procedures on dead people

[canoehead]

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 are done after the code is obviously going to be unsuccessful (ie asystole since found 40min ago).

And even worse...Do you open the morgue so students can practice on newly dead during slow times?

I think that all these are insane but I am a minority of one at my hospital, because

"how else will they learn,

it leaves no permanent mark on the body,

it doesn't hurt the patient,

and if the public needs practitioners with excellent skills in an emergency situation they have to tolerate (and pay for) procedures on the dead"

So who is right? I need input from both sides so I can decide what MY response will be in these situations.

[CATHYW]

Originally posted by micro

of course I would be an organ donor first......

life is for the living..... [/b]

Canoe, I have a real problem with this, as do you. Our resp techs used to attempt ET tube insertions on recently deceased people. They would simply pull the curtain before the body was moved, and have at it! I complained, and said it was disrespectful. My answer was, "how else do you expect them to learn?" Multiple attempts with different ACLS intubation "heads," is how! It's how I learned!

I'm not quite as unselfish as Micro-I am a donor-of anything they can use, but what's left gets buried.

[mattsmom81]

I also learned to intubate on newly dead corpses. Students were respectful, and did not traumatize the body whatsoever. The attending was there and supervising while we practiced.

What better way to learn to intubate correctly?? I do think central lines, pacers, and any disfiguring practice should require permission from the family if they have not donated their body to science.

I never felt the intubation practice to be unethical, personally.

[nursejws]

I am completely appalled at the thought of any type of practice on newly dead corpses. Probably the very same reason our family did not want to leave the side of my Dad or Grandmother after their passing. Of course, if my Dad or Grandma had given any written consent prior to their death, my family would respect their wishes. I know my Dads wishes were to try once, and once only, and those wishes were given to his oncologist, months, prior to his death. I am almost positive my Mother would not allow this to her Mother at the time of her death.

If ever in this type of situation, would it be wrong to ask if permission was given from the family?? I'm starting my pre-req's now, so obviously I have no experience in this matter. I just know how I would feel and would want to respect the patients wishes as well as their families.

[Agnus]

Without consent of the patient/family, this violates the ethical principalS of autonomy, and verasity. If suffering is prolonged for family or patient then nonmalificense is violated. There are probably more principals violated that I can't recall at this time.

If the family, insurance, medicare or other is charged for this then it is fraud/theft. And you are mandated to report this if you are aware of it.

Federal - The Prvacy ACt of 1974 is violated when family/patient are unaware that information is bieng shared.

The ANA (1985) guidelines out line these rights.

reguarding reasearch and patient treatment

Right to self-determination, right to privacy and dignity, right to anonymity and confidentiality, right to fair treatment, right to protection from discomfort or harm.

This amounts to descrication. We are not allowed to use aborted featus for reasearch, experimentation or learning tools by federal law.

We are not allowed to recover bodies from tombs for students to learn on. This amounts to desacration of bodies.

It violates the religious rights of the individual and family. It is very disrespectful.

This sort of thing gives us all a bad name. The fact that "no marks" are left does not excuse this.

I and many others have willed ourselves to science. However, if I were to learn that this practice occurred at the institution where I have made this bequith then I would without hesitation withdraw it.

It has certainly given me second thoughts and I am a nurse.

This needs to stop. Where is this institution's ethics board????? If this is not properly addressed and stopped, then it needs to be brought to public light. The public has a leagal right to be informed that this is happening and the institutions and persons who do this.

The end does not justify the means. Managers do things right. LEADERS DO THE RIGHT THING.

[disher]

This type of "practicing" treats others as mere objects, as if human beings are tools and not worthy of respect and dignity. It may be an accepted practice in many hospitals, but it should be discussed with staff. Maybe the hospital's bioethicists can present the topic in grand rounds? I bet many staff are uncomfortable with the ethical dimensions of this practice and would appreciate the opportunity to discuss ways the can either make this more acceptable or stop this practice.

[caroladybelle, BSN, RN]

As I am jewish, the practice of performing unnecessary procedures on someone (live or dead) who have not given permit is sacreligious and a voilation of religious law.

Ethically, it falls in the same place as a student doing a pelvic exam on an anesthetized woman, who declined that exam when awake. Morally it is inappropriate, but it still happens way to frequently.

[Agnus]

Driving home from work tonight I thought about this. Our hospital and every hospital in our geo. area invite families into the room when there is a code.

I have read in several journals that this practice usually results in greater satisfation on the part of the family as they saw with thier own eyes that everything possible was done.

If those of like mind to you were to advocate at your hospital to start this practice the problems you brought would no longer exist. (I don't expect it would be an easy fight, maybe one you would not even want to take on)

From what I can tell this is starting to become common practice around the country and I imagine that it will become the standard of care.

[mario_ragucci]

Since you are not totally gone till all your cells die, doing this to a newly dead person is morally unethical. If others wanted to practice intubation, I would advise them of their inferior intelligence to have to practice their work/vocation on dead. Thats taunting - and thats Mario :-(

Seeing an autopsy, and potentially feeling an organ in your hands is different, because the folks are then totally dead. I would be learnin,practicing a skill by doing this, and someone can rightfully say that I lack the imagination to picture and experience the inside of a human w/o having to see it dead. Mario will not call the kettle black.

Getting familiar with intubation is serious, and can only improve the way for yourself and other patients as well.

If I person is totally homeless, would that make it easier for you? What does that say about you as a person? It says you are a slice and dice person.

The best would be if a hospital employee willed it to be done. Guilt free intubation practice.

I'm still not comfortable talking or thinking about death since my parents died :-(

Please do not re-paste my words again, and please don't snipe at me on another thread just because of what I say here :-(

[SmilingBluEyes]

[unbelievable. What hospitals are doing this? Don't want MY loved ones passing on in such a horrid place. I find it disgusting. Dead or not, the indignity is disgraceful and makes me heartsick! What are we coming to that anyone thinks this is "ok standard practice"? UGH!

[micro, RN]

i say again, as i have said on other threads.........

death is as much a part of living as the rest of life.........

morally and ethically.............life should be reverenced for the person, the body and those closely associated to...............

that is why I would have no problem and would probably relish an opportunity to attend an autopsy, scheduled and correct,for the learning opportunity of it, but in no way would welcome anything other than standard ethical practice towards the just deceased'.............

death is a very private thing...........and so much more than physical...........

love to all

micro and out

[semstr]

This would be illegal here. Even in the University-clinics, where patients are often "rabbits" in clinical research, they have to sign though, corpses are left alone.

Autopsies are done without asking the families though, something I find hard to swallow, but that is absolutely legal.

We go and watch an autopsy with our students once in the training, but we make sure, that this is neither a child, nor a dismembered, watercorpse or something like that. Our students don't have to go, but most of them do. In 10 years of teaching only one of them had to go, because she almost fainted.

Personally, I am not so sure, whether this is necessary to learn about the human body.

but, intubating on "fresh" bodies is a no, no, no!!

Take care, Renee

[Jenny P]

Quote by Micro:

i say again, as i have said on other threads.........

death is as much a part of living as the rest of life.........

morally and ethically.............life should be reverenced for the person, the body and those closely associated to...............

Micro, my sentiments exactly! (You've been making WAY too much sense since hitting 1000, girl! JK, Love Ya!)

Seriously, life should be treated reverently, and both the warm body and the person practicing would lose some of their inate humanity in these situations.