Stay tuned for a provocative comic strip coming soon with frank commentary on common physician frustrations with purported irrationality in ICU transition conversations with families
Also coming soon is another comic revelation examining some nurses' perspectives that they are functionally "flogging" dying patients on the front lines of late-stage care in many ICUs
While the doctor and nurse perspectives can be depicted humorously for catharsis, the family perspective is not a laughing matter and deserves a more considered response
What you hear from Alma's story in the above video is that supposedly ethics-based decisions surrounding end-of-life transitions can be tragically self-defeating. Whatever systemic justice was achieved by the better monetization of an ICU bed vs. a nearby inpatient hospice bed was very short-sighted indeed. The lack of ethnocultural sensitivity devoted to this end-of-life transition had pyschosomatic effects that ravaged Alma's health for many years to come. Fortunately, there is no conundrum here requiring us to weigh Alma's suffering against the suffering of others given inefficient resource utilization surrounding her husband's ICU bed. The systemic costs of Alma's Medicaid and Medicare-provided health outcomes from unethical disenfranchisement far outweighed any and all savings incurred by the proper monetization of her husband's ICU bed. Additionally, that medical team could have achieved the same hospice transfer decision with a radically different approach to Alma's hopes. What is at stake here is not only Alma's tragic suffering but also the team's own self-respect, quality of life, and likelihood of burnout. Harming others harms ourselves. HopeCare is a win-win.
In the end, the best means achieve the best ends. For HopeCare, Ethnocultural Sensitivity Training for End-of-Life decisions is not a disembodied political agenda but a practical and concrete solution. Innovation is not limited to drugs and devices. HopeCare offers transformative solutions for communication conundrums. Learning simple, win-win interventions can radically alter the experience of end-of-life transitions from irritation and angst to connection and peace for all involved: patients, families, and providers alike.
Pregnancy is a time of heightened sensitivity and vulnerability. Judgement is harder to hide than we might think. It is not lost on black mothers when a white clinician thinks they know best regarding a difficult prenatal decision. No one can impose their fears and values on the life of another through manipulation or pressure. Black mother know best what is right for their bodies. They also know what is best for their ill children. The likelihood of complicated and life-long disabilities or permanent vegetative states poses difficult decisions for parents who are given the option of compassionate extubation. The best and healthiest route to considered decisions and the minimization of long term health-ravaging regret can be counterintuitive.
There is nothing more devastating to a mother than the death of an infant. No matter which side one might take on the culture war surrounding "law and order" vs. "defunding the police", hospital responses to infant death should be an oasis of common ground. Militarized responses to infant death cause irreparable harm to grieving mothers and ravage health. This short-sighted approach only entrenches what it judges. With conscious effort, we an work to lean against racial profiling rooted in unconscious bias. Even in cases of suspected foul play, we must lead with compassion. Honoring grief and personhood is healthy for patients and providers alike.