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COPYRIGHT 2006 All rights reserved. Reproduced by permission of The Condé Nast Publications Inc.
One afternoon in 1982, a twenty-eight-year-old Michigan state trooper named Craig Scott stopped a speeding car on U.S. Route 127, outside Jackson. Scott discovered that the car, a Camaro, had been stolen, and arrested the driver. As Scott was helping the driver into the back of his patrol car, a passenger in the Camaro pulled out a .38-calibre revolver and shot the trooper three times in the back. Bleeding profusely and gasping for breath, he was taken by ambulance to Foote Hospital, in Jackson. As doctors tended to Scott in a trauma room, his wife arrived at the hospital, and so did several of his colleagues. In the lobby of the emergency room, Scott's wife pleaded with the hospital's chaplain, Reverend Hank Post, to let her see her husband, and Post agreed to convey her request to the physician in charge of the trooper's care.
"We debated back and forth," Post recalled. "The staff was very uncomfortable." Finally, the doctor went to Scott's wife and explained that the hospital prohibited family members from attending resuscitations. But she continued to insist, and eventually the doctor gave in. "It was hard to deny her with all those blue shirts staring you down," said Post, who accompanied the woman to her husband's bedside.
They watched as Scott was given blood transfusions and sent to the operating room for surgery, where he died. Over the next week, Post talked to doctors and nurses at the hospital about allowing patients' family members to accompany them inside the E.R. The doctors and nurses dismissed the idea; many argued that laypeople would have trouble coping with the stress of witnessing resuscitation efforts and patients' deaths. Post disagreed. Ordained in the Christian Reformed Church, a Protestant denomination, he was inspired by the Calvinist tradition of challenging prevailing dogma. He told me that he regarded his effort to open Foote Hospital's emergency room to families as a campaign for "human rights."
For several years, whenever Post was on call, he urged physicians to let patients' relatives sit in on resuscitation attempts, and, when doctors agreed, he stood with the family members next to the patient's bed. "It moved grieving along," Post said. "The families saw quickly how hopeless things were, and, by being present, the family can own part of what went on." In 1985, Post sent surveys to seventy people who had witnessed resuscitation attempts in Foote Hospital's E.R. Among the questions he asked was "Would you choose to participate again if the opportunity were presented to you?" Forty-four of the forty-seven respondents said yes. Several added that although the experience had been unpleasant, it had helped them come to terms with a relative's death.
In 2003, emergency rooms in the United States treated nearly a hundred and fourteen million people; about one in every hundred received CPR or underwent another kind of resuscitation procedure. Resuscitations are gruesome--physicians occasionally have to split ribs or cut into a windpipe in an effort to keep someone who is bleeding or unconscious alive--and just fifteen per cent, at most, are successful. Foote was one of the first American hospitals to permit patients' relatives to witness these procedures, but the practice, which is known as "family presence," is spreading, promoted in many instances by chaplains and nurses over the objections of doctors. (There are no reliable data, but advocates estimate that as many as half of American hospitals allow some form of family presence.)
In 1993, at the annual meeting of the Emergency Nurses Association, Patricia Howard, an emergency nurse from Kentucky, submitted a resolution to the group's general assembly endorsing the policy on the ground that "when family members are prohibited from visiting before . . . death, the grief process may be hampered and left unresolved." To her surprise--the association had never discussed family presence--the resolution passed by a large majority. "We've always taken excellent clinical care, but not always excellent psychosocial care," Howard, who just finished a term...
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