‘You dont know Jack’

Watch this clip before reading on.

http://www.youtube.com/watch?v=wcwtT8qnSCc&feature=youtu.be

‘You don’t know Jack’ was released by HBO Films in April of 2010. The role of Jack Kevorkian led to a nomination and win for Al Pacino at the Emmy’s. The film gives viewers an insider perspective of the life and work of Jack Kevorkian, or as he is often called, Doctor Death. Regardless of your views on physician-assisted suicide, this movie evokes thoughts on death and dying, the role of God in our destiny and the standards set forth in the Hippocratic Oath.

Athena du Pre (2010) introduces us to the Hippocratic Oath that has been a major influential code for physicians for many years.There have been many changes to the oath over the years; as medicine and time changed the need for a modern oath arose. The current version of the oath contains statements such as:

“If it is given me to save a life, all thanks. But it may also be within my power to take a life; this awesome responsibility must be faced with great humbleness and awareness of my own frailty. Above all, I must not play at God (Tyson, 2001).”

This statement is meant to draw the line between physician and God. What gives a person the right to take a life? Should this even be an option? There are a lot of things that are open to debate but as this clip shows, great respect, compassion and sympathy must be given when speaking with patients about this subject. As the scene shows, Jack Kevorkian (Al Pacino) communicates with the patient in a calm and reassuring manner.  He speaks directly to the patient and acknowledges their presence instead of speaking to other people on his behalf, a skill that Athena du Pre (2010) suggests caregivers follow when communicating with people with disabilities (p. 147). There are times when Dr. Kevorkian lacks compassion, for example when he talks about sensitive subject matter such as the organ donation. His goal in communicating this to the patient may have been just to make him aware of his options and the benefits of organ donation but his delivery of this information could have been perceived as disrespectful, as was illustrated on the faces of the people in the room. However, when it comes to explaining the medical information behind his invention, Jack does a wonderful job at maintaining direct eye contact with the patient, making the process understandable and thorough.

Patients like the one seen here, are often talked down to or are not able to provide input regarding their care because of their disability. You can tell that Jack understands this delicate situation and has compassion for this patient. It is evident that Jack has a patient-centered focus on care. As Athena du Pre (2010) suggests, “patient-centered care has been linked to favorable patient outcomes” (p. 57).  All of Jack’s patients were very thankful for his compassion and empathy for the pain and suffering they experienced. He was favored because of his approach to medicine; putting the patient first.

The Hippocratic Oath still has great value in modern medicine. It sets a standard of care for physicians to adhere to. This film is a great agent for ongoing discussion of physician-assisted suicide. There is no denying that this film is meant to sway viewers towards feeling compassion for terminal patients who wish to end their suffering as well as feeling compassion for the work of Dr. Jack Kevorkian. This film makes me question how one can be considered ‘acting as if they were God’ if they side with a patient who wishes to end their suffering but not ‘acting as if they were God’ when they prescribe medications to alleviate symptoms or cure illnesses; is this not a method of intervention or is this not also going against God’s plan? Also, when we have a pet that is sick it is considered inhumane to make them suffer through illnesses yet it is considered an act of kindness to put them down and end that suffering. Is it that we hold animals to a higher standard of care or a lower standard and what does that say about our society? Personally, this film really registered with me and reminded me that some things, like medicine, are best served without religion. I have always been a firm believer in the freedom of choice for an individual and I believe that has to include the way a person chooses to live their life and how they choose to die.

I propose you watch this film with an open mind. If you agree or if you do not agree, I am certain you will take something away from film.

Until next time…

-N

References:

Athena du Pre. (2010). Communicating about health. New York: Oxford University Press.

Tyson, P. (2001, March 27). The Hippocratic Oath today. Retrieved from

http://www.pbs.org/wgbh/nova/body/hippocratic-oath-today.html

‘Puncture’

PLEASE WATCH THE CLIP I HAVE EDITED AND POSTED TO YOUTUBE BEFORE READING!

http://www.youtube.com/watch?v=tKzpCLQXxSc

Ideally, I would have liked to upload this video I made directly to WordPress but apparently I am given a limited amount of space for a free account so I uploaded to the next best thing, YouTube.

I first saw this film last year shortly after it came out. As an independent film, it was only screened in select theaters. It really is a shame that it wasnt selected for wide-release because it carries such a strong message. This movie is a real-life story of two lawyers that take on a case regarding needlesticks and safety needles. For those that are not familiar with needlesticks, the CDC estimates around 385,000 sharps-related injuries happen every year (Cunningham & Burnett, 2011). That is a frightening statistic considering the implications that can come from a needlestick (HIV, hepatitis B, hepatitis C). During the time that this film was set, needlesticks accounted for over 800,000 sharps-related injuries a year. New laws have been put in place to ensure safety when dealing with needles and many healthcare facilities have started to purchase safety needles, like the ones described in this clip. All of these advances have helped lower the number of needlesticks but more must be done in order to eradicate them completely.

This clip does a great job at illustrating the animosity that some nurses and medical professionals feel when it comes to these statistics. Speaking from experience, there are often situations that occur within a hospital environment that for some reason or another, tend to get overlooked. Either it is cheaper for the purchasing companies to go with one product over another, as was the case with this film, or not enough attention is given to the complaints of the people who are most familiar with the processes that could use improvement. Most decisions are made by medical boards that have little to know idea how things really are on the frontlines of healthcare. Medical staff are aware of the issues and in an effort to cope with their mismanagement, some people take on a humorous or sarcastic approach when it comes to talking about them. The nurse in this clip for example, uses sarcasm to deflect the questioning coming from the lawyer. It alludes to the sense that this nurse is very familiar with needlestick data and is also aware that not much was being done to prevent them.

Medical mistakes happen and when they do they often bring a lot of cost to the medical facility and the physicians responsible. My question is this, who should be held responsible in the event of a ‘medical mistake’ where the victim is an employee? Shouldn’t it be considered a medical mistake for a hospital purchasing department to knowingly refuse to purchase and provide materials that ensure employee safety? If the same regard were not given to patients it would qualify as a case for malpractice. ‘First, do no harm’ is often one of the first oath’s a physician takes, why then would we subject people to something potentially harmful in lieu of something that can save lives and prevent illness? Essentially, it is a lack of communication between the powers that be and employee’s lower on the proverbial totem pole that are responsible.

As Athena du Pre (2010) suggests in her textbook, communication is interdependent. We communicate with others in order to come to a common understanding; working together is the way we accomplish our goals. I bring this up because it plays a direct role throughout this film. The lawyers have to work with medical professionals to ascertain accurate data to support their case (as can be seen when he approaches the nurse for information on needlesticks) while also working with healthcare administration to incorporate the purchase of safety needles (which can be seen when he is directed to speak with purchasing). In this particular clip, the nursing staff is working directly with the lawyer to reach an ultimate common goal of decreasing the occurrence of needlesticks. Once it is communicated by the lawyer that he desires the same outcome as the nurse (the implementation of safety needles) the nurse is more forthcoming with information to help the lawyer build his case.

By continuing to work together, we can continue to push for more safety laws and procedures in an effort to make medicine a safe place for both patients and their caregivers.

Until next time…

-N

References:

Athena du Pre. (2010). Communicating about health. New York: Oxford University Press.

T. Cunningham, G. Burnett. (2011, November 15). Puncture: Exposure for bloodborne pathogen exposure. [web log comment]. Retrieved from

http://blogs.cdc.gov/niosh-science-blog/2011/11/puncture/