Transform Healthcare

The heads have lost their hearts

May I share with you what happened in FoolishLand recently?

Many armed robbers hurt themselves whilst shooting at those they were robbing or at the police. The reason for this was that they did not know how to handle their guns well.

It wasn’t long before family members of the injured robbers started a public campaign for the better education of robbers in the use of firearms. In the beginning, most citizens of FoolishLand were against the campaign.

The argumentations of the campaigners included the following:

1.     Every robber has the right to carry a gun. The slogan was: Boss Over Own Gun.

2.     All robbers should receive training in the use of their guns, whether the gun was illegally owned or not. They are gun owners and all gun owners should have the same rights.

3.     It is cruel to let the families of the robbers suffer so much. The campaigners published many heart-breaking stories of how the robbers and their families suffered from their injuries. The message? If only our daddy received better training in the use of his gun, he would not be hurt and we would not suffer so much…

4.     The robbers will continue to use illegal guns anyway, so we can just as well legalize the weapons training of armed robbers. Thus we will decrease the number of injuries among armed robbers.

5.     We might even think about legalizing armed robbery. Once it is legalized we can control it better.

6.     It would be so much better if they could get the training in their own country from local experts. What a waste of money for them to go to neighboring countries for training.

7.     In any case the number of injured robbers was increasing; at least that is what the campaigners claimed.

8.     Many heads of society supported the campaign – many famous and prominent people in FoolishLand were used to influence those who follow them.

After more than a decade of campaigning, a national referendum was held. Not enough people turned up to make the referendum legally valid (less than 50%). But a small majority (54%) of those who did vote was in favor of the training courses for armed robbers.

The heartless head of FoolishLand concluded that the people have spoken – the training courses should proceed. No more injured armed robbers in FoolishLand, he said. I am standing on solid ground even if my interpretation of the referendum outcome is illegal and even if the majority of a minority is not a democratic majority. We are a civilized country.

What happened in FoolishLand?

1.     A group of people did something that is ethically unacceptable.

2.     They continued to do so even though a number of them were hurt in the process.

3.     Somebody then decided it should be made safer for them to continue to do what is ethically unacceptable.

4.     The campaigners developed all kinds of deceptive arguments.

5.     Through these ‘arguments’ the campaigners convinced ‘enough’ people that it is right to help people so they do not get hurt, conveniently not mentioning that what the people were doing in the first place is ethically unacceptable.

6.     Then the heads of the country changed the laws to make it safer for that group of people to do what is ethically unacceptable.

The heads of FoolishLand have lost their hearts. Maybe they have lost their heads too…

Does the FoolishLand story sound familiar to you? It should because it has been the basic blueprint for legalizing abortion and euthanasia in many countries. Recent developments about ‘legalizing’ abortion in Portugal seem to support my case.

Healthcare Transformation begins on the inside

Since the iron curtain came down, healthcare services in Central and Eastern Europe have been in great turmoil. In some countries, the healthcare system has undergone four major changes in the past 15 years. The policy makers have greatly underestimated the amount of stress which each change process has caused. They made another serious error – they thought that outward changes in the system would be adequate.

It is no use changing the system if the people in the system are not changed either. It is far more important to change the people in the system than to change the system.  For example, corrupt people in an outdated system will remain corrupt also in a revised one.

Now the question arises: what is the best way to change people in a healthcare system? By sending directives from the ministry of health? By introducing new laws? By appointing a new minister of health? By making a new five year plan? By introducing quality management and ISO standards?

All of the elements mentioned above are necessary and helpful, but they cannot do what needs to happen first – changing the hearts of those working in healthcare.

How do you change human hearts? The answer is profoundly simple and simply profound: Jesus Christ.

Some people will be tempted to go into anaphylactic shock at my proposal. Others will write me off as crazy and out of touch with the real world. But before you react too hastily, please hear me out.

Let me ask you a question first: Do you have a better answer to the deepest needs of healthcare workers? Where do you propose that they go to receive inner strength to cope with all the changes that are necessary and with the draining impact of working with sick and dying people every day? Do you really have a better answer than Jesus Christ has? Have you made an in depth exploration of who He is and what He has to offer?

For more than thirty years I have been struggling with these questions. Each time I came to the place of acknowledging: Jesus Christ knows better than I do what healthcare workers need and He can do for them what they cannot do and what nobody else can do.

What does this mean in practice? He begins a change process in the inside of people. This results first of all in changing people working in the same system. These inwardly changing people do not become better than others; they become different people – step by step they are transformed into becoming more like Him. As they are inwardly changed, they become involved in change processes at various levels. First of all, they change in a positive way in their relationships with colleagues and patients. Next, they change in the way in which they are doing their work; seeking to raise their level of professionalism. At the same time their interest turns towards change processes on an institutional level. How can we transform our healthcare institution into a place of even greater blessing to those who suffer? And ultimately, they become concerned about the transformation of healthcare systems.

Jesus Christ introduces an approach for the transformation of healthcare systems that works from the inside outwards. Policy makers think their approach which works from the outside inwards is better.

Take a look at what is happening in healthcare in your country. Can you honestly state that the approach of the policy makers is a better one?

Deception is the name of the game

On the Reuters News website the following heading was published on the 2^nd February 2007: Most women view “morning after pills” favorably. They are reporting on an article that appeared in the American Journal of Obstetrics and Gynecology of January 2007, written by C.H. Rocca and colleagues.

The implications of and assumptions behind such a heading include:

- If you do not favor “morning after pills” you are part of a minority group that does not take medical research seriously

- If the majority thinks it is good, then it must be good

As one delves into the article, it becomes clear that the term ‘most women’ means more than 90% of a group of 1,950 Californian women between the ages of 15 (yes, 15) and 24 years old.

Can the ethical considerations of this group of young Californian women be extrapolated to include all women in all cultures? Certainly not. Such a heading creates a false impression of acceptability.

The ‘results’ show that 92% of these women believe the pills are be safe. By now the article refers to the “morning after pills” as emergency contraception – because they can be taken directly after having intercourse. One does not have to wait till the morning after…

In the Journal extract, the authors state: “Advance provision improved promptness and convenience of use overall…” 

Advance provision – for an emergency? So what exactly is the emergency our esteemed researchers are talking about in their randomized trial? Having ‘unprotected’ or ‘unplanned’ or ‘unintended’ or ‘unexpected’ sex?

The deceptive term “emergency contraception” together with the “advance provision” of the pills is used to mask the fact that these women were simply put in a position to use the pills as a non-emergency form of planned contraception.

Questions that trouble me are: How much did the young Californian women know about what these pills actually do? Were they told that the pills cause what can be ethically interpreted as a very early abortion? Should such young women be allowed to decide the future fate of their unborn children so soon after they have had sexual intercourse without adequate moral support and/or time to reconsider their choices? Will this type of publication not promote social acceptance of such pills as part of ‘normal’ family planning practice? Is it ethical to use misleading terminology and headings about pills that are highly controversial in medical ethical discussions?

If it is possible, should we do it?

Look my dear, this is how you looked when you were only twelve weeks old and inside your mom's tummy. You were so cute then...

What would you do if you expected to see an inspiring 3D image of your next baby and you discover there is possibly something seriously wrong with it? Especially if you have no qualified medical staff around to provide you with the necessary support and guidance?

What would you do if you were the 'abnormal' baby? Especially if in the shock of the moment somebody might decide on your behalf that your life is not worth living?

Inquisitive parents need to prepare themselves before they go for any pregnancy-related ultrasound. In an article by Roxanne Khamsi in New Scientist Issue 2564 research is mentioned that seem to indicate that although there is no indication that ultrasound for medical purposes is harmful, there are reasons for being reticent about too frequent exposure to high intensity ultrasound.

Reliable information about how to prepare yourself for medical ultrasound can be found at http://www.goingfora.com/radiology/ultrasound.html

It might be prudent to avoid going to private businesses for repeated  so-called 'boutique ultrasonography' to make 'keepsake' ultrasound 'photos'.  Read what  the British Medical Ultrasound Society has to say in this regard: http://www.bmus.org/asp/detail.asp?ref=141&url=/ultras-info/ui-news01.asp?ref=1

Healthcare transformation is needed

Healthcare is in desperate need of transformation. Two crucial gaps reveal the gravity of the problem.

First, the gap between Jesus Christ and sick people. They really need His love. He certainly wants them to experience it. Healthcare workers are in an ideal position to express the love of Christ on His behalf.

Second, the gap between the local church and healthcare. Local churches have vast numbers of volunteers who should be part of God’s ministry team for blessing the sick and dying. However, many local churches only minister to their own members. Some want to do more, but they do not know how.

Some related powerpoint presentations can be downloaded from the Download Resources page of www.hcfi.givengain.org