Some time ago I started treating a patient with chronic neck and shoulder pain from a colleague. I only got told that she had a discushernie C4/5 and 5/6 some years ago with persisting symptoms.
With the time, the patient told me more and more details about her history: starting with a go-kart accident with symptoms of whiplash she contacted the chiropractor in our village who treated her serveral times, each session leading to aggravation of her condition, finally with loss of strength and sensibility in her right shoulder. After a time, she visited the surgeon specialized for spine of our clinic who diagnosed a stable vertebrae fracture and a discushernie. Surgery was done to stabilize the cervical spine. But the symptoms remained. She told me that she thinks the problems came from the chiropractic treatment. When she asked for the x-rays done by the chiropractor, the secretary told her that they couldn’t find them anymore and she or her insurance never got a bill for the treatments there. Since then, she couldn’t work anymore as hairdresser.
I felt quite irritated about the story and asked our “senior therapist” about that case. She said that the doctor from our clinic asked us to continue the treatment in our clinic. It seemed as if he didn’t want that there was done anything about the case, except trying to do the best we can from therapist side to relieve her symptoms.
From my ideas and principles, it was against justice not to tell the patient that her symptoms could really be due to treatment error by the chirorpractor and that it is illegal to hide patient documents (xrays, case history). Care ethics and law were violated. The responsible seemed to profit from the fact that the patient didn’t know what her rights were and that she told herself that she just always has bad luck and things always go wrong in her case and she has to accept her fate. In my opinion it was misuse of power / dependence and utilizing of the lack of knowledge of the patient.
But it also seemed that she didn’t had a strong wish to fight against this injustice, she didn’t mention anything like hate or anger against the chiropractor. She still made the assignment of guilt to him but seemed to accept her situation
I was in a dilemma between my moral principles but also, I was not sure if getting active in this situation would not only lead to a worse situation: the patient could feel worse in the end when she fully realizes what happened. The chiropractor (in the time retired) could get into problems. And I also could risk to bring myself in a difficult position as I’m working against the team I’m depending on (doctor/clinic).
This all happened in a small village, everybody knowing everybody and a lot of dependence from each other everywhere.
So either I have to break my moral principles and continue being a part of this injustice. Or I hold on them but maybe in the end everyone feels worse… which is ethically seen more arguable?