The other day, I was visiting a good friend and mentor ofmine, Ed Halperin, who is Chancellor and CEO of New York Medical College. Dr. Halperin is a radiation oncologist, ahistorian, and an ethicist. I sat in on aclass he was teaching called “At the Intersection of Religion and Medicine.” Together, with a rabbi and a representative ofthe Archbishop of the Catholic church, they took on some pretty tough issues--but it was beautiful to see how they embraced pluralism and a sense of humanitythat valued patient-centered care in the truest sense of the term.
The rabbi, for example, talked about the trepidation he feltwhen he discovered that the intern assigned to taking care of his elderlyorthodox Jewish father was a young Middle Eastern man who wore a PLO pin. Hisfather was critically ill, and there was little that could be done to prolonghis life. The intern spoke to the familyabout their wishes regarding end-of-life care, and DNR orders. The rabbi told the story that he and hisfamily wanted everything done in keeping with their beliefs, and refused theDNR. Shortly thereafter, the rabbi’sfather coded. The intern leapt intoaction, performing CPR-–he looked completely spent when he came out to tellthe family that they were successful-–the rabbi’s father was intubated, buthis heart was beating again. The rabbi,who had now gotten to know the intern, asked him why he had worked so hard torevive his father, particularly when the intern knew it may well have beenfutile. The intern responded that he knewthis is what the rabbi’s father and his family would have wanted. This waspatient- and family-centered care at its best. There was compassion andunderstanding that transcended any political or ideological differences theymay have had. The rabbi talked about“people of good faith”--he could have equally said “good people”--people whorespect the individuality of their patients and the pluralism of oursociety. I returned from that visit filledwith a renewed sense of belief in the goodness of humanity.
More recently, there was an interesting LinkedIn discussionon the Healthcare Executives Network regarding a BBC article about sendingelderly relatives to care homes abroad. Clearly, there are many different viewpoints here--some felt that carewas outstanding in the Third World, and certainly far less expensive than itwould be here; others felt that they didn’t feel comfortable sending theirloved ones thousands of miles away. These decisions, like so many in medicine,are personal. There is no right or wronganswer. A Muslim noted that this wouldnot be something that he would be comfortable doing, sharing a quote from theQuran that discussed the imperative of respecting elderly parents. What got me was that someone had the audacityto post a reply that wreaked of ignorance and intolerance (too awful for me torepeat here). Don’t get me wrong--thisperson has the right to freedom of speech--but (perhaps naively) I hoped that,particularly in medicine, we would embrace diversity and be tolerant of varyingviews.
Every day, we treat patients with dire diagnoses who mustmake tough decisions that are congruent with their own values. This is “patient-centered care” . . . In a fewweeks, as our medical students graduate and are admitted to this nobleprofession, I hope they remember the Declaration of Geneva, and regardless oftheir religious affiliation (or lack thereof) remember to treat their patientsas “people of good faith.”