Keeping Vegetative Patients Alive Should Never Have Been An Option!

The story of keeping a vegetative patient alive to keep the transplant program open for one New Jersey hospital has made headlines this month. Mr. Darryl Young, a 61-year-old male who received a heart transplant on 21 September 2018, never awoke from his transplant operation. His medical record notes showed the same comments “He follows no commands. He looks very encephalopathic”. When his name was brought up to the hospital’s weekly meeting, the response to it eas we “need to keep him alive till June 30 at a minimum”. The goal here was to keep him alive, even though he suffered from pneumonia, strokes, seizures and fungal infections so that the transplant program would keep its survival statistics high enough for them to meet federal regulatory requirements. After all, a higher survival rate one year after a transplant directly correlates with increased financial and reputational incentives. And if the survival rate is too low, CMS can intervene and remove the program’s Medicare certification. Simply put, no more federal health care dollars. The recordings even show staff assuring and warning each other to not offer palliative care treatments despite agreeing that this was unethical. Throughout this process the family was kept in the dark.

How many other physicians, or should I use the newly accepted term, “providers”, have experienced this? If you haven’t, then you aren’t paying attention and its time that you do. And if you have and chosen t keep quiet, then perhaps you should re-evaluate your values and the oath you took to “Do No Harm”. 

But, how did this happen in the first place? Do you blame the physician, the hospital administrators or the system? Its easy to blame the physician because he is the one sitting in the driver’ seat as its easy to blame the quarterback for the team’s troubles, when in fact it’s the offensive line that’s abysmal.

However, what this article fails to mention is the number of lives the hospital has saved with transplants. It is one of 12 hospitals that has transplanted over 1000 hearts. It also misses the fact that Dr. Margarita Camacho, the transplant surgeon, was the first woman ever to win the American Heart Association’s Distinguished Service Award. But what makes a juicer story – the fact that one saves lives, or the fact that we have yet another group of physicians breaking their oaths? Whatever the case, let’s` hope good things come out of this case for patient safety and transparency.

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  5 comments for “Keeping Vegetative Patients Alive Should Never Have Been An Option!

  1. Kurt
    October 31, 2019 at 10:26 pm

    Ditto on the gender of someone winning an award shouldn’t matter. I went to a scientifically oriented college and I had a lot of female classmates oriented to professional school and/or PhD’s in a variety of fields. My thought was that XY or XX didn’t make a difference whatsoever as long as one had a scientific knack. One of the older math professors was a freaking genius, it was rumored worked on the Manhattan project. Her CV was such that she was an undergrad at the University of Chicago when they split the atom in the atomic pile under the stadium at Stagg field. It was only after she died that it was mentioned in the Alumni bulletin that yes, she worked on the Manhattan project and yes, she had some patents on the timing device of the A-bomb that she eventually signed the royalties over to the college! Wow! Folks were granted patents on their discoveries on the “bomb” but they were kept secret as much as possible.

    • mamadoc
      November 3, 2019 at 8:39 pm

      Actually, the case you cite IS a matter of gender. Many of the women scientists who worked on the Manhattan Project (and in science in general) were pretty much ignored when it came to handing out credit for achievement (Rosemary Franklin comes to mind). This stuff has been declassified forever.

  2. ben
    October 30, 2019 at 11:08 am

    Goes to show that Value or Quality based incentives just increase the cost of care.

  3. R Stuart
    October 28, 2019 at 2:11 pm

    You want one-year survival? We’ll give you one-year survival.

    Grotesque stories like this are the inevitable result when something as complex as medicine is reduced to childishly crude measurements and statistics.

  4. Pat
    October 28, 2019 at 9:45 am

    No facility should be held hostage for federal dollars or beholden to CMS, because there should never have been any central government involvement in health care. This is a great post, and this story exemplifies my point. The creation of Medicare, CMS, et al commodified patients in a way that could not have been accomplished without federal force, and it shouldn’t matter if the moron mob majority supports it or not. In this case the best interests of the patient, the organic, non-communicative blob at the center of the story, were not considered. He became an object by which others advanced their own agendas, which, whether well-intentioned or not, were all rendered as bad by this naked use. The patient was reduced to a raw material, as philosophically bad as anything that ever happened to Winston in “1984.”

    I don’t think medicine can ever recover in society that would allow this crap to occur.

    (PS – the gender of someone winning a surgical award is totally irrelevant)

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