies and educate the professions. The clinical advisory assists the clinicians to enable in making treatment decisions and soul wrenching. In the emotional and historic process, Belkin describes the patients and the families that present treatment choice dilemmas to care givers (Belkin 275). The committee members do not seem to learn the intimate stories. Some of the views of the dilemma include overwhelming family burdens, debilitating illness, and determining ethical opinions of stakeholders such as family, committee, physician, and the patient. The principles of medical ethics include justice, autonomy, beneficence, and nonmaleficence. Additionally one has to understand the patients’ ethnicity, background, religion, and family. The ethics committee has to address complex technology, high expenses, legal fears, moral uncertainty, lifesaving possibilities, and making of better decisions. Some of the questions that the ethics committee should address include when physicians should withdraw life-support. What level of medical care is recommended for specific patients? The ethics committee faces tough questions as well as the government regulations in the hospital.
Belkin (344) says that Claire and Kennedy Sparks always consider their everyday decision since for two consecutive years Landon remained confined in a wheelchair. He needed constant physical therapy and was prone to different infections especially on the lungs. One day Landon developed bronchitis and had trouble in locomotion. The Sparks rushed Landon to Hermann Hospital where he was placed on a ventilator. Sparks were considering the machine disconnection to seek peace of death unlike in previous scenario where they had voted for life. Doctors attending to Landon suggested to the parents for a session with the Ethics Committee while they declined to attend. Kenny and Claire refused to attend since they could recall their fateful experience on the first time. The doctors agreed to remove the ventilator and Landon continued to breathe on his own. Currently, Landon has resumed normalcy and is now at home.
After reading the book I think there is a problem in the treatment of the patients since most of the physicians push patients into surgeries and other procedures with the knowledge they cannot benefit the patient. Doctors have discretion in treating the patients since some are treated differently from the rest. Money is the consideration that separates the patients for instance when Armando Dimas comes to the hospital nurses notice that the patient does not insurance cover and requires extra effort they quickly want him out. Discrimination is thrive in the hospital since people unable to pay due to lack of insurance cover they do not receive any assistance. In addition to that, discrimination in the hospital is the consideration of assisting an American or an immigrant. The action depends on the attitude and the feelings of nurses. The ethics committee is ironical since it expresses an ideology of assisting all the patients with equality but does very little to the patients in the hospital. Belkin (278) cite that the hospital will not turn its doors from poor patients while the decisions bases solely on the medical need. This is not true since every patient gets treatment after making a decision on whether the patients require extensive rehabilitation. The decision depends on the ability to pay the hospital for instance the doctors assumed that Armando would die due to inability to pay and in that case, he would be a potential donor. The doctors regretted saving his life since they knew he was not in a position to settle his bills. If the patient knew of this plan, he could be extremely hurt. Some of the medical practitioners talk disrespectfully toward the patients. All the nurses’ practitioners in the hospital love Patrick and did everything for him.
Some of the hospitals do not have ethic committee like this one in Houston, Texas. I do not know the consideration taken by doctors has the intent to prolong death or one that the patient desires. In my opinion, I rather treat a patient other than having a choice to pull the plug since the patient cannot afford the bill. Hospitals incline to financial corruption since they make decisions based on economic decisions rather on social and medical grounds.
Works Cited
Belkin, Lisa. First, do no harm. New York: Simon & Schuster, 1993. Print.
