Human Exceptionalism

Putting Privacy Over Patient Safety

The government’s federal regulations about health care are rigidly pro-privacy. That is generally to be applauded, although I have heard (perhaps Apocryphal) stories of staffers not being able to tell a spouse that their beloved is in the hospital.

On the other hand, sometimes bureaucrats can be too literal in these matters. An important piece appears in today’s New York Times by surgeon Atul Gawande, exposing how government bureaucrats shut down a promising experimental system for preventing hospital acquired infections–a real and growing problem in America and elsewhere. He writes:

A year ago, researchers at Johns Hopkins University published the results of a program that instituted in nearly every intensive care unit in Michigan a simple five-step checklist designed to prevent certain hospital infections. It reminds doctors to make sure, for example, that before putting large intravenous lines into patients, they actually wash their hands and don a sterile gown and gloves.

The results were stunning. Within three months, the rate of bloodstream infections from these I.V. lines fell by two-thirds. The average I.C.U. cut its infection rate from 4 percent to zero. Over 18 months, the program saved more than 1,500 lives and nearly $200 million.

Such a success cannot be tolerated: The Feds shut the pilot program down because it allegedly violated the privacy rights of “human subjects:”

Yet this past month, the Office for Human Research Protections shut the program down. The agency issued notice to the researchers and the Michigan Health and Hospital Association that, by introducing a checklist and tracking the results without written, informed consent from each patient and health-care provider, they had violated scientific ethics regulations. Johns Hopkins had to halt not only the program in Michigan but also its plans to extend it to hospitals in New Jersey and Rhode Island. The government’s decision was bizarre and dangerous. But there was a certain blinkered logic to it, which went like this: A checklist is an alteration in medical care no less than an experimental drug is. Studying an experimental drug in people without federal

monitoring and explicit written permission from each patient is unethical and illegal. Therefore it is no less unethical and illegal to do the same with a checklist.

Only a bureaucrat could come to that conclusion.

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