procedures on dead people - page 5

How many hospitals allow practising procedures on dead people by students? Do you prolong codes in order to allow the students lots of time to be successful? Do you charge for those procedures that... Read More

  1. by   disher
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    Last edit by disher on Jun 5, '02
  2. by   disher
    bobstein, "Law has nothing to do with ethics??"
    Do you mean law and ethics are separate disciplines but are also interconnected? Ethics has to do with what is morally right and the law may or may not have to do with what is morally right. Often they are interconnected, abuses of moral rights have led to legislation. I think the deceased family could have grounds for cival action for interferring with religuos freedom.
  3. by   ceecel.dee
    Some of our new docs like to practice intubation on the newly called code, but I agree with the concept of inviting the family in to see what we are doing...it usually gets called sooner if the family see's what actually is being done and you get more professional behavior from all involved. We do need to practice, but without permission?????
  4. by   bobstein
    Ideally, ethics and the law would always be interrelated. Most of the time, what is "right" is legal and what is "wrong" is illegal. I believe we would all agree, however, that the daily headlines provide proof that at times what is wrong isn't necessarily illegal. This, in my opinion, is one of those cases.

    Civil liability is not the same as being criminal (reference the OJ trial). Civil liability only allows for monetary payment to someone to "make right" a harm done to another. As I referenced in my original post, there may be some civil liability in practicing procedures on the newly deceased without consent of the next-of-kin, but it is not criminally illegal to do so.

    If you were unhappy to learn that a non-disfiguring procedure was performed on a family member without your consent I would understand. If I were in that position, I would be too. Your burden (or mine) would be to prove that a harm was done. But, what harm would have been done? Unnecessary mental distress??? That, by itself, probably isn't sufficient for you to find an attorney willing to take your case. Delaying ending a code to allow for skill practice probably falls into the same category.

    Much of what I have posted is what I have learned while doing research for the article and textbook chapter that I authored. Personally, I feel that the practice is objectionable and morally wrong. I do understand the need for education and skill practice, but given the research that shows approximately 50% of families would consent to the practice if asked, I cannot justify the practice "for the greater good".

    The references that I posted previously are not available online. For those wanting to learn more, I recommend the AACN continuing education article

    Medical and Legal Implications of Cardiac-Arrest Protocols

    Scroll down the page to the "Ethical and Legal Ramifications of Waived-Consent Protocols and Postmortem Procedures" section and then specifically to the "Postmortem Procedures" part. The article additionally has a great reference list for further reading.
  5. by   disher
    bobstein, re proving what harm was done. Hypothetically, the harm done could be connected with a families spiritual beliefs. What if for generations a familiy's practice was to leave the mouth of the newly deceased open because they beleived that the soul escaped from a persons mouth? If the physician inserted a tube in the deceaseds mouth, then he/she would be interferring with the deceased's passage to the afterlife. This could cause unecessary mental distress for the surviving family members. Distress which could have been prevented had the physician just asked for tbe families permission instead of assuming that no harm could be done.Just a thought on one way families could pursue civil litigation.
  6. by   bobstein
    disher: Theoretically, you are correct. The problem is that damages are still limited to mental distress. Our justice system only allows for monetary payment to "make right" a non-criminal civil wrong. Juries do not award much for mental distress without any other damages. As a result, I believe that you'd be hard pressed to find an attorney to take the case to trial. Remember that plaintiff attorneys pay for all the expenses of going to trial (upwards of $100,000) out of pocket in hopes that they will win. If they lose, they have to eat all the expenses they paid. If you could somehow add losing an arm / leg / eye to the scenario in addition to the mental distress you would have no problem finding an attorney. Again, I don't make the rules and I'm not saying that this is how it OUGHT to be ... only how it IS. Even though the practice is not criminally illegal and makes for a weak (at best) civil case, I feel that it is inexcusable to perform procedures on the newly deceased when research shows that approximately 50% of families would consent if only they were asked.

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