Wednesday, January 13, 2010

Speeding MD sparks a debate Should doctor racing to emergency get ticket?

There is no consensus in the case of the cop-cardiologist conundrum.

Was the police officer who gave the doctor a speeding ticket overly rigid? Was the speeding doctor overly reckless? Did both do something wrong? Did neither?

Perhaps you'd have to be a brain surgeon to figure it all out. The heart surgeons can't.

"There's no right answer to it," says Gideon Cohen, a staff cardiovascular surgeon at Sunnybrook hospital who has sometimes run red lights – though cautiously – when rushing to the operating table. "The police say if you're speeding you're endangering other people even though you're trying to save somebody's life; you're endangering yourself and other people's lives as well. Having said that, if it's your mother on the table, then you want – know what I mean?"

On the table at St. Michael's Hospital on Saturday was Jeffrey Halstrom, a 47-year-old who had suffered a heart attack. Racing to his side, allegedly at 35 km/h above a 40 km/h speed limit in the Bayview and Moore Aves. area, was cardiologist Michael Kutryk, who was to perform angioplasty.

While Halstrom waited, Kutryk was pulled over and handed a $300 ticket. According to Halstrom's partner, Kutryk said upon his late arrival that he had been delayed "for the better part of 10 minutes."

Experts in ethics came down on different sides of the thorny dilemma when asked for their thoughts Tuesday.

Saint Mary's University philosophy professor Chris MacDonald applied a rule-based ethical doctrine. Society would be worse off, he said, if police officers always let excuse-making speeders off scot-free.

"(Kutryk) claims that there's something urgent going on at the hospital, but the police officer doesn't have any way to know that," MacDonald said. "And so you sort of have to ask yourself, do you really want the police letting people go because they claim to have some sort of emergency going on? ... Are they supposed to look into the individual's eyes and judge whether it really is a life-and-death situation or whether it's a quote-unquote `life-and-death situation' where they're late for dinner?"

Susan Dimock, a York University philosophy professor and past director of the school's Centre for Practical Ethics, applied a utilitarian cost-benefit analysis. The "minor risk, or minor increased risk" created by Kutryk's speeding, she said, was far outweighed by the benefits of treating his patient in a timely manner.

Brian Patterson, president of the Ontario Safety League, sided with the police officer. He argued that Kutryk's speeding increased the likelihood that he would kill any pedestrian he struck; Kutryk, he said, "may not have considered the risk he was putting the public at."

Toronto doctor and ethicist Philip Hebert says he's been pulled over by police more than once while speeding to a medical emergency, and never been given a ticket.

Once, he even got a police escort to the hospital – just like something out of the movies.

Hebert, who also teaches medical ethics at the University of Toronto and is author of Doing Right: A Practical Guide to Ethics for Medical Trainees and Physicians, says the officer in this case should have allowed the doctor to proceed to St. Michael's – and even helped him get there quickly.

"Attempting to save a life is on a higher plane" than traffic laws, Hebert said.

"There should always be some flexibility in the rules."

Cohen, the Sunnybrook surgeon, said "it's tough to justify" speeding to the operating table even though he himself has done it.

But he said the officer's decision to not only issue the ticket but also make Kutryk waste precious minutes waiting for it was "excessive."

He proposed a compromise. "Take his licence plate number, follow him to the hospital and put (the ticket) on his car or something."


Reposted from the Toronto Star, Wednesday January 13, 2010.

Original article, click here.

1 comment:

  1. I have been working on health information systems in developing countries for some time and it is interesting that a lot of your principles are the same as what I have been proposing to resource poor countries. The ideas of keeping things simple, incremental development, local use of data, minimal data set, appropriate technology and of course data standards and interoperability.

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