This post about the April 15th bombings at the Boston Marathon comes from Jerry Abraham, MPH, a 3rd year medical student at UT Health Science Center San Antonio.
“The real question is…How does it feels to treat someone who repulses you? Not just someone who annoys you—anyone training or working in healthcare in an urban area treats plenty of the very annoying: drug dealers, pimps, prostitutes, thieves, and thugs, as well as embezzlers, defrauders, money launderers, and inside traders. Rather, what is it like to treat someone whose very right to exist strikes a passionate chord?
Some health care workers may come to feel infuriated or morally wrong. A sense even may arise from some staff that they are abetting an enemy and are somehow complicit in his crime.
Of course they are not. Similar to the provisions of the Third Geneva Convention, which dictate that even the most heinous war criminal must receive humane treatment, every ill person must receive proper medical care. But this approach should not arise from the fact that it is our contractual duty under the law and we want to keep our job. Rather, providing drama-free, professional care even under extreme personal duress demonstrates our one priestly quality—our humanity, the single trait that distinguishes us from the person whose inhumane actions have caused so much sorrow.
The legal dilemma facing medical staff is clear: the Emergency Room is compelled to treat everyone who enters the doors in need of emergency care.
In 1986, Congress enacted the Emergency Medical Treatment and Labor Act (EMTALA) to assure that patients in need of emergency treatment receive medically proper attention.
This law prevented patient dumping—the convenient refusal to care for the indigent demonstrated by certain hospitals looking for an exclusive, cash-and-carry clientele. Doctors and nurses, as employees of the hospital, have agreed to follow the hospital’s rules as a condition of employment.
In other words, though the issue of a morally objectionable patient has not specifically addressed, the law provides no room for personal choice—hospital staff must treat everyone—equally.”