Emergency medicine: do societal pressure, stress and technicality leave any place for humane treatment and compassionate approach care?

SCHMITT M, VIZZARI M, LEFORT H. Emergency Medicine: do societal pressure, stress and technicality leave any place for humane treatment and compassionate approach care?. Med Emergency, MJEM 2015; 22:8-12.
Key words: burnout, care, cure, emergency, humanity, humanism, humane treatment, ill-treatment, ordinary abuse, respect, security

  • Authors’ affiliation
  • Article history / info
  • Conflict of interest statement
Correspondent author: Michel SCHMITT, MD

Imaging Department, Groupe Hospitalier du Centre-Alsace

68003, Colmar Cedex, France

michel.schmitt@ghca.fr

Schmitt M, MD1, Vizzari M, MHSc1, Lefort H, MD2

1. Imaging Department, Groupe Hospitalier du Centre-Alsace, 68003, Colmar Cedex, France

2. Emergency Medical Service, Fire brigade of Paris, France

Category: Original article

Received: Nov. 20, 2014

Revised: Dec. 10, 2014

Accepted: Jan. 7, 2015

There is no conflict of interest to declare

ABSTRACT

Introduction: To look after a person in an emergency situation leaves little time for philosophical reflections. A life must be saved. The sensitivity of care receivers and their relatives is however at its highest when faced with the caregiver’s humane negligence, which they perceive as abusive.

Materials and methods: Creating a working group of the different professional caregivers and of care-receivers. Writing down a list of shared values of care, and of what is considered to be unacceptable behavior. Definition of care, both that which is respectful of the individual person and that which is not, and what to do in the case of excesses of abusive situations. Conclusions of the French Ministerial Group “Humane treatment in health care institutions (2010-2011)”.

Results: The ordinary, involuntary non-respectful care treatment (the “bad care”) is found in all our activities, mostly through the trivialization of the human being and the caregivers’ indifference, preoccupied more with urgency, action, the medico-economic and administrative contingencies, and technicality. Awareness must be increased, which will allow the questioning of all those who take part in the care chain. Discussions should be led with a selection of caregivers, which would allow them to express their human values and their feelings about the quality of their work environment. A virtuous circle unites humane treatment of care receivers with that of caregivers.

Discussion: All caregivers’ efforts must tend to an improvement in quality of life of care receivers, to a care system which respects the human being. Nevertheless, recent concepts which tend to make the patient a “health system user”, if not a “client”, carry within them the seeds of a consumerist tendency which, far from building a joint relationship of trust, where one requires the other, impose its views while asking the other to assume all the responsibilities. And, unlike the past paternalistic approach in medicine, it is not the caregiver that put themselves in such position. Good care can only come from shared trust and respect.