hyzmarca
Jul 6 2006, 12:22 AM
I was watching House last night and I got to thinking about medical ethics as they relate to Docwagon. For those who don't know, House is an hour long television show - broadcast on the Fox network - about a Diagnostition named Gregory House.
Dr. House is presented as the Sherlock Holmes of the medical profession. Although he refuses to see patients in person because he hates humanity in general, he is able to skillfully diagnose some of the oddest and most unusual illness using information gathered by his underlings. The only time House actually does see patients is when his staff would refuse to go along with his treatment plans due to little things like "ethics". In these cases, House often forces his patients to reveal embarrassing secrets under the assumption that they will help diagnose the illness. Sometimes this is the case, sometimes it isn't. He also tortures his patients using unnecessarily painful procedures on occasion. He skillfully manipulates patients and staff alike using lies, half-truths, and the bluntest possible honesty. He bribes and blackmails other doctors to force them to perform unethical procedures and then turns around and betrays them anyway. House also indulges in self-experimentation and, due to pain from an old leg injury, treats vicoden like candy.
In general, if you were sick with a bizarre illness he's the guy you'd want to treat you.
He is annoying and is he is addicted to narcotics but that does matter. He is the best there was, the best there is, and the best there ever will be. The fact that he has no ethics actually makes him that much better.
A recent episode made me think about DocWagon and how it would treat the concept of medical ethics. In this episode, a woman has the factitious disorder known as Munchausen's disease. She fakes medical problems to get attention. House believes that she actually is sick. He thinks that she has Aplastic Anemia. If this is the case she'll die without treatment. However, everyone else assumes that she is faking those symptoms and she is released. House meets her outside and stops her from getting into a cap. He tells her of his suspicions and then injects her with drugs that will lower her white blood cell count and cause her to have a seizure.
When she is found outside having a seizure she is brought back in. When tests reveal her lowered white cell count, House's diagnosis is confirmed and she is scheduled for treatment. While she is having radiation treatment to kill her bone marrow in preparation for a transplant, House is in her hospital bed reading a magazine. Suddenly, he notices that her shirt smells like grapes. He stops the procedure in time and reveals that several self-inflicted bruises on her torso had become infected. It was a bacteria that was causing her real symptoms, not Anemia. When House revealed that he had injected her with drugs to fake symptoms that would support his diagnosis. The response of his colleagues was an odd half pat-on-the-back-for-a job-well-done-half-gaping-stare-of-abject-horror.
Now, DocWagon is a extraterritorial Megacorp. They are not subject to any regulations and they cannot be sued. In short, they don't need medical ethics. Standard medical ethics would just get in the way of their profit.
My Proposal for DocWagon's Ethical Guidelines-
1) The Paying Customer is Always Right: If their check clears then they can tell you what diseases they have and what drugs they need.
2) Corpses Don't Come Back: We are built upon a foundation of customer satisfaction and repeat business. Avoid killing patients whenever possible.
3) What the Insurance Company Doesn't Know Won't Hurt It: If the patient's insurance won't pay for the treatment then do not diagnose the disease. Tell them to get better insurance and then come back.
4) A Terminal Patient is a Regular Patient: Try to avoid curing diseases that can be treated by a lifetime of expensive medications.
5) Don't ask, don't tell: Confidentiality keeps our customers happy.There's no reason to tell anyone that you pulled police-issue bullets out of Mr. John Smith in room 303.
Of course, maximizing profit may lead to some other issues. Drug importation rules, for example. A patient who leave a DocWagon facility with perscription medication may be in volation of local drug laws and subject to arrest. I can imagine that DEA agents would be able to get quite a few busts just by camping outside of a DocWagon hospital.
James McMurray
Jul 6 2006, 12:53 AM
You can charge more if they have to come to your clinics to get a drug that will keep them alive but is illegal outside.
Drraagh
Jul 6 2006, 02:09 AM
| QUOTE (hyzmarca) |
Now, DocWagon is a extraterritorial Megacorp. They are not subject to any regulations and they cannot be sued. In short, they don't need medical ethics. Standard medical ethics would just get in the way of their profit.
My Proposal for DocWagon's Ethical Guidelines-
1) The Paying Customer is Always Right: If their check clears then they can tell you what diseases they have and what drugs they need.
2) Corpses Don't Come Back: We are built upon a foundation of customer satisfaction and repeat business. Avoid killing patients whenever possible.
3) What the Insurance Company Doesn't Know Won't Hurt It: If the patient's insurance won't pay for the treatment then do not diagnose the disease. Tell them to get better insurance and then come back.
4) A Terminal Patient is a Regular Patient: Try to avoid curing diseases that can be treated by a lifetime of expensive medications.
5) Don't ask, don't tell: Confidentiality keeps our customers happy.There's no reason to tell anyone that you pulled police-issue bullets out of Mr. John Smith in room 303.
Of course, maximizing profit may lead to some other issues. Drug importation rules, for example. A patient who leave a DocWagon facility with perscription medication may be in volation of local drug laws and subject to arrest. I can imagine that DEA agents would be able to get quite a few busts just by camping outside of a DocWagon hospital. |
Corps can be dealt with through ways that corporations have the abilities to. For example, when it comes to DocWagon, I wouldn't be surprised if there aren't at least three other companies doing similar services, as it is a niche market after all, an no one company would hold a monopoly. I would recommend checking out the short story Blood Sisters by Greg Egan. It's an example of what happens when a medical corp cares more for its patients money than it does for its patient's health.
So, while you will be milking your customers for their cash, you do need to consider treating what they have (though I do agree with the giving pills for something that we can cure), though you NEED a good story why if/when the customer comes back with some information of the surgery or cure that's out there.
For example, let's say a patient comes in with 'Big Head Syndrome', or whatever it was called in Theme Hospital. If you just give him some placebos and tell him to go home, take two with each meal and come back for a refill (knowing that it'll go away in a few weeks), that's no problem. Or even if the pills do cure it, some people don't like having to worry about pills, slap patches that sort of thing. We've all forgotten medication at one time or another, I'm sure. But if we were to find a second option that could cost as much as the pills or less, then we would probably take it. We could find it on the trix, through our doctor, a friend, whatever. It's sort of how it happens today. I didn't really look too much into laser eye surgery until a friend of mine was getting it because I had no problem with glasses. Now that he's had it and there's no problems, it seems a more possible idea.
With regard to rule 3, you could let the patient pay for it, since it would likely be at least half of the cost of that upgrade to a better Docwagon contract or something. After all, Shadowrunners pay with cash since they don't want to be tracked by insurance.
And finally, this is something that may be worth taking a thought to, or I may just be wrong. DocWagon is a retreval team for bodies, as part of its service. They do make slight mention to it being a medical care provider as well, but what I tend to see them as is that they are like the police medics that come in and take the wounded and try and patch them up on the way to the hospital. Similar idea, except better tained and better equippws. But once they heal the person back to the living, they pawn them off on the nearest hospital to deal with, so they can go back to finding bodies.
To some degree, this gives some extra possible plothooks. What about docwagon people organlegging or ghouling people's cyberware who die on the ride to the hospital? Tweak the logs slightly saying there was nothing recoverable at the scene or some such. Hospitals aren't going to really pay much attention to a DB notshowing up, even if they monitored the DocWagon signals.
El_Machinae
Jul 7 2006, 12:30 PM
It's amazing how all the DocWagon painkillers are wonderfully addictive, yes? Though, "because we caused the problem", the price of the drug drops after you're addicted.
It's called customer service.
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