Further Light and Knowledge

No I'm not having one, but I am taking a summer course and have to write a paper on one. I know most of the people in the class are going to write on end of life stuff, and since I always like to buck the norm i'm looking for something unique and possibly a little bizarre cause the only ones I can think of are those dealing with end-of-life stuff. I know there are lots of different ethical dilemma's nurses run into.

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I'm not sorry, I like to get laid. --Mercury

I took roughly 1/3 of my available vacation for the year to chase 12- and 13-year old boys through the woods. --Mcarp

Well, the opposite to end-of-life would be reproductive ethical scenarios. If that doesn't interest you, can you get a copy of the book "Doing Right?" It's all about medical ethical issues.

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"For some reason, mormons have this 'I can talk shit but it doesn't mean I'm a judgmental asshole' attitude." -Junesu

I blog.

A patient begs you for contact information for marijuana to ease their pain, if you know of a trusted seller do you tell the patient?

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”Most of the harm in the world is done by good people, and not by accident, lapse, or omission. It is the result of their deliberate actions, long persevered in, which they hold to be motivated by high ideals toward virtuous ends.” - Isabel Paterson

I don't know if this falls into your course's definition of ethics, but there are a couple important ones in queer issues:

1) anything dealing with transgender people is on the radar right now; transgender people have incredibly difficult time finding ethical, caring, thorough medical care, even here in the Bay Area. I'm not talking about transition care; I'm talking about doctors willing to treat them or even to be their GPs.

2) anything dealing with reproduction for LGBTs. For example, inseminating a woman with a gay man's sperm; serving lesbians in a reproductive clinic, etc.

3) Actually, LGBTs are routinely denied medical care around the country. It's one of the biggest issues we are facing. Hospital emergency rooms will often serve LGBTs, but then once they're in the hospital, they have problems with visitation and medical power of attorney. Even in CA with "virtually" equal Domestic Partnership benefits, we have a handful of cases a year of hospitals refusing spousal rights to same-sex couples. In specialized clinics and in general practice offices, the descrimination is more pervasive and common (e.g., finding a family or personal doctor; Ob-Gyns for lesbians; reproductive treatments and services; etc.).

Dunno if that gives you some ideas.

have a look at this wiki page for ideas
http://en.wikipedia.org/wiki/Medical_ethics

queer issues didn't even cross my mind, which makes me glad I ran out of basic ideas and decided to come here and ask. Thanks.

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I'm not sorry, I like to get laid. --Mercury

I took roughly 1/3 of my available vacation for the year to chase 12- and 13-year old boys through the woods. --Mcarp

I wouldn't think twice of a patient using marijuana for pain or appetite or nausea issues. If I knew of a reputable dealer, I'd be more concerned with my own issues than theirs. hahaha

Geez, cumom, just reading your post makes me ache inside. So sad for so many. I know when we've had transgenders and gay patients, nobody cares or openy judges them. I've never heard a snarky remark about them. Healthcare has alot of gay workers, I'd be surprised to witness open discrimination here where I live. I'm not ignorant in believing it doesn't exist, but the teams I've worked on are more CURIOUS about the transgender process an lifestyle, than against it.

"Don't tell granny she has xyz disease, we don't want her to know"

Not necessarily an EOL issue but could be.

My friend's uncle had a major heart attack about a day before her dad was due for some risky surgery. Any stress would have caused her dad to be very much at risk prior to surgery. The uncle was expected to live only for days at most. The doctors and nurses agreed not to tell her dad about her uncle's (and her dad's closest brother) heart attack, and he then died before her dad had recovered enough to be told. The rest of her family had a chance to 'say goodbye' to the uncle, but her dad did not. The doctor and nurses all kept it mum until my friend could tell her dad at a better time.

I spent 23 years as a nurse, and am still licensed. A huge problem I ran into was doctors writing non-sensical orders that I had to complete, even after questioning said doctor about the problem. Another problem, the largest, was pain control. Get some green resident right out of medical school, and he/she might give you a real hassle when a patient isn't getting appropriate pain control. It's like some doctors still function either out of the dark ages, or, they have an ax to grind against certain patients. Say, a patient who once in his life had an addiction problem, and now you are caring for him for a horrendous wound, that requires the use of a scalpel to clean the thing out. The doctor might read the chart and decide that since 15 years ago this poor schmuck had a problem with drugs, he isn't worthy of pain medicine now. There are a host of ethical issues still plaguing the health care system that aren't related to euthanasia. I once had a resident doctor give me an order to give a man dying of gangrene two tylenol every twelve hours whether he needed it or not. She and I actually got into a pissing match over it, and she won. I was disciplined.

I'm sure that a great many health-care providers, especially nurses, are hip to the LGBT thing, especially here on the west coast where we live. But the discrimination happens routinely outside of urban areas, with couples not allowed visitation, etc. Hopefully the big policy change (was it national or just here in california) where the patient gets to define his/her family for him/herself will solve a lot of these issues. And transgender folks have a nearly impossible time of it. There are informal networks to help transgenders get medical care with understanding and compassion; but they often don't have a choice.

The big problem with medical care is that the patient is at the mercy of the care-provider; the structures of the medical industry and the insurance industry and the HMOs and hospital owners, in addition to the massive dominance of medical practitioners—meaning that culturally Americans tend to defer without question to the judgment of medical doctors, even when the doctor is talking out of her ass—means that they are in a position to exercise a great amount of power, even unknowingly. And when they bring their religious or cultural prejudices to the job—e.g., homophobia—it can get pretty ugly.

Please don't misunderstand. I know that the majority of health care workers, especially nurses and GPs, are doing great work (surgeons I'm a little more dubious of). So we're talking about systemic power inequality + cultural prejudice = ethical stickiness.

I was privy to the LGBT hospital thing with a dear friend whose partner died unexpectedly of a brain aneurysm. He actually had power of attorney, gave it to a nurse to copy, who promptly brought the original back. The next day we were kicked out of the Intensive Care ( partner kept on life support by his parents for 48 hours) as the parents had come to town and ordered the staff to keep my dear friend away. They blamed him for their son's homosexuality. Lo and behold, nobody made a copy of the power of attorney, and not only could we not say our goodbyes to him, but the funeral home kicked us out as well. I encouraged my friend to sue, not because I'm sue happy, I've never sued anyone, but because I could see he was never going to get over this mess, and, he would be poverty stricken. He was too anguished to do anything except go home and go to bed for 6 months. I filed a written complaint about how the nurse sitting outside partner's room had treated us, claiming that in 23 years of nursing I'd never seen anything like it before. She was fired.

FWIW designate a medical power of attorney if you don't want your kids, wife, parents, third cousin from Idaho making your medical decisions when you can't speak for yourself. Do it now and make sure MPoA knows your wishes for end of life care and if/if not you want a DNR. So much confusion/angst/anxiety can be avoided when you have decided what you want for yourself before you lose the ability to express yourself. I've seen too many scenarios to not firmly believe in advance directives.

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All views expressed by jahedgpeth are the sole property of jahedgpeth inc. and subject to change by edit without notice.

I really hope the new visitation rules, which I'm almost positive are nationwide, will eliminate this problem forever. Of course, no one can prevent homophobic parents from being dicks. I wish I were a believer so that I could take comfort in the thought of the nurse, hospital, and parents burning in hell.