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Health Care Ethics Consortium of Georgia grapples with health care harms

A key ethical principle of modern day bioethics is nonmaleficence, defined by Beauchamp and Childress as “the principle that we ought not to inflict evil or harm on others.” Long attributed to Hippocrates, the maxim “above all, do no harm” has long been a fundamental part of the tradition of medical ethics. But what does one do when in the process of intending to be helpful and do good one causes another harm? The Health Care Ethics Consortium of Georgia’s annual conference—“Causing Harm in the Name of Doing Good,” held April 23-24—addressed just this dilemma.

John Banja, clinical ethicist at the Center for Ethics, defined harm as that which thwarts one’s interest. Harming another is not always the same as wronging another. For example, when patients must endure a painful test or procedure, it can be said that they have been harmed, but they have not necessarily been wronged. Or if a medication error occurs but causes no adverse results, it can be said that the patient had been wronged but not harmed.

How is the issue of harm addressed within our healthcare institutions? Renee Mallett, VP from Licking Memorial Health System, described how her organization implemented innovative education and communication tools to improve the overall health of the community. Through the use of fictional or de-identified stories of medical error and patient harm in a monthly “Patient Safety Newsletter,” staff was informed of what went wrong and what could be done to prevent future occurrences.

Licking moved beyond its own staff to the entire community with the creation of a website and publication of a “patient safety community report card,” both of which reported on their clinical outcomes–even negative outcomes. The theory behind the “community report card” is that it is the community’s decision as to whether Licking provides top quality care and disclosure of clinical data that allows the community to make informed choices regarding their health care.

Other situations where the questions of harm loom large were discussed. Dr. Marla Salmon, Emory School of Nursing, examined the constellation of problems contributing to the current nursing and other workforce shortages in health care and the impact on patient care. Some of the small group discussions included a review of mistrust and suspicion in many African-American communities about health care providers, treatments, and research participation; the growing awareness of the need for adequate pain medications often complicated by such problems as the abuse of oxycontin; exploration of the potential burdens that may come from HIPAA as it attempts to improve privacy in healthcare; and questions about the use of physical restraints intended to protect patients from injuring themselves and their impact on patient rights. Dr. Richard Zaner, Professor of Medical Ethics and founder of the Center for Clinical and Research Ethics, Vanderbilt University, closed the conference with reflections on the day and an intriguing narrative on harm and its impact on patient care.

For more information about this conference as well as the work of the Health Care Ethics Consortium of Georgia you can contact Karen Trotochaud at (404) 727-2796 or Kathy Kinlaw at (404) 727-2201.

[ Posted by Karen Trotochaud at September 1, 2002 10:58 AM | More HCECG articles ]

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