The given case study is of Gosport War Memorial Hospital in UK regarding the incident of a medical malpractice during 1990’s which resulted in the death of 456 patients. According to the reports, 456 elderly patients were prescribed opioids drugs which were really not needed by the patients and caused the deaths of the patients (Darbyshire and Ion 2018; Boseley 2018). The opioids drugs were moreover administered at dangerous levels, many of which were not completely justified, which led to a series of investigations on the hospital. The drugs were prescribed by Dr. Jane Barton throughout the 1990’s (Walshe 2018). The practice of administering the strong opioids drugs to the patients were noticed by the medical consultants, however they failed to intervene in the matter and put an end to it. Even the pharmacists and nurses knew about this practice but they had to follow the instructions of the hospital and continue administering the drug to the patients. This matter was also brought to the attention of the Royal College of Nursing by some senior nurses working at the hospital, but they were advised not to pursue this matter any further thereby sidelining any chance of investigations. The patients were within the age groups of 61 to 99 years and many patients died the day after being administered the drug. According to the reports the deaths of the patients were caused because of the drug being administered, often for ‘no clear reasons’ and thus showed the medical negligence by the hospital (Boseley 2018; Brown and Calver 2018). In 2009 however, based on charges of medical negligence, Dr Barton was presented between General medical Council (GMC) for disciplinary action. She was found guilty of medical misconduct but was not struck off the register. The families of the deceased are still fighting for criminal charges being filed against the doctor and hospital authorities (Boseley 2018).
The aim of the study is to assess how this event damaged the hospital’s reputation and how it can rebuild its reputation.
The incident of medical malpractice at the Gosport War Memorial Hospital not only caused the deaths of the patients, but also significantly eroded the reputation of the hospital (Dyer 2018). Discussed below is an analysis on how the acts of medical negligence and medical misconduct erode the reputation of healthcare organization:
According to the UK Government, ethics is a central aspect for any healthcare organization and a central part of public health and healthcare professionals should abide by the ethical code of conduct to foster the health and wellbeing of the people. NHS also focuses on ethical codes of practice that can help to maintain safety, rights, dignity and wellbeing of the patients (hra.nhs.uk 2018). Such ethical code implies the use of strategies to protect the patients from any harm from the process of treatment and taking steps to maximize their health and wellbeing.
Medical ethics or Bioethics is a framework of ethical code of conduct for healthcare professionals and is built on four basic tenets: Autonomy, Justice, Beneficence and Non-malfeasance (Percival 2014). The tenet of Autonomy implies that the patient should have the right to choose the treatment they are given and make their own choice regarding the provision of care, helping them to make informed consent and without any coercion. The tenet of Justice implies fair and equitable provision of care for every patient and abiding by the legal obligations. The tenet of Beneficence implies that healthcare professionals have the moral duty of providing care with the intention of treating the patients with their best interest in mind and strive to maintain a high quality of professional practice to maximize benefit for the patients. The tenet of Non-malfeasance implies that the healthcare providers avoid any actions that can harm the patient or at least ensure minimal harm to the patient from a medical procedure, as well as thoroughly assess any hazards or risks from a medical procedure for patients (Hope and Dunn 2018).
The failure of the Gosport War Memorial Hospital to assess the risks of administering opioids drugs to elderly patient, failure to report the act of medical negligence to the authorities, and continuing the malpractice despite the risk of death to the patients breaks the tenets of Non-malfeasance and Beneficence as the hospital authorities failed to act towards the best interest of the patients as well as increase the risk of death by administering the opioids drugs to elderly patients unnecessarily. Breaking such code of ethics therefore significantly eroded the trust of the people on the hospital (Griffith 2018).
The practice of administering strong opioids drugs to the elderly patients, often without any apparent reasons was the main cause of 456 reported deaths among the patients. The opioids drugs that were administered to the elderly patients included diamorphine, morphine and fentanyl (Brown and Calver 2018). Studies have shown that due to the administration of these opioids drugs, the patient died of cancer, heart attack, stroke and bronchopneumonia. Thus administering these medications to the elderly patient not only significantly reduced the longevity of the patients, but also caused the onset of different medical conditions leading up to their death. Moreover, the failure of the hospital administration to fully comprehend the risks of administering the opioids drugs to the patients has further caused the continuance of the medical malpractice (Matthews-King 2018a).
According to Boseley (2018), healthcare administrators have the responsibility to fostering the health and wellbeing of the care users. The trust of the patient and care users is based on the ability of the hospitals to maintain the health and wellbeing of the patients as the patients often lacks the knowledge to take care of them and make informed decision regarding their care, due to which they look for the expertise of the healthcare providers. Moreover, a high level of competency shown by healthcare organization helps to develop trust as well as the reputation of the organization, while a low level of competency can cause erosion of trust and reputation of the organization (Sawer 2018). The failure of Gosport War Memorial Hospital authorities to ensure the health and wellbeing of the patients highlighted a significant lack of competence towards their responsibilities. Thus the acts of medical malpractice have caused erosion of trust as well as the reputation of the organization (Ward 2018).
The medical malpractice has also caused a significant amount of negative publicity by newspaper and popular media. Report from The Guardian accuses the healthcare Administration of Gosport War Memorial Hospital for their overlook, as they failed to properly assess the cause of deaths of the patients as a result of which the practice continued, leading to further deaths (Boseley 2018). Report by The Telegraph points out that the inadequate resources of the hospital was the main reason for the medical negligence as the doctors were not able to give proper medications to the patients and therefore had to rely on strong opioids to manage the patient’s symptoms (Sawer 2018). It was also reported by The Telegraph that the NHS was involved in the cover-up of the incident to prevent any investigations on the medical malpractice, and that HNS rapidly dispensed powerful opiates into the bloodstreams of the patients for nearly 30 years, that has caused multiple incidents of death, right until 2013 (Ward 2018). Report from BBC also suggested that the deaths at the Gosport War Memorial Hospital were completely unnecessary as the patients did not really need the opioids medications and there was no clear medical justification for their usage on the patients (Brown and Calver 2018). Reports from Independent added that investigations on this event have failed repeatedly with the police ‘stepping back’ from the investigations and the authorities have failed to build the trust of the families damaged by the medical malpractice and the whistleblowers and hospital staff who tried to raise concerns were often recriminated by healthcare authorities (Matthews-King 2018a; Matthews-King 2018b).
Such reports clearly show that the hospital received significantly bad publicity due to their failure to comply with their responsibilities. This negative press have further caused in the erosion of trust on the organization as it showed the incompetency and lack of ethical practice within the organization that allowed the deaths of hundreds of patients. A lack of a culture of openness within NHS has further caused the persistence of the malpractice and limited investigations into the incident (Observer 2018). Considering that NHS has always gained trust of the public for their competency, the negative publicity from the media has caused a significant erosion of trust and fame of the organizations.
In 2018, fresh investigations were initiated on Gosport hospital for their medical negligence. The families of the deceased have filed complaints of criminal negligence against the hospital authorities for administering the deadly drug to their family members without assessment of the involved risks and due to the failure of healthcare professionals to intervene and stop the practice on time (Boseley 2018). Dr Baron is also facing criminal charges filed by the patient’s families, who are looking for justice against such medical malpractice. The litigations against the hospitals and medical professionals have further reduced the trust of the general public on the organization and severely affected their reputation as several patients no longer can keep their trust on the organization and on their ability to work towards the best interest of the patients. Also, the legal complaints against the organization have also reduced the reputation of the organization in the international healthcare professional fraternities (Ward 2018).
Conclusion:
In the 1990’s Gosport War Memorial Hospital started the practice of administering high doses of opioids to elderly patients to manage their symptoms. However, the healthcare authorities failed to properly assess the risks from the medicine and such an overlook resulted in the death of hundreds of elderly patients as a direct result of the medications. The medical malpractice resulted in the deaths of 456 elderly patients and Dr Barton who was responsible of prescribing the opioids drugs at the hospital faces criminal charges from the families of the affected families. This incident of medical malpractice not only caused the deaths of several patients, bur also significantly eroded the trust of the patient’s families as well as that of the general public as the incident increased doubts on the competency of the healthcare organizations to work towards the best interest of the patient. Moreover, the negligence and malpractice not only caused the ethical code of practice to be violated but also adversely affected the wellbeing of patient, caused significant negative publicity in media and led to litigations against the organization.
In order to rebuild the reputation of the organization, the healthcare administration and organization have to work hard towards earning back the trust of the public. Outlined below are some of the strategies and approaches the organization can take to rebuild the trust lost due to the incident:
(Boseley 2018; Sawer 2018; Ward 2018)
References:
Boseley, S. 2018. Gosport hospital: more than 450 patients died due to opioid drugs policy. [online] the Guardian. Available at: https://www.theguardian.com/society/2018/jun/20/gosport-war-memorial-hospital-opioid-drugs-policy-inquiry [Accessed 16 Dec. 2018].
Brown, D. and Calver, T. 2018. Gosport: The numbers behind the scandal. [online] BBC News. Available at: https://www.bbc.com/news/uk-england-44574899 [Accessed 16 Dec. 2018].
Darbyshire, P. and Ion, R., 2018. The Gosport War Memorial Hospital Panel report and its implications for nursing. Journal of advanced nursing.
Dyer, C., 2018. Gosport hospital: GP prescribed opioids that shortened at least 456 lives.
Griffith, R., 2018. The Gosport inquiry and the principle of double effect. British Journal of Nursing, 27(13), pp.762-763.
Hope, T. and Dunn, M., 2018. Medical ethics: a very short introduction. Oxford University Press.
hra.nhs.uk 2018. Research Ethics Service and Research Ethics Committees. [online] Health Research Authority. Available at: https://www.hra.nhs.uk/about-us/committees-and-services/res-and-recs/ [Accessed 16 Dec. 2018].
Matthews-King, A. 2018a. Hampshire police to ‘step back’ from investigation into Gosport deaths. [online] The Independent. Available at: https://www.independent.co.uk/news/health/gosport-hospital-scandal-latest-hampshire-police-jane-barton-investigation-deaths-a8410856.html [Accessed 16 Dec. 2018].
Matthews-King, A. 2018b. Hundreds of whistleblowers claim they faced recriminations as NHS fears repeat of Gosport scandal. [online] The Independent. Available at: https://www.independent.co.uk/news/health/gosport-scandal-latest-inquiry-jane-barton-whistleblowers-deaths-war-memorial-hospital-a8410761.html [Accessed 16 Dec. 2018].
Observer. 2018. The Observer view on Gosport War Memorial hospital | Observer editorial. [online] the Guardian. Available at: https://www.theguardian.com/commentisfree/2018/jun/24/the-observer-view-on-nhs-gosport-hospital-culture-of-not-listening [Accessed 16 Dec. 2018].
Percival, T., 2014. Medical ethics. Cambridge University Press.
Sawer, P. 2018. Dr Jane Barton blames ‘inadequate resources’ as she breaks silence over Gosport hospital deaths. [online] The Telegraph. Available at: https://www.telegraph.co.uk/news/2018/06/27/dr-jane-barton-blames-inadequate-resources-breaks-silence-gosport/ [Accessed 16 Dec. 2018].
Walshe, K., 2018. Gosport deaths: lethal failures in care will happen again.
Ward, V. 2018. Gosport inquiry panel accused of “NHS cover up” over faulty syringe drivers. [online] The Telegraph. Available at: https://www.telegraph.co.uk/news/2018/06/23/gosport-inquiry-panel-accused-nhs-cover-faulty-syringe-drivers/ [Accessed 16 Dec. 2018].
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