Recent experiences with doctors brought back to me a time I was on a human subjects review committee at a hospital. An experimental procedure was brought to the committee’s attention. A psychiatrist wanted to investigate the underlying biological cause of panic attacks by artificially inducing a panic attack in his subjects. The committee typically assured that the subject understood the nature of the protocol and that she has given her informed consent. No problems there. Before taking a vote to approve of the protocol, someone asked if the doctor could describe a panic attack to those on the committee who weren’t familiar with it. He said that it was qualitatively different than an anxiety attack. During a panic attack, people are frequently driven to the brink of self-mutilation or suicide. Panic attacks are particularly horrible episodes. A lively discussed ensued. Some raised the concern that the experiment subjected the patient to what was tantamount to torture. "I'm not fooling the patient," the doctor said. "It is because the attacks are horrendous that people are willing to subject themselves to one in hopes of finding a cure." Find another way, some said. It doesn't matter if the patient knowingly volunteers. Torture is torture and you can't volunteer for it. No matter how noble the goal, an experimental procedure cannot violate the sanctity of the person. The committee was evenly divided between those who thought the goal was important enough to justify such a procedure and those who thought otherwise. Only a vote by the entire committee resolved the issue, sending the protocol back to the psychiatrist for him to develop a different protocol. The presenter was visible frustrated by what he construed to be unwarranted interference in important research by those who knew nothing about his specialty. Judgment and knowledge—the use of reason and rationality—help in making a decision between hard choices. But if all that hospital human subject review and ethics committees looked at were matters of finding the proper balance between means and ends and getting the informed consent of patients, something would be missing. Even more fundamental than reason and judgment is compassion. Patients want to be treated as human beings, they want to be respected; they want tenderness, mercy, and consideration while they are at their most vulnerable. A medical isn't like an auto repair shop for people. As for my recent visits as a patient, I was glad for the new technology put to use on my behalf. But there was also something missing. I had become less a person and more a machine. It happened this way: the doctors looked at their computers, examined the information and reached their conclusions. Several times I interjected a personal story I thought might relate to the condition they were examining. My anecdotes were dismissed with scant response with barely a glance in my direction. The screen was more important than my face. Humans are story-telling creatures. Stories put data into context. Patients have stories to tell their caretakers and those stories are necessary to fully understand the human condition. There is a great deal of pressure for physicians to get through the crush of patients. Consulting the computer and disregarding a patient’s tale is efficient. Listening, after all, is time consuming. But to reduce people to efficiency principles is to treat a person as a thing. A key ethical precept states that people subjects, not objects; they are ends per se, not a means towards an end. A keen listener is a good diagnostician. Doctors once knew this. Many today think they don’t time to listen to what I’m trying to. source
