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Dehumanising hospital wards

Martin B Van Der Weyden
Med J Aust 2010; 192 (9): 481.
Published online: 3 May 2010

British hospitals, still reeling from the bureaucratic edict that banned flowers from hospital wards, have now been informed that sitting on patients’ beds — by either visitors or clinicians — is also prohibited. In the name of infection control, hospital wards in the United Kingdom are being progressively dehumanised and becoming sterile and austere places. These edicts join a previous bureaucratic direction that doctors should not wear ties on hospital wards, as such sartorial ornaments may be vehicles for cross-infection.

Commenting in the BMJ on the latest prohibition on ward behaviour, Iona Heath, a London-based general practitioner and medical columnist, argues that there is

“no hard evidence for either of these demeaning prohibitions ... Doctors should never be discouraged from sitting, because patients consistently estimate that they have been given more time when the doctor sits down rather than stands ... Some of the most intimate and effective interactions between doctor and patient that I have either witnessed or experienced have occurred while the doctor has been sitting on the patient’s bed.”*

Furthermore, the ban seems to affect even patients who are dying, and these cold and imperious commandments may simply be

“all in the interests of being seen to be doing something very noticeable about the worrying levels of hospital based infections, however ineffective and otherwise disruptive”.

Heath concludes that

“rules that mostly diminish the joys of life rather than enhance them ... unless absolutely necessary, have no place in hospitals, where joy is too often in short supply”.

The interesting question is: could such bureaucratic bulldozing directives occur locally? The UK’s National Health Service is a monopolistic organisation that holds the purse strings for payments to hospitals and doctors in practice, and it is controlled by a central and interventional bureaucracy. With the current talk of health and hospital reform in Australia, hopefully this will not be replicated here.

* Heath I. Do not sit on the bed. BMJ 2010; 340: c1478.

  • Martin B Van Der Weyden


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