Dr Z. Essak, MD - Vancouver BC - March 4, 2018

The TEDx Stanley Park event at the Queen Elizabeth Theatre in Vancouver on Saturday March 3, 2018 was incredible with 13 (a bakers dozen) memorable and inspiring speakers and 4 brief, fun energerizer programs to keep the audience engaged. Two of the presentations addressed medical errors.

With cancer as the leading cause of death and heart disease as the second leading cause, medical errors are referred to by some as the third leading cause of death and disability.

Whether errors are third or not, it makes sense that anything that helps to reduce or prevent medical errors is worth pursuing. Every error that can be prevented has direct benefit to individuals and their families.

Dr Chris Sedegreen.

Some time before the Christmas holiday a colleague mentioned a book, The Bhagavad Gita Comes Alive, on the Doclounge listserve. I’d like to thank him for bringing this lovely book to our attention. I ordered and received the paperback version (somewhat cheaper than the hard cover, but in retrospect I wish I'd ordered the hard cover). This publication is beautifully printed.

Medicine is, at its center, a moral enterprise grounded in a covenant of trust. This covenant obliges physicians to be competent and to use their competence in the patient's best interests. Physicians, therefore, are both intellectually and morally obliged to act as advocates for the sick wherever their welfare is threatened and for their health at all times.

Today, this covenant of trust is significantly threatened.

This is one of my favorite Rick's Rants. In less than 2 minutes he lays it all out. Beginning with the problem for scientists then in the middle he turns it up a notch, "Get over yourselves. It's not like scientists are the only ones being told to shut up. No, it's everyone." Then after some fine examples he ends with a polite, "Thank you for not talking." A great entertaining and thought provoking rant.

2019-03-12 Dr Z.Essak, MD - Vancouver, BC

Ethics are a big part of our lives as principles that govern our actions. Doctors take an oath to serve the patient's interest and not their own or that of others.

We expect ethical actions of people involved with our daily lives: teachers, accountants, professionals, merchants and others. It is the basis of the trust we have in them. We depend on them as people with privilege and power over ourselves, children and others.

It's not just ethics in medicine and health: it's ethics in politics, in technology, in corporations and the list goes on. People are growing more concerned about the decline of ethical leadership in politics and also business tech giants like Facebook, Google and others.

What happens when an individual's actions run contrary to ethical principles?

The late Dr Morris VanAndel, a well-respected GP and subsequent Registrar of the BC College of Physicians and Surgeons, reminded doctors in 2002 this way: "An ethical principle, by nature, is not modified by circumstances, regardless of the validity or justification of the reasons leading to the action."

Health professionals not effectively or adequately engaged.

Approach should ensure health professionals, stakeholders and the public are informed.

On February 17, 2010 the Auditor General of BC, John Doyle, issued his report on “Electronic Health Record Implementation in British Columbia” which is available on their website http://www.bcauditor.com

In his report, the BC Auditor General, acknowledges “The development and implementation of an EHR system … is a complex and high-risk endeavour … because of the large investment of public funds” and “because collecting, storing and disclosing information electronically raises concerns about the privacy and security of personal health information”.

Concerns about the privacy and security of personal health information is not covered to any great extent in the BC Auditor General’s report.  However, several issues have been reported on by the BC Commissioner of Privacy and individual orders are available on their website, http://www.oipc.bc.ca/.  The BC Civil Liberties Association also provides information and discussion on eHealth issues on their website, http://www.bccla.org/ehealth.html

BC is one of five Provincial Auditor General Offices that will issue separate reports for their jurisdictions and the Office of the Auditor General of Canada will be issuing a joint summary report in April 2010.

There’s more in the full report than contained in the news release and Executive summary.  Here are some key highlights.

What happens to children born with cerebral palsy when they become adults?

In one case an individual born with cerebral palsy when they were an adult in their early 30’s had progressive deterioration of function involving their affected upper limb.

The individual was reviewed by their orthopedic surgeon who suggested botox injections for spasms and possibly some cosmetic improvement to the upper extremity although not optimistic for functional improvement.