Herewith the vignettes for a class this Sunday, geared toward medical professionals (and with CME credit available) but not limited to them. How would you answer these questions?
Category 1
Jim, a medical resident, is doing rounds in a neurology unit on Shabbat morning, and he notices that a recovering stroke victim is less responsive than he had been on the previous day. How should he record this information, or arrange for its recording?
or
Sam, 40 year old male normally in good health, presents to the doctor's house with fever and cough, and on auscultation has a pneumonia which does not require hospitalization, but does require antibiotics. May a prescription be written, and how?
Category 2
In a hospital's stepdown ICU unit, vital signs are checked every four hours. Sarah, a nurse, is charged with doing this on her Shabbat shift and recording the results, even if the signs are unchanged from the previous recording. How should she record this information, or arrange for its recording?
Category 3
Chaim is an ER nurse working in the hospital on Shabbat. A patient's wife needs to leave for several hours, and she wants to give Chaim her phone number as an emergency contact. In what way may Chaim record the information, or arrange for its recording?
Update: The shiur is now available on-line here.
Looks like Category 1 present cases where a direct act of melacha is not necessary. It doesn't sound like the stroke victim's status needs to be immediately recorded - it could be noted after Shabbat. Similarly, I believe a non-Jewish pharmacist could fill a prescription if a doctor personally goes to the store and asks him to fill it - avoiding the need to write one (likely needs to be a standing prearranged agreement between the two - with the written prescription to follow after Shabbat).
ReplyDeleteIn Category 2, perhaps she can prearrange for a non-Jewish colleague to enter the data at her direction. Or perhaps enter it with a shinui (since this is choleh sh'yaish bo sakana)
For category 3, fridge magnets with the digits 0-9! (Like we do page numbers in the machzor on Yomim Noraim in shul)
What do hospital rules have to say about these cases? I'm concerned about #1, because if recording the patient's status is deliberately put off until after Shabbat, this task could be forgotten, especially if emergencies or other non-routine tasks present.
ReplyDeleteIf a staff member is violating medical ethics or hospital procedures because of Shabbat, he or she should arrange a schedule that does not include Shabbat, even if he or she thinks the problem is surmountable.
Michael-
ReplyDeletePre-arranging can definitely solve many problems, here and in every realm of halachah; more on that at the shiur.
Tesyaa-
Agreed.