A joke has been circulating in my hospital recently: inside a hospital ward, a patient who is waiting anxiously for a heart operation the next day, asks the nurse: "Miss, I am so afraid of tomorrow's operation. Will there be any problems?" The nurse comforts him with a smile, saying: "Don't worry, everything's ready. Besides, the chief surgeon has viewed the videotape already."
A few days ago, Chang Gung Memorial Hospital (
The operation was performed by the Chang Gung University (長庚?j學) President Chang Chao-hsiung (張昭雄). [Editor's note: Chang has been named by James Soong (宋楚瑜) as his running mate.]
Through the live broadcast, we saw the operation, the patient's recovery, the surgeon's craft and the excellent teamwork of the medical staff.
However, what caught my attention most was the trust the patient and her family put in the surgeon, as well as Chang's warm "bedside manners," as they say in medical circles.
After the broadcast, some people began to question whether it was legal -- and whether it was just PR. Tan Kai-yuan (
But let's analyze the whole event from the perspective of medical ethics.
I wonder what went on in viewers' minds as they watched the live broadcast.
Were they overwhelmed by the blood?
Were they fascinated by the surgery?
In my opinion, an operation must be important before it may be broadcast live on TV. For example, a ground-breaking procedure that turns a new page in medical history, or a specific case that catches the attention of the entire nation.
In this case, however, the hospital chose a medical procedure that is no longer new in Taiwan. Putting aside lay viewers who watched for mere entertainment, I must say that even a medical professional such as myself got a lot out of it.
From the perspective of education, I think merely watching a brief live broadcast without actually participating in the procedure does not help any surgeon improve his or her operating skills very much.
What matters more than anything in terms of medical ethics is whether the live broadcast takes a patient's rights into account.
Does such a broadcast increase the psychological and physical burdens on the patient? Is it possible that the timing of the surgery might be delayed for broadcast purposes?
All these concerns may seem unimportant since the surgery ended smoothly, but I do feel that live broadcasts of operations should not be encouraged.
Although I personally do not agree with such live broadcasts, I do see some of its positive effects.
We often see scenes such as this in TV soap operas: family members of the patient wait and pace nervously outside the operating room, as background music plays softly.
On these shows, when the surgery turns out to be unsuccessful, the medical personnel break the bad news with much remorse.
Despite their shock and confusion, in most cases the soap opera family trusts the physician's professionalism and accepts the heartbreaking news.
However, sometimes the family refuses to accept the explanation offered by the physician, and a medical dispute ensues.
Such scenes are not only wirtten into soap opera scripts; they are also common place in many hospitals. I've seen them.
From the standpoint of the patients, they have the right to know about their medical conditions and treatment. This information should be recorded in detail in the medical records already.
However, the operating procedures inside the OR are not easily understood by the patient.
Therefore, a physician who has done his or her very best would have no way of defending himself or herself, should questions arise regarding the procedure.
Actually, video recording of the surgery is a kind of medical record-keeping.
Therefore, if a procedure could be recorded with the patient's consent and paid out of the patient's pocket, then not only could unnecessary misunderstanding and disputes be avoided, but surgeons could also further refine their skills by watching their own taped performances.
Taur Jy Jyh is chief of internal medicine at the Capital Branch of Taipei Hospital.
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