A Public Health Stranger in the Land of Medical Care
Sunday, September 20, 2009
I don’t need to know if you are sick. Or do I? How about if you have a contagious illness? Perhaps H1N1?
Fortunately, the latest pandemic has not been as fatal as we had feared. While tragedy has struck some families, the death rate is about the same as or less than seasonal flu. Most of those who have perished had prior illnesses or conditions that left them susceptible to opportunistic infections like H1N1.
In the Ithaca community, tragedy struck a Cornell senior who became the third college student to die from H1N1 in the US. We do not know if any prior conditions contributed to his death. Yet, headlines in the Cornell Daily Sun this week read:
Hospital Says It Has Not Discussed Whether Any Underlying Condition Contributed to H1N1 Death
The laws are clear: patient privacy is secure and protected. Only the patient or the family has the right to grant access to health information. Even when the climate of fear permeates the community, our culture and laws value and protect the individual right to privacy. For that we should be thankful. For now.
What about the next epidemic? When the extent of the disease is more widespread, the fatality rates are higher, and underlying conditions are an obvious risk factor? What can we learn from the current epidemic? Shall we do anything different? Dare say, shall we suspend the laws and culture of privacy, for example? They do that in many other parts of the world in order to protect the public's health.
Do I need to know if you are sick? Or did you have an underlying condition, or not? Is the greater responsibility to protect the community or the individual right to privacy?
Stay tuned. The next epidemic is…..
Meanwhile, here is my highly recommended reading for this subject: The Last Town on Earth by Thomas Mullen; a novel about the morality issues of isolation, quarantine, and fear surrounding the deadly 1918 flu pandemic.
Tuesday, September 15, 2009
Public health spaces are everywhere.
Public health is about prevention through collective action involving teams of health professionals from engineers, to basic scientists, policy makers, health providers, and dozens of others.
Medical Care is about treatment and cure primarily revolving around the physicians’ treatment of individuals. About 95% of resources in the US go toward medical care.
So as public health advocate, medical care is “strange” to me as in the metaphorical sense that Heinlein presented in his famous novel. This blog will attempt to articulate my public health position as a counterpoint to the dominance of medical care.
In other words, I am a public health stranger spying on the spaces occupied and colonized by medical care.