Quand ton urgence est congestionné... aux USA... tu peux te retrouver en tôle!
http://www.medicalpost.com/news/article.jsp?content=20061024_133936_5376 Waiting room death in Illinois ER ruled a homicide October 24, 2006 | Matt Borsellino While not a Canadian case, CMPA notes courts have not addressed how scarce health-care resources should affect standard of care WAUKEGAN, ILL. | A coroners jury has declared the death of a heart attack victim who waited nearly two hours in a hospital emergency waiting room a homicide. Gross deviations from the standard of care that a reasonable person would have exercised in this situation were the cause of the womans death, ruled panel members. Its not clear whether last months ruling will result in charges against any doctors, but according to published reports, the deputy coroner quickly subpoenaed documents after noticing what appeared to be discrepancies in the hospitals record of events. The facility north of Chicago co-operated with the coroners investigation. Emergency physicians and nurses go into emergency medicine to save lives, noted Dr. Rick Blum, president of the 24,000-member American College of Emergency Physicians. To criminalize their efforts would be a terrible mistake and have a severe chilling effect on people going into the field. The Medical Post contacted the Canadian Medical Protective Association, this countrys pre-eminent provider of medical liability protection, but its officials would not speculate about the impact an incident in another country would have on this countrys emergency physicians. Still, in a submission to the CMPAs 2000 annual report, general counsel Marg Ross warned physicians that while their work environment may be under pressure, they cannot defend decisions that interject administrative concerns on a patients well-being. The courts have yet to fully address how the scarcity of health-care resources will affect the standard of care expected of physicians, she noted. To date, the courts appear unwilling to accept an economic defence to justify withholding treatment or services from a patient for reasons of overall resource containment. Though written more than five years ago, the CMPA still stands by that assessment executive director and CEO Dr. John Gray told Medical Post West Coast freelance correspondent Ann Graham Walker for a story on health delivery services in British Columbias emergency rooms published early last year. There have been no cases in Canada where a court cited resource issues or an inadequate work environment as mitigating factors in a medical error, he added. Theres no question theres a tension between the duty of care you owe your individual patient and the duty you owe society to participate in the efforts to rationalize scarce health resources, Dr. Gray said. Most physicians are trained to direct all our efforts to our individual patients while increasingly doctors are pressured from administrators and governments to look toward the societal ability to deliver ideal health care for everyone. It is a terrible place to be. Unfortunately, the judiciary is not helpful in this regard because they tend to fall on the side of the doctors duty to take in the interests of their individual patient. . . . Eventually, the law is going to have to come to grips with the environment and either recognize that the environment has changed and hold physicians to a different standard or else I think these tensions will continue. The CMPA urges its more than 60,000 members to document their concerns about resources since those notes may carry weight in any future case. The womans death also raises questions about what emergency patients should do if their medical condition worsens while theyre waiting. Physicians have been sounding an alarm for years about the growing crisis in our nations emergency departments, Dr. Blum said. All emergency departments use a triage process. . . . However, sometimes a patient will come in with mild symptoms and while they are waiting, their condition worsens. Its very important for emergency patients in waiting rooms to notify the triage nurse if they are in pain or if they start to feel worse. If they are still concerned, they should ask to speak to an emergency physician or a patient advocate. People should not leave the emergency department without being seen. (About 3% of patients leave this countrys emergency rooms without being seen, according to the Canadian Association of Emergency Physicians.) Dr. Blum also reminded the U.S. media that federal law requires all emergency patients to be seen according to the severity of their condition whether or not they have health insurance. People with less urgent medical conditions must wait until all critical patients have been stabilized and admitted to the hospital, he noted. Emergency room gridlock stems from the recent closure of nearly 200,000 inpatient hospital beds across the U.S. as well as shortages of on-call specialists and nurses, he added. -----Original Message----- From: [email protected] [mailto:[EMAIL PROTECTED] On Behalf Of Dr Pierre Hamel Sent: October 27, 2006 1:23 PM To: [email protected] Subject: URG-L: congestion urgence pour votre information --- URG-L Pour quitter URG-L, envoyez un message a la liste ([email protected]) avec, COMME SUJET, le mot REMOVE (rien d'autre).
