I just read Caroline Fife’s article from Today’s Wound Clinic on Ethical Issues in Hyperbaric Medicine.
Thanks you for beautifully and completely articulating all the pieces to consider when treating ‘off label’. I just wish I had read it before my visit to an HBO center struggling with this issue. You pulled together so many key aspects that it felt like you had actually been in the unit with me this week to observe it just as I did; there were issues with equipment capability; billing cost to the patient; the patient not fully informed of risks or understanding that the indication was ‘off label’; supporting science behind the indication in some way other than personal testimony; and just because the physician may not charge because he is a nice person, the hospital still charges the patient. And you are correct, the hospital is putting pressure on the doctor to ramp up treatment numbers, but I doubt off-label treatment is what the hospital had in mind.
Caroline, Thank you so much for your well written article that was so timely and just the reassurance I needed to read to remind myself that I was not some mean ogre denying patients treatment.
Stacy Handley, RN, BSN, ACHRN, CWCN, CHT
Vice President, National Baromedical Services, Inc.
I want to compliment you on Today’s Wound Clinic. As a new publication, I look forward to receiving it every season. It is the most practical and clinically relevant publication currently available to wound care practitioners. The contributing authors are all so well recognized and accomplished that one feels safe in their recommendations and guidance.
Bettina Magliato MS, RN, CIC, CWCN, CHRNC
Wound Center Manager
Just read with interest your Feb 5th article Ethical issues in hyperbaric medicine. Very succinct and helpful, thank you. I always cite the cost/benefit ratio in light of limited scientific evidence when patients call our center requesting treatment for off label conditions. I think your points about it being an ethical/justice issue as well may help soften the let down when I explain why we cannot treat x, y or z. Good food for thought.
Seth McEwan RN, BSN, CCRN, CHT
Hyperbaric Medicine PVH, MCR