Gunderson
Lutheran Hospital is responsible for the authorial and publishing duties of
“Notice of Privacy Practices,” their informed consent pamphlet. In it is a
section titled: “For Healthcare Operations,” which is the focus of this
critique. The section contains a list of all the reasons the hospital may use
your information in regards to healthcare operations. All of it is beneficial
to patients and services, but if you were to read the sentence: “We may use or
disclose, as needed, your health information for certain administrative,
financial, legal, quality assessment and improvement, accreditation,
credentialing services and training activities,” it may feel otherwise. It feels
daunting and ludicrous that a hospital would need your information for all of that. The rest of the paragraph fleshes
out what this first sentence means, but the fingerprints of the Official Style have
dirtied the paragraph with its reading ease level of 12.8 (this is not like
golf, where lower means better, oh, and it is out of 100),
its 29.8 words per sentence, and its average reading grade level of 19.6, meaning
that if you are not in the midst of obtaining your doctorate, you may want to
read slowly and with Google search open, just in case.
In this specific case, the use of
Official Style seems counterintuitive to what Gunderson is trying to do. The
hospital wants to use patient information to improve upon programs, treatment, and
their health care experience as a whole, which is evident in the passage:
“For example, we may use health information to review our
treatment and services, and to evaluate the competence, qualifications and
performance of our staff in caring for you. We may use health information to
conduct training programs in which students, trainees or practitioners in areas
of healthcare learn to practice or improve their skills.”
The information seems promising, the
patient may even go, “Oh, well isn’t that nice?” But, that quotation comes very
early on, being the second and third sentence of the paragraph. From here on
out, though, it is a list, a list of obscure processes, using words that gloss
over and do little to illuminate said processes. Two examples are, “formulary development” and “business management.” The
Official Style threatens to derail the train of progress, by forcing the
patient to read about every place their information may go. The patient has the
right to know, but the Style is so sterile that the “it will help you in the
long run” message, evident in the above passage, cannot shine through. The entire
thing reads like a list of the people who have seen you naked (no matter the
length of that particular list), making you feel exposed, and well…naked. Now
if you absolutely have to be exposed, would you not want it to be for a
purpose? What if that list also included the outcome of each instance of
nakedness, instead of only just the names? “We may also disclose information to
doctors, nurses, technicians, students, and other Gundersen Lutheran hospital
or clinic personnel for review and learning purposes.” Why not elaborate on
these learning purposes?
According to the American Medical
Association, the point of informed consent is to create a communication between
patient and physician, which is most likely also a goal of Gunderson Lutheran.
In this case, the hospital has to communicate to the patient the various places
and desks it might find its way to. “For example,” shows up twice in the only
two clarifications in the entire paragraph. The use of these two words makes it
seem that Gunderson Lutheran is withholding pertinent information, only
allowing a glimpse of what they can do to be seen by patients. The inability to
disclose all of the things your
medical information will be used for hinders communication between the hospital
and the patient. Also, the phrase, “we may use,” appears in the paragraph a
total of four times. Robert Lanham might say that this phrase may be the
perfect metronome, the dangling pocket watch, to hypnotize the reader and put
them to sleep. The drowsiness affect goes against the intended outcome of the
informed consent. The repetition mentioned above, and the passage’s list-like
format, make for a very boring read. Oh, and don’t forget that it is a long,
single paragraph. Is there any better way to make a patient zone out, or better
yet, just skip it entirely? So not only can the lack of specifics (only two
clarifications, remember?) make the list seem daunting, but also it is such an
eye sore to even look at (and God forbid, to read) that it might not even do
its job, you know, of communicating.
By law, the hospital has to spell out
everything for the patient, so the governing bodies seem to have forced the
hand of Gunderson Lutheran into using the Official Style. The operators of the
hospital want to continue to have a job, and thus, must comply. Gunderson
Lutheran wants to use your
information to improve on what they do, be it through research on your
condition or reason for visit or using it as training material for new staff.
Informed consents are very much a legal document, which means that the Official
Style is all but required. But, this necessity to use the Style severs the
communication between hospital and patient that is stressed by the American
Medical Association. The message of the consent form, “we want to improve,” is
buried underneath the Style.
The Style shuns the audience, focused,
in this case, on covering legal bases. The Style should not be allowed anywhere
near consent forms, forms that are supposed to promote communication. Most
people are not going for their doctorate, but most people want to know what their
information is being used for and why. If legal forms like this one were
written with the reader, not just the judge in mind, lawyers and healthcare
systems everywhere would be pleasantly surprised at the level of compliance
from the intended audience, those signing their life away. Why not, at the end
of each section, tell the patient who they can go to with questions, questions
that may be specific to their particular experience. If these ideas are kept in
mind, communication would be repaired, and the beneficence (a component of
ethics!) that is trying to be conveyed via the consent form would be not only
present, but visible.
This
pamphlet can be acquired by either asking for one in person at Gunderson
Lutheran, or having them mail a copy to your residence.
--Chad Nickerson
No comments:
Post a Comment