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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