This week has been filled and frustrated me with the concept of determination of a person's "best interests". I've worked in the health sector for quite some time but I think it is even MORE illuminating having been a patient of the health sector for most of my life. After some discouraging feedback this week, I'm starting to think that often medical doctors hold more power over a person's life then even the Police force does. The Police force acts according to the law...the medical profession seems to use and abuse the law according to their own interests which they then justify as taking such actions in the "best interests of the patient".... when does it become okay to override a patients OWN values, knowledge, belief and TRUTH with a doctors own ideas and when does this give them the right to break moral and ethical codes of practice and even more so, the law? Seriously? When?
Mental health is an obvious area where this is a big issue, so often people with mental health issues are not respected very much because they cannot think "normally" and thus there are people that are able to take away all the rights that patient has! (At least in regards to mental health care....but in some regards, if a guardianship order is enacted then ALL rights are given to another party, not just mental health care!) But ironically, this happens in other areas too, like with physical health...I have illnesses that are not easily seen. In many ways I now amd THANKFUL for blood tests that aren't normal because at least its something on paper that I'm believed about...but it took time before that to be believed, even with specialists on your side, so many other people would not listen. I'd go to the emergency department to get treatment but I'd be treated like I was seeking inappropriate help when actually I was doing everything in my power to act appropriately and responsibly! ARGH! You can't win! But there is always a risk! If you're honest, you could end up losing everything because of the way a doctor or a health professional decifers that honesty....so many things can happen.... doctors have a lot of power and to me it seems, very little accountability.
They just have to say that they were "honestly" trying to act in a patients "best interests" and then everything is magically okay. But those "best interests" may leave a patient writhing in pain, sleepless nights on end, or extremely traumatised. Even the police will allow legitimate emergency phone calls to be CANCELLED by a doctor or hospital! Even when I can prove through logic that a doctor is not acting in a patients best interest, and that irrespective of logic, irrespective of a patients "best interests" some of the things that were done are illegal, they aren't grey, they are black and white....they aren't the Pirates Code which, if you watch Pirates of the Carribean is decided to be more of a set of "guidelines" then rules....they are legal rules and guess what? They are there to protect both patients AND staff and help everyone know what is and isn't okay....so when those rules are broken....how can it then be okay to say that they were broken because they were in the "patients best interests"? Umm, I'm sorry, but WHAT?
So this brings us back to the original question....when is something in a patients best interests, what tools do we have on decision making as professionals and what recourse do we have and what empowerment do we have as patients to STOP doctors (and relevant health professionals) from acting incredibly inappropriately? How do we hold them to account for their treatment suggestions and implementations? How do we ensure that all relevant facts are given and informed consent can be obtained? HOW do we ensure that a patient gets the appropriate treatment without the prejudices of a doctor own self-opinions? How do we ensure that patients are treatment like the human beings that they are, treated with dignity? And how do we ensure that when things go wrong, that it is not the fear of litigation or civil suits that direct the process of investigation but appropriate investigative and reasoning is used and outcomes determined? (And I'm not talking about borderline things here, I'm talking about things that can have a profound and long term impact on a person's life.)
So again, how oh how do we ensure that doctors, with all their inappropriate levels of power, ensure they literally ARE acting in a patients best interests and that on the occasions where they do not, that they are appropriately held to account for it....like any other person in society would be....especially given these people have the lives and livelihoods of other people in their hands. How?
1 comment:
this is a hugely important issue. I know what happened that has you writing this, and it was not okay, not even remotely okay.
I've had times myself, when a health professional's decision has affected my entire life, and when they have had entire control over my life. You are right they do have more control than the police has. They can control us physically, mentally, financially, and can detain us for indefinite periods of time. To challenge that power, you get maybe 5 minutes to state your case to a panel of three well meaning people, but who rarely find in favour of the patient - because you are mentally ill. Nothing you say can therefore be counted as meaningful or valid. You are a non-person. And your feelings count as much as many people consider the feelings of animals in captivity - those who feel for them and are infuriated over their stolen liberty and rights, usually can't do much about it.
I know many fellow patients of the mental health services who greatly fear them. Who have lived their lives being medicated, detained, rough-handled by the police, even handcuffed by them, just for being unwell. The police were acting at the orders of their mental health service. They don't get a say. They've lost jobs and homes when being detained on an ITO meant they couldn't go to work or pay rent or bills. They've in some cases been made sicker by poor use of drugs or ECT, and they've been denied the right to choose how they want their lives to be.
And rights include the right to be heard, the right to complain about being mistreated, the right to call emergency services and have them actually attend. What would happen if a doctor was seriously assaulting, even killing a patient, police were summoned and didn't come because the person had a mental illness? Are we still gullible enough to think that just because someone is a doctor, they are a good person who will not hurt others? Have we not learnt from the many doctors who have killed patients, who have sexually assaulted patients, and so on?
Not to forget that it's just a basic and essential right to be treated humanely. Like another human being. The impact of a lot of decisions made by mental health professionals will affect these people for the rest of thier lives. We can't just leave our lives at the end of the day and go home. This IS our life. I think many professionals forget that, especially as they move higher in the heirarchy and become further removed from the actual human face of their patients.
I'm so sorry you went through what happened, and so sorry you have been failed by another set of people who should be protecting patients from this sort of criminal behaviour. Too many MH professionals are starting to think they really can play God. A heads up to them - you can't. You just can't.
Post a Comment