“Playing as a doctor”-a warning story from a pioneer in health IT. – Healthcare Blog


Author: Mike Magee

Warner Vincent Slack, MD, Pioneer of Medical Informaticss, is a professor of medicine in the Department of Clinical Informatics at Harvard Medical School. When he died in 2018 at the age of 85, His memorial:

“For more than 50 years, Dr. Slack has conducted pioneering research on the use of computers in the medical field, and is one of the founders of medical informatics. His goal is to enhance the communication between doctors and patients to enhance their capabilities. “

For the past half century, Dr. Slack’s followers have been working hard to design solutions that strengthen rather than weaken the doctor-patient relationship. But as he has repeatedly pointed out throughout his career, if politicians are allowed to “play doctors” in citizens’ lives, this goal will become even more difficult.

His awareness of the impact of the Terri Schiavo “right to death” case began more than a decade after his groundbreaking publication “The power of the patient: a patient-oriented value system”, May cast a long shadow over his optimistic vision. The case lasted for 15 years, because it brought an unfortunate woman’s poor health and disability literally into her grave, with devastating consequences for all involved.

As the Supreme Court prepares to present its opinion in the Texas Volunteer Police and Mississippi abortion case, the Schavor case remains a story worthy of alert. Scrutinize. This is a quick summary:

  • Teresa Marie Schindler was born on December 3, 1963 in a suburb of Philadelphia.
  • Terri married her husband Michael in 1984 and moved to Florida to be close to her parents.
  • On February 25, 1990, she suffered from an eating disorder and fell in the lobby of their apartment. She was hospitalized after the rescue failed.
  • Her husband Michael became the legal guardian on June 18, 1990. Two doctors independently declared that she was in a “permanent vegetative state.” Insert the gastric feeding tube.
  • In mid-1993, Michael signed the “Do Not Resuscitate” (DNR) order.
  • In May 1998, he submitted a petition to remove the feeding tube.
  • The parents challenged the deportation in court and lost. The tube was finally removed on April 24, 2001.
  • The parents accused Michael Schiavo of perjury, and the judge ordered the tube to be reinserted two days later.
  • On September 17, 2003, the appeal judge ordered the removal of the feeding tube for the second time.
  • Rescue Operation/Right to Life Extremists Randall Terry Started daily public demonstrations in nursing facilities.
  • Passed by the Florida State Assembly “Terry’s Law”, allow Governor Jeb Bush The feeding tube was reinserted through surgery for the third time.
  • On May 5, 2004, “Trifa” was declared unconstitutional.
  • Senator Mel Martinez (R-FL)’s political career The memo has been revealed He plays politics on this issue.
  • Senator Bill Frist’s hopes for the presidency fell to nothing on March 17, 2005, when He declared In the Senate, “I questioned it (vegetative state) based on a review of a video clip I watched in the office for an hour or so last night.”
  • Presidentt Bush transferred the case to the Federal Court. The federal court agreed to the appeal of the previous state court.
  • Terri Schiavo’s feeding tube was removed for the last time on March 24, 2005. She died At Pinellas Park Hospice Hospital on March 31, 2005.

In 2010, Dr. Slack wrote, “The dialogue between doctors and patients is still the backbone of clinical medicine.” Obviously, not all health technology innovators have this narrow focus.most Today’s focus Ensure patient autonomy by achieving faster and more accurate prescriptions, rapid information sharing, reducing paperwork, reducing unnecessary testing, increasing reliable follow-up actions, and the privacy and security of information.

But Slack believes that when faced with complex life and death decisions, perfect information management cannot replace the guidance and advice of trusted professionals. This is the case of Schiavo’s end-of-life debate that has been entangled in the courts of our country for 15 years. A more current example of malicious intervention is Governor Greg Abbott’s attempt to get citizen volunteers to insert themselves into complex, individualized decisions made by women facing unexpected or unintended pregnancies. .

Health information technology should be complementary and transformative. Dr. Slack’s contemporary Canadian-born American biomedical engineer and educator Edward (Ted) Shortliffe, MD.The doctor echoes the same theme An address 1991 to the American Philosophical Society in Philadelphia. He said, “Any effort to predict the impact of information technology on the relationship between patients and doctors must be viewed in the context of this larger social change. Doctors and patients will be very different… if there is any dehumanization As a result, it will happen because we allow it to happen, not because the technology itself has some inherent dehumanization.”

Do HIT innovators now have to directly intervene in controversial contemporary issues, such as abortion rights? Will not. But Slack would argue that HIT innovators have the opportunity to continue designing products that fully empower contemporary patients. This is indeed consistent with the patient’s rights movement and requires social awareness and elements of participation in today’s issues.

Mike Magee, MD is a medical historian and health economist, also “CodeBlue: Inside the medical industry complex.”



Source link