Tue, Jan 25, 2005 - Page 8 News List

Editorial: It's time to salvage responsibility

Hopes that the battered little girl surnamed Chiu would wake from her coma have been dashed. On Sunday the four-year-old was pronounced brain dead. Her parents have donated Chiu's organs so that her misfortune may now save the lives of other children.

The case, which has caused considerable anger around the country, started with brutal abuse but did not end there. The child's parents had split up, and her father, an unemployed alcoholic, assaulted Chiu while drunk, causing severe head injuries. This was not the first time Chiu had suffered such abuse, and one of the many tragedies in this saga is that neighbors did not report this case to the Department of Social Affairs or other child welfare agencies earlier.

What started out as a case of domestic violence took on greater implications after the negligence of the Municipal Jen Ai Hospital was exposed. In Taipei City, which boasts the best medical resources in the country, Chiu, whose injury status was unclear, was refused admission to a series of facilities before finally being rushed to a hospital 200km away in Taichung. Precious time needed to save her life was wasted.

Lin Chih-nan (林致男), a surgeon who was on duty at the Municipal Jen Ai Hospital on the night Chiu was brought in, originally claimed to have followed hospital procedures in refusing to admit Chiu because no post-op beds were available.

However, the director of the Taipei City Government's department of health, Chang Heng (張珩), later revealed that Lin had not even reviewed patient X-rays before signing her transfer order to another hospital. He was subsequently alleged to have altered medical records and to have forged the signature of the presiding physician.

The case has therefore turned into a general indictment of medical ethics. An investigation by the Taipei City Government has revealed more inconsistencies, and this has led to accusations of inadequate management at the highest levels of the city government. Chiu's mother is reported to be suing the Taipei City Government for compensation, and this is only right and proper.

Procedural failures also brought the operations of the national Emergency Operations Center into question, which suggests that a review of the center's procedures might be appropriate.

If anything can be salvaged from this disgraceful series of events, it is that Chiu's death will lead to improved emergency care and coordination. Her death has put a spotlight on issues such as child welfare in single-parent families, support for the unemployed, awareness of the need for state intervention in cases of child abuse, paralysis in emergency-response operations, inflexible hospital operational procedures, medical ethics overwhelmed by the profit motive and deficiencies in the administration of the city government.

If this country can learn its lesson and make the necessary changes, the death of Chiu could save the lives of a number of children and other patients whose less dramatic deaths might otherwise have disappeared behind doctored paperwork and buck-passing bureaucrats.

Although her life was short, Chiu might end up unwittingly performing a service of tremendous importance. But this also depends on Taipei Mayor Ma Ying-jeou (馬英九), the medical profession and the general public having the humility to learn from this debacle.

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