Little Things Mean A Lot

For various reasons I have been doing a lot of hospital visiting lately and it has offered an opportunity to observe the care that is provided by obviously overworked health care professionals, who are routinely faced with challenging situations in conditions that inevitably involve scarcity of resources.

One incident that I witnessed concerned an apparently frail elderly person whose dentures had been lost in the hospital. The person's daughter was understandably annoyed by this and was offered an opportunity to claim for monetary compensation. While this may be the best that could be offered under the circumstances, it does not address the immediate needs of the patient, as obtaining new dentures may be difficult in this case. At the very least, it would take some time.

Thinking about this from a bioethical point of view, some might invoke a principle of dignity and argue that to leave a patient without his dentures infringes such a principle, although this obviously was not done deliberately. There are other ways of looking at it, however. With frail elderly patients, considerable focus is naturally placed on capacity to make decisions, and there is a surrounding legal framework to establish what counts as such capacity or the lack of it. There is another, natural, sense of capacity, however, concerning ability to function physically. Without one's dentures the capacity to take in nutrition is clearly compromised.

This thought leads to consideration of the class of ‘add-ons’ that might have similar importance. Artificial body parts and mobility aids should be considered. Spectacles and hearing aids are obvious examples that spring to mind. Another possible candidate is a watch. While younger generations might rely on their mobile phones for telling the time, for their seniors this might not be the case, and when eyesight is failing, seeing a clock on the wall might be challenging. Knowing what the time is, however, may be important to a patient in maintaining a sense of normality.

Hospitals cannot be expected to take responsibility for the possessions of their patients. The suggestion being put forward here, however, is that there should be some systems in place to safeguard those patient possessions that are key to their physical functioning. Obviously there are challenges to be faced, for example when patients have to move between beds or wards to facilitate the best care for themselves or for other patients. It is easy to see how possessions might get lost in the transfer. But some of those possessions, such as those mentioned above, are much more important than others (e.g., books and magazines), in so far as they support physical capacity. Where they do not already exist, there should therefore be a system of specific checks in place for these, just as there are mechanisms for checking that the proper medication has been administered. This is because they are in an important sense an extension of the patient's physical person. Incorporating this into a daily routine alongside other checks would (it is to be hoped) arguably be not too demanding for staff who are already working under pressure.