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- Page navigation anchor for RE: Failure to cope: It’s the system that is ‘Failing to cope’, not the emergency department!RE: Failure to cope: It’s the system that is ‘Failing to cope’, not the emergency department!
The heartfelt commentary by Luther, Richardson and Detsky, comes from a good place – we should, as a society be appalled at a system that devalues the needs of citizens that are failing to manage in it. It does, however present a very simplistic view of the context in which these appalling situations occur. They close with the phrase ‘it is never a mistake to do the right thing’. This unfortunate (and rather sanctimonious) statement ignores the context in a system where the demand for services exceeds the resource availability to supply them. In the current system of triage and rationing, ‘doing the right thing’ for a person whose needs fall outside the mandate of the provider, means ‘not doing the right thing’ for someone else who has a right to expect care in the place specially designed for that purpose. In the current context, the weight of this decision seems to be thrust most notably on the emergency department. The authors ask us to consider how we would react if we had heard that our mother was considered less deserving of care after showing up in an emergency department because she had nowhere else to go. One might wonder what answer they would expect if we had been asked our reaction to her being turned away from an ophthalmology clinic? Perhaps they also might ask how we would react if our mother died of a myocardial infarction or sepsis after waiting on an ambulance stretcher in a hallway for several hours, while the ED was congested with stable patients ‘board...
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