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Doctors are using hospital “robots” to tell patients they’re dying, sparking an outcry

When it comes to end-of-life care, some things are irreplaceable. Face-to-face communication might be one of them.

Doctors are using hospital “robots” to tell patients they’re dying, sparking an outcry
[Photo: Chanikarn Thongsupa/rawpixel]

How can you turn a possible Black Mirror scenario into reality, but make it sadder?

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That’s what folks are saying about a new hospital trend: using telemedicine to deliver devastating medical news. A doctor at Kaiser Permanente Medical Center in Fremont, California informed a 78-year old man, surrounded by his family in the ICU, that he was unlikely to survive–by way of a rolling video technology “robot.” A nurse was in the room to accompany the remote conversation.

“We knew that this was coming and that he was very sick,” the patient’s granddaughter told KTVU on Friday. “But I don’t think somebody should get the news delivered that way. It should have been a human being come in.”

In addition, the family says, the technology suffered some clarity and quality issues. The hard-of-hearing patient couldn’t understand the doctor through the screen, prompting his granddaughter to relay the heartbreaking diagnosis herself.

Please share this…. This was regarding a friends Dad a couple of hours ago. This is not the way to show value and…

Posted by Julianne Spangler on Wednesday, March 6, 2019

As expected, the news inspired widespread criticism from both the medical community and average citizens alike. It was called unprofessional, insensitive, and downright “horrifying.” Some also couldn’t justify the practice seeing as how Fremont (pop: 234,000) is by no means a rural city short on living, breathing docs.

Dr. C. Michael Gibson, a Harvard Medical School professor of medicine, questioned whether a face-to-face convo is necessary in such instances. In a Twitter poll, over 4,300 replied, with 79% admitting they would “be upset” to receive a terminal diagnosis by telemedicine or robot.

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“No amount of technology will supplant the benefits of the human presence and physical touch,” wrote one follower. “Empathy’s greatest benefit is by being displayed live, not televised.”

But others had seemingly more understanding for the newfound practice. Dr. Zubin Damania, founder of a primary care clinic in Las Vegas, points out it’s likely less about the method of transmission and more about the content and delivery. “It’s really hard to give and receive bad news in person or telephonically,” he wrote on Twitter.

Physicians and nurses are steadily adopting telehealth, which has been championed as an efficient, cost-effective solution for patients in remote areas or for people suffering from chronic ailments that prevent them from moving—like arthritis. According to a recent medical survey by Kantar Media, 2 out of 5 physicians participate in telemedicine or plan to within the next year. Meanwhile, half of consumers think they would feel less comfortable during a telehealth visit versus receiving an in-person diagnosis.

But as the industry incorporates new modes of communication, it must analyze the ethical repercussions of swapping humans for devices. This proves especially difficult for older populations who might not have as much interaction with new technology, or might even harbor a fear of it. Add in a sensitive, emotional situation and the ramifications are even more challenging.

In response to the controversy, Kaiser Permanente Greater Southern Alameda County said the medical center is taking the family’s concerns seriously.

“Our health care staff receive extensive training in the use of telemedicine, but video technology is not used as a replacement for in-person evaluations and conversations with patients,” Michelle Gaskill-Hames, senior vice president of Kaiser Permanente Greater Southern Alameda County, said in a statement. “This is a highly unusual circumstance. We regret falling short in meeting the patient’s and family’s expectations in this situation and we will use this as an opportunity to review our practices and standards with the care team.”

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