dras knowledge

Monday, March 04, 2002

Emotional stories can't prove an injustice

"...a device called a pulse oximeter failed to detect a pulse or show how much oxygen Joshua's blood was ferrying to his vital organs...But the doctor pressed ahead after attaching a second, experimental monitor that showed encouraging signs: Joshua's blood was taking on more oxygen. Today, Joshua Diaz is a healthy 7-year-old living in Ontario, Calif.

"The reason, Mr. Kiani says, is that he has effectively been locked out - his much larger competitor has secured exclusive contracts to sell its device to thousands of hospitals, in part by paying fees to two national purchasing groups that largely determine which products many hospitals buy. These two private groups act as middlemen for about half the nation's nonprofit hospitals, negotiating contracts last year for some $34 billion in supplies, from pharmaceuticals to pacemakers, bandages to beds."
(NYTimes_03042002)

I'm not ready to go hook, line, and sinker on the observations or arguments the authors make. Conspiracy theory sounding reports bring out the skeptic in us, I hope

First, I wasn't there, and I won't make a critical analysis of the protocols or conditions set forth in the story. But, while avoiding a full discourse about a pulse oximeter's indications and limitations, I suspect a pulse oximeter wouldn't be used as any key determiner of life or potential life - or at least I would hope. Second, I want to know more about this "experimental" pulse oximeter that didn't DO anything, but was at least able to offer a glimmer to the ER team to not give up hope. After this, I had to wonder just how much the presence or abscence of the described middle-man medical monopolies really would have in the outcome of this case.

What I get out of the opening paragraph is this: An infant was showing few or no signs of reviving a full-arrest. A persistant physician did not give up hope, or likely, was following the algorythms of advanced life support beyond the "gut" feelings of some of the support staff - and it paid off. This story is weak in providing real substance for the later argument. But it provides emotion, and the reader is ready to pounce on any injustice that presents itself in the following paragraphs. The rest of the article? Well, I must be among the brainwashed minions that believe things in our medical society aren't as overwhelmingly wrong and unjust as they are often made to sound.