I was sitting in the dentist chair the other day for an implant procedure. To my surprise the surgery had been furnished with surgical drapes, the dentist and assistant wore full surgical gear in mimicry of hospital surgeons. Sterility was obviously of prime consideration. When I commented that the mouth was not a sterile place and could not be made to be so, my dentist laughed and told me that studies had shown that such precautions during dentistry have been shown to make not the slightest difference to infection outcomes. I asked about the cost of all this gear that had to be binned at the end of the procedure. I surmised a 10% increase and he told me that it was more.
So why does a dentist waste so much time and money doing something that has been shown to make no difference? A major concern is the risk of legal action. If absolutely everything has not been done to secure the safety of the patient and something does go wrong, then the dentist, or any other health care professional for that matter, may be liable for damages.
In short, expensive and time wasting additions are purely ass covering because of a breakdown of trust between patient and health professional. This represents major community damage that puts our common life at risk in all sorts of ways. It is a symptom of the isolation of the individual from the community and the common subscription to avarice.
The conversation about useless sterile arrangements led to my dentist telling me about a list of patient rights that the local body responsible for such things urges to be displayed in the surgery or read to patients. He confided to me that he was embarrassed by this document and refused to display it because it was an insult to his and his patient's intelligence. He laughingly read out some of the "rights" of patients. The first was the right for everyone to have dental care? This mind-numbing first right was followed by a list of equally obvious motherhood statements to which no one in their right mind could object.
Attempts to establish jurisprudence on individual rights is fundamentally misguided. They are Utopian and sterile; Utopian, because they do not exist in real life or in law; sterile, because they cannot form the basis of a coherent jurisprudence. Rather, they are based on subjective whim with no relation to actual circumstances.
It is obvious now that the language of human rights has become do debased as to be next to useless. Any idea that seems good is now elevated to the status of a right. The result is laughable. Try telling anyone in the third world that they have a right to dentistry. Does it mean that someone who has no private health care and no money can go to a dentist can demand treatment because treatment has become a right? Such lists bear the mark of the work of a committee. I can imagine them sitting round a whiteboard listing all of the things they deemed to be a right.
I have had another experience of overregulation of health care procedures. I was asked by a local surgeon to assist in making some electrophysiological recordings during a surgical procedure. I proposed that we could carry out these recordings using a laptop computer, some software written by an old friend and a battery-powered pre-amp that could be located near the recording site. Electrical isolation could be achieved with fibre optic links so that there was no chance that stray current could damage the patient. I put the total cost at about $3000.
It soon became apparent that this was impossible because any device used for recording signals in a patient undergoing surgery had to be approved by the Therapeutic Goods Administration as a matter of hospital policy. In order to do that the device had to be sent to Germany so that it could be inspected and given the TGA seal of approval. The time involved and the cost were prohibitive.
I leant that the only device I could use that had approval from the TGA was a machine that cost $50,000 and which was not designed to measure in the microvolt range because it relied on the signal being transferred along meters of cable. Anyone who has done any electrophysiological recording knows the importance of pre-amplifiers that are located as close to the recording site as possible so as to reduce interference from electrical radiation.
I gave up. I told the surgeon that I was not confident that I could make such recordings particularly under the pressure of human surgery. A chance to enhance a surgical procedure with neural monitoring was lost because of red tape.
It seems to me that we are gradually digging a hole for ourselves that will continue to increase the cost of medical treatment and suffocate innovation. Surely a local biomedical engineer could take a look at our instrumentation and give it the tick of approval.
We have here three examples in which we surrender our common sense to the idea of perfection. This looks like religious behaviour. If so, what is the god that is being worshipped? Is it not the idea of the perfection of all things? Is this not a new kind of self-righteousness? The criticism of religious behaviour is that superstition trumps reason and we lose the freedom to act as we would.
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