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Death With Dignity

I recently read an article in the New York Times regarding a family who faced a challenging time in their lives. The article described the life and death of a 60 year old father and husband who taught at a day care center. The man was diagnosed with amyotrophic lateral sclerosis also known as A.L.S. or Lou Gehrig’s disease just two years prior to his death and according to his wife; he was not able to die in the manner he has wished. His wife also stated that her husband wanted to have the option to end his life but did not because “death with dignity” law had not been passed in the state of Massachusetts.  A.L.S. is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. This terminal illness has no course of treatment or hope of recovery.  Before death, the disease can leave the patient totally paralyzed.

The “death with dignity” act was passed in both Oregon in 1997 and Washington in 2009 giving patients suffering from a terminal illness with no hope of recovery the right to receive a lethal medication from a physician to voluntarily end their lives. The wife of the Massachusetts man has hope that this law will be passed in her state so no other family has to go through the same painful death as her husband. However, Catholic’s heavily populate the state of Massachusetts and are opposed to the direct, intentional, and purposeful taking of a human life. Therefore if the law ends up on the ballot in November, advocates for the law may have a difficult time retrieving votes.

This law poses and ethical dilemma between pro life advocates and death with dignity advocates. Pro life advocates believe that the passing of voluntary killing will promote involuntary killing in the future. Whereas dignity advocates believe that with proper restrictions on the drug and qualifications to receive the drug, patients will have the right to die with dignity and peace.

Like many people, I am on the fence about passing the law. Taking the life of a human whether it’s voluntary or involuntary is still ultimately ending a life, and that goes against everything many of us have been taught. Who are we to decide when it’s time to die? Does this mean we are trying to play God or any other higher being one may serve? For now, I will remain on the fence about the decision, for one may never be able to decide unless we are put into a situation such as the wife and husband of Massachusetts.

Link to New York Times Article:

http://newoldage.blogs.nytimes.com/2012/05/29/massachusetts-debates-death-with-dignity/?ref=health

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What is quality in healthcare?

There is no single definition of quality as it can be defined differently depending on the situation it pertains to. However, there are some common factors that are universal when it comes to measuring quality regardless of the entity.  For instance, there are different grades of quality in relation to products, services and customer experiences. Each element of quality can then be broken down into different factors. For example, the quality of a product such as food can be determined but the look, feel, smell, and taste of the item. The presentation of the food is the first impression, whether the food looks and smells edible as well as whether the food is cooked to the right temperature will affect the quality measurements drawn by the consumer.  Another factor that affects the quality would be the service rendered. Sticking with the food example, the service will be an important part of the quality test. Consumers want to know that there food was handled with clean hands and prepared on clean surfaces while simultaneously have fast service with exceptional servers. Finally, the over customer experience has a tremendous effect on quality.  Each element has to flow with one another to create a positive customer experience. For example, if a restaurant has incredible food but the service from their staff is horrible and the wait times are too long, the restaurant will receive poor quality reviews from consumers. For this reason, it is important for restaurants owners to put a emphasis on consumer satisfaction with the food, the service and the environment in which they operate.

The same elements of quality go for the field healthcare. Within healthcare, quality of care is the degree to which health service for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge (Ransom, Joshi, Nash & Ransom, 2009).  Healthcare affiliates alike agree that healthcare should be safe, effective, efficient, timely, patient, centered and equitable (Ransom, Joshi, Nash & Ransom, 2009).  These six elements can have a drastic affect on patient satisfaction and the quality results within the hospital.

Within my internship during my undergrad experience I got a chance to work with the department of volunteer services at a hospital here in Orlando. Before I became an active intern, I did not realize how much volunteers actually contributed to the overall quality of the hospital. The director of volunteer services along with hospital administration has changed the duties of an active volunteer. As a volunteer, you are taken through a process which ensures that you are first and foremost focused on patient centered care. Your process includes orientation, accountability statements, trainings, and observations to ensure that you are helping the patient have an overall great customer experience. With all of these steps you are taught to tackle the 3 universal factors of quality, delivering a great product with impeccable service while simultaneously improving the customer experience. With that being said the quality of healthcare for patients at that particular hospital have skyrocketed simply because administration understands the need for quality and the affects it can have on the hospital as a whole.

Reference:

Ransom, E., Joshi, M., Nash, D., & Ransom, B. (2009). The healthcare quality book, vision, strategy, and tools. (2 ed.). Washington, DC: Health Administration Pr.