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THE HEART UNDER ATTACK: CRISIS CONDITIONS: WHAT DECISIONS
You have had a hypothetical heart attack and have been admitted to the nearest emergency cardiac department (which may be miles out of your way. Worse, it may be an inferior hospital, which is more serious, of which more later).
You, or more probably your spouse, is going to be asked to sign permission for medical staff to take any surgical measures they see fit to stabilize your condition,” including major (bypass) surgery. They will especially press for wide permission if you have health insurance. (Never forget that hospitals are commercial organizations: you are not protected from commerce by virtue of being at death’s door! British readers who think that they are protected from this aspect by having a National Health policy are also mistaken: in this instance the commercial interest merely becomes indirect and is based on the size of the desired grant or slice of the budget the hospital can justify by its turnover.)
It is surely wise, therefore, to examine the options which you are likely to be offered, also to keep in mind that you do have one other option – the right of refusal. But this right carries responsibilities and means you will need to know how to discuss alternatives with existing staff who may be pressuring you to give permission ‘before it is too late’.
Statistics support your hesitation by revealing that surprisingly few heart attack decisions have to be made in a hurry. They also support you in another way: the risks of dying during surgery or of sustaining serious complications can double (conservatively speaking) depending on the excellence of the surgical team doing the operation and on the standard of intensive care after it, facts which were revealed in a comparatively recent and disturbing survey (in 1988) from America.
Conducted by the Joint Commission on Accreditation of Healthcare Organizations, it found that 50 per cent of US hospitals did not monitor patients properly in coronary and intensive care wards, a percentage which rose still more in the case of regular ward care. Additionally, 35 per cent did not monitor blood transfusions properly.
There were a (conservative) confirmed number of 10,000 deaths from anaesthesia alone, which meant people just didn’t wake up from their operations, and nearly one-quarter of all patients left hospital with a condition they didn’t have when they entered.
It is difficult to imagine that the situation in Britain would be any better, with the totally demoralizing contemporary picture of closures and shake-ups of key hospitals and disbanding of long-established surgical teams, etc.
*25/104/2*