Introduction
This essay aims to analyze several stressful issues, raised in such TV series as ER and their relevance to the present-day health care system in Canada. In particular, it is necessary to discuss the episode Viable Options, and the questions, explored in this film, namely 1) the consumerism of Medicare and the relations between physicians and patients; 2) the distribution of medical services and the criteria for decision making; 3) the disclosure of diagnosis and ethical dilemmas, faced by medical workers. On the whole, these are the problems, which practitioners have to resolve on a daily basis, not only in Canada but all over the world.
The consumerism of the health care system
As it has been mentioned before, the most important question, discussed in Viable Options is the consumerism of health care system. In order to substantiate this argument, one should first briefly summarize the plot of this episode, at least one of the storylines. Dr. Covac is forced to determine which of the patients will get the only available kidney. One of them is a relatively well-to-do person, whereas the other is poorly insured. Covac decides in favor of the latter, and soon he is suspended. It is not a gross exaggeration to claim that health care in Canada has become highly commercialized and subsequently this gives rise to many adverse consequences and even incites medical workers to break their ethical principles, which is undoubtedly not acceptable.
Probably it would be more prudent for us to refer to some works, dedicated to this problem, for example, to the research article: Consumer Access to Health Care: basic right 21st century challenge, written by Mary Jones. The author analyzes the peculiarities of Medicare in Canada and the United States, because it is possible to draw some parallels between them. Her overarching thesis is that in the present-day community, there are certain layers or strata of society that are not able to get recourse to qualified medical services. Additionally, she states that medical institutions and authorities are not trying to alleviate the situation in any way (Jones, 2000, p 224). According to her, the consumer approach to such a sphere is ethically off-limits, because, it makes practitioners assume prejudiced attitudes toward some of their patients and spoils the overall image of the profession. As for this issue, we may take a closer look at the statistical data, indicating that the image of a medical worker has suffered a considerable blow, and some people do not assume a very favorable position toward the representatives of this profession, just because the relations between them have taken a different course and become more mercantile (Ramsay, 2004, p. 388).
Naturally, one cannot deny the fact that the services of the medical workers are chargeable, but is it really permissible to transform the hospital into some kind of shop, or supermarket, affordable only for very few? In this respect, we can mention Crag Ramsays book Health Care Reform and the Law in Canada. The scholar also claims that the consumer approach in the medical system creates a vast chasm between profit and non-profit clinics. Certainly, it can be partly ascribed to insufficient financing and lack of government support. The author believes that at present medical institutions are left to their own devices and are compelled to develop certain strategies for surviving. As a result, the relations between the physician and the patient have undergone a drastic change. They have become more commercialized as if between the buyer and seller. In his belief, the most tragic thing is that every physician who deviates from this rule is treated as some outcast. Such behavior has been eloquently described in Viable Options. The ideas, expressed in this film seem to be well-grounded that even though any would-be physician may be very reluctant to admit this fact.
The distribution of medical services
It is quite possible for us to single out another question, which is closely intertwined with the previous one; we should primarily speak about the distribution of medical services and criteria or principles of decision making. Traditionally, it is believed that there are guidelines for such situations and any practitioner must adhere to them in all circumstances. One of them is justice. At first glance, such a statement may seem rather commonplace, and self-evident. Nevertheless, this issue has always been a subject of heated debate. What are the criteria for decision-making? How can we decide who needs medical resources most? It should be kept in mind that Dr. Covac decided in favor of a poorly-insured man just because he was in urgent need of operation any delay could prove fatal. However, this decision was not approved by the administration of the hospital. At this point, we may suggest the problems of Medicare in the United States are strikingly analogous to those ones in Canada.
On the whole, one has to acknowledge that unfortunately this episode is quite evidence-based and it is possible to draw numerous examples that currently, health Medicare in Canada leaves much to be desired. We may elaborate this argument by the observations, made by one of the students in the emergency department. There is no necessity to name this medical institution, yet the event appears almost outrageous. He saw a person with a heavily injured hand wait in the line for a considerable amount of time because he was underinsured. Moreover, no one was willing to assist him. The thing is that such cases are not singular and they can be observed throughout the country.
The disclosure of diagnosis
As far as ethical dilemmas are concerned, we may speak another very important moment in the episode. It also explores the relations between the physician and the patient. Dr. Chen is inclined to tell one of the patients that her father suffers from Huntington’s Disease (practically a terminal illness), but Mark opposes this idea and prevents his colleague from disclosing the diagnosis. Scholars and physicians have not come to an agreement as to this question. On the one hand, the patient and his or her relatives have the right to know the truth, and it is the duty of a doctor to provide accurate and concise information, he or she must not conceal or distort the facts. But sometimes, this rule is not quite applicable because the disclosure may inflict severe emotional trauma and lead to unpredicted complications. One cannot provide any guidelines for solving this very complicated because much depends on the specific circumstances and we cannot make any generalizations. Perhaps, a practitioner should first remember such principles as nonmaleficence (do not harm). We should always take into consideration the possible aftermaths of the disclosure, if it may only hurt the patient or make his or her life intolerable, probably some facts should be concealed or at least not fully revealed. This issue has always been animatedly discussed by many practitioners and some of them insist that there really the facts must never be kept back, for example in Japan, the physician is obliged by law to tell all the truth to the patient whereas in Canada or the United States there is practically no legal interpretation (Veatch, 1997, p 88). In Viable Options, the filmmakers only compare opposing views on this question and show how medical workers may approach this question.
Conclusion
To conclude, the ER episode Viable Options reflects certain issues, which have become rather urgent, namely, the consumerism in the health care system and its adverse consequences. Despite the fact that the action takes place in the United States, similar cases can be observed in Canada as well. The scholars argue this phenomenon transforms the relations between the patient and physician, which now reminds the interactions between the buyer and seller. Such conditions may force a practitioner to violate the rules of his or her professional ethics. he impacts of consumerism only begin to manifest themselves yet even at this moment it can be observed that this phenomenon gradually undermines the functioning of the health care system. Apart from that, this episode illustrates the distribution of health care services and the decision-making process in a medical institution. Moreover, we may speak about the choice between the disclosure and concealment of information to the patient. There is no general pattern for solving this problem, except for the principles of nonmaleficence. The questions that we have analyzed here are vital for the Canadian Health Care system as well as for any other.
Bibliography
- Crag Ramsay (2004). “Health Care Reform and the Law in Canada: Meeting the Challenge”. American Review of Canadian Studies, (34), pp. 386-390.
- Joa Pric Boase (1996). “Health Care Reform or Health Care Rationing?”. Canadian-American Public Policy, (26), pp. 1-28.
- Mary Gardiner Jones (2000). “Consumer Access to Health Care: Basic Right 21st Century Challenge”. Journal of Consumer Affairs (26), 2, pp. 221-227.
- Robert M. Veatch (1997). “Medical ethics”. Jones & Bartlett Publishers.