February 27, 2010

morality vs duty of care

At the top of the home page for the Mercy Hospital for Women, there is an emblem of a cross - a symbol of the hospital's Catholic foundations. 
Next to the cross are the words Mercy Health - Care First. Beneath the emblem is a mission statement that reads as follows: Mercy Hospital for Women is a major Victorian hospital providing public and private care for women and babies.
Founded in 1920 by The Sisters of Mercy, the Mercy Hospital for Women was originally built in East Melbourne, however in 2005, the hospital moved to a new, state of the art facility in Heildelberg, a suburb located in Melbourne's north east.

Unless you have been presented with a situation like the one I am about to describe, you probably haven't given any thought to the ethical implications that might arise when a public (tax dollar funded) hospital has its roots firmly planted in Catholicism.
I would like to make the point here that what I am about to debate refers primarily to the public sector of the Mercy hospital and not the private sector, because while the issue up for discussion can and should be applied to both sectors, I am only interested in discussing the implications of religious morality vs duty of care in relation to the public tax funded section of the hospital.
In January this year, a woman and her partner walked into the Mercy Hospital public (the hospital to which they were zoned) for their scheduled pre-natal ultra sound. 

This was the couple's first pregnancy and they were were eager to find out the sex of the baby. 
During the procedure and only moments after the woman requested to be told the baby's gender, the technician dropped the ultra sound apparatus and ran out of the room.
The woman was 5 months pregnant at this stage and felt terrified by the technicians unprofessional reaction.  Roughly 20 minutes later, the technician returned to the room with a swarm of doctors, all of whom confirmed the couple's worst fears.
The doctor in charge explained that due to unexplainable circumstances, their baby/fetus had been growing outside of the amniotic sack. 
Upon further investigation by a team of professors it was revealed that the baby/fetus had severe brain damage, and furthermore, all of its limbs had become fused to its body.
The professors, who were called in independently of the hospital, all agreed that if the woman was able to carry the baby/fetus to full term, it would require every imaginable transplant and the baby would not be able to survive the ordeal. 
The same professors concluded that the baby had a very slim chance of even surviving full-term childbirth and would more than likely - at any given point - die in utero.
Upon the advice of those doctors and the independent professors, the woman decided to be medically induced and deliver the baby/fetus at five months gestation. 

The ethical dilemma arose when the Mercy Hospital for Women told the couple that they could not endorse such a procedure as it conflicted with the moral/religious code of the hospital.
Had the woman disregarded the advice of trained professionals and carried that baby/fetus to full term, in accordance with the moral requirements of the hospital, what duty of care would the hospital have been providing to the woman? How were they putting her care first

In my opinion, the hospital failed to uphold their duty of care to the woman and the priority instead became a duty of care to the baby/fetus who had virtually no chance of survival.
Upon transferring the woman to another hospital (not steeped in moral agenda), the Mercy Hospital told the woman that the tests ruled out genetics as the cause of the medical problem and concluded that the odds of this happening were 1 in 750,000.
They proceeded to tell her that should she and her partner wish to become pregnant again, the Mercy Hospital for Women would have no qualms about having them back, as it was unlikely that the same issue would arise again.
It is evident that the Mercy Hospital for Women are opposed to abortion because of their religiosity, however it is my belief that there is an inherent difference between a woman's right to terminate a pregnancy because of choice and a hospital's obligation to provide a duty of care to one of its patients when that patient in faced with the trauma of having to carry a severely disabled baby/fetus to term with a zero percentage survival rate.

While in this situation that duty of care to the woman was not necessarily a physical one, I have no doubt that the emotional and mental trauma inflicted upon the woman - were she forced to carry the baby/fetus to full term - would fall under the public health guidelines of a duty of care.
Furthermore, for such a hospital to disregard the professional opinions of its own trained medical staff as well as the opinions of esteemed professors from other institutions, because of its religious agenda - beggars belief. 
Because at the end of the day, she was refused treatment, the same treatment that had been recommended to her by the Mercy Hospital professionals.
One of the basic strengths of Australia's public health system is that universal access to free public hospitals has been financed substantially through progressive taxation.
In other words we pay our taxes and the government take a percentage of these taxes and reassigns those dollars into public health. 
As a tax paying Australian, I find it abhorrent that my hard earned money is/ has been syphoned into a hospital that puts its moral and religious agenda above the mental and emotional safety of its patients.
Further down the home page for The Mercy Hospital for Women it says: Every year over 5,000 women trust Mercy Health to help them deliver their baby in a safe and supportive environment. For the woman at the centre of this medical/moral nightmare, this was clearly not the case. 
Her safety was compromised, her trust was broken and all support was withdrawn immediately (she was asked to leave) when she failed to be railroaded by the hospital's archaic, religious agenda.
As stated in its mission statement, the Mercy Hospital for Women is a major Victorian hospital providing private and public care for women and babies. 
It is my opinion that the same hospital failed in its obligation to provide that duty of care.
In this day and age it is unfathomable that a major public hospital should be permitted to override the science, knowledge and expertise of the medical profession in favor of an 'in God's hands' approach to treatment. 
Should the couple choose to take legal action against the hospital, I sincerely hope that the hospital would be found guilty of a breach of duty of care.
Eventually the woman was transferred to the Northern Hospital where she was induced immediately. After laboring for three days, the baby/fetus was delivered still born.


john reeves said...

Interetsing story and points Misha.

In guess it represents the layers of double standards than can abound in society around such issue nwithout any kind of due care towards the people innvolved.

I see it as the detritous of past intent infiltrating the present and if there was any real way of suggetsing what 'should' happen i think that a basic bill of rights outlining the define rights of individiuals in any sector of society and any kind of treatment or standard is based on those rights.

Clearly in the case u have noted the commonse sense approach to a tragic situation was waylaid in favour of the outdated ideaologies of the hostpital.

Clearly a muich reduced trauma for the mother would have resulted from immediate abortion rather than carrying to full term.

Theres a lot of things in out society need updating and this is just one example that religious or psudeo moral 'beliefs' dont really help people in real terms

mishaloula said...

Thanks for your comments John. I agree that a basic bill of rights is what is needed, however I would have thought that under the banner of a duty of care a major public hospital would already have such a bill. Clearly this is not the case.