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Lecture 11

Lecture 11 Nov 22nd.docx

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McMaster University
Gail Coulas

ndSociology 3HH3 Sociology of Health Nov 22 2012 Lecture 11 Last week medical system is becoming more transparent there is demedicalization More technology that can reduce errors Bates study looked at two hospitals Found adverse medical affects in about 4 of all hospital admissions almost 14 lead to death Hospital induced injuries estimated that over 120 000 patients died because of the errors A common reaction to medical system setting is to fix blame but not the issue Not about safety and improvement but pointing fingers and thus competition between workers no collectivity where people share responsibility Errors could be reduced if every ER was standardized Change was implemented in 2009 called the checklist o 75000 patients in Toronto and other countries o Simple checklist procedure similar to the one that pilots use before take off o Helped to cut the death rate from 158 significant drops in complications from infections heart attacks and blood clots This adds up to 60000 patients per year free of complications o This process means checks are done collectively are members take part and everyone has to sign it o It is a simple and quick process Despite our social trust in medicine evidence suggests that medicines complexity results in risk of patients Movement of improvement coming from everywhere Ethics Discipline helps identify values to good decisions and good policy o Helps to define clarify and prioritize good decisions Bioethics medical values that we as a group share o We as a group have a lot of power in ensuring that change can be made o Trust that no matter medicine will do no harm and thus give them a large amount of social power However there are segments of the population saying we need more say in whats happing and more transparency in the system In a complex society it cannot be assumed everyone has the same ethics Members of a group can lose touch with social norms with what society wants and shifts to the norm of the occupation o Public pressure can make change so that a profession can move back to public good Political theatre People use media to get their point Political theatre of medicine government give money to the medicine system and the public trusts the medicine system and then we give the government money to pay the system taxes Reality is people die from medical care system errors o Individualism is creeping into the ideal o Want a two tiered system Members of a group can lose touch with social normsshifts to occupational norms Selected valuereflects powers What choices should be made ethical dilemma uncertainty about choice and correct actions o Good statistical evidence there is going to be a poor outcome How do you decide where resources should be spent Who takes control Parents or state How do you set priorities for healthcare research only finite amount of resources
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