383206221 Unethical Malpractices
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Nov 24, 2024
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What caused Joan Rivers's Death
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What caused Joan Rivers's Death
Unethical Malpractices that Caused Death
For those who got to enjoy Rivers’ stints and comedy on “Celebrity Apprentice” and any
other show, it is noteworthy that her stage presence and performance was “different” to say the
very least. Once she remarked after one hour of performance, “I do not like blind people, they
never say, oh, you look good” (Cook). In the current case, there is controversy about whether the
physician dealing with Joan Rivers's endoscopy conducted a biopsy without discussing the
procedure with Joan or any responsible next of kin. Lack of discussion of the intricacies of the
treatment process can impose higher risk to the patient as well as the physician because of
potential malpractice. Many types of medical procedures have a level of threat for injury or
fatality in case the best practices and precautions are not followed. Therefore, informed consent
was necessary in the case of Joan Rivers to ensure the patient is aware of the inherent risks of the
biopsy. Many medical procedures can have the risk of injury or death, medications can have side
effects, and some therapeutic procedures can exacerbate the patients underlying condition.
Because the physician did not seek informed consent from the patient, the biopsy that led to Joan
Rivers ‘death qualifies as medical malpractice.
High ethical standards are necessary and pivotal in healthcare success. These standards
are mainly concerned with the moral decision-making processes that are applied in medical
practice. The case of Joan Rivers shows instances where malpractice can be fatal. Hartcollis
reported that investigations from the Centers for Medicare and Medicaid Services found that the
doctors in charge of the routine checkup failed to identify the side effects of propofol based on
the deteriorating vital signs. This delay in detection lasted for 15 minutes before the patient went
into cardiac arrest. When medical practitioners fail to monitor the efficacy and progress of a
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medical procedure, they can be considered to be negligent of professional and ethical practice.
Joan Rivers’ physician performed a procedure that injured the patient leading to a lack of oxygen
flow to the brain and subsequent death. Medical malpractice can be defined as a doctor’s action
or inaction deviation from the standard care processes. Hartmann notes that the family knew that
Joan was undergoing a routine procedure to examine her throat but the physicians’ decisions in
the process led to complications. Because the doctors were not keen to follow routine procedures
in the operating room, the patient developed complications that pass as medical malpractice.
Medical malpractice in the case of Joan Rivers can be understood from four main
perspectives. First, the untimely death of Joan Rivers could be a result of the physician
neglecting essential actions defined in the duty to the patient. Duty defines the relationship
between the healthcare practitioner and the patient. This principle asserts that every client-
professional relationship is based on the principle that physicians should are obligated to help
patients improve. Medical practitioners have a duty to follow particular guidelines and offer the
care that the patient requires. In case a doctor cannot offer the standard of care, then the patient
should be referred to a specialist who can attend to their inherent needs and desires. Reports
show that there was no anesthesiologist in the operating room meaning that the doctor who
administered the same was not permitted to act accordingly. No matter the circumstance, the
healthcare worker’s actions should not betray the patient’s trust because this decision can have
devastating impacts in case of injury or death. According to Liberty, the physician who
performed the biopsy on Joan Rivers was not permitted to do so under the law. Cherry notes that
some people suffer from Dunning-Kruger effect which is a cognitive bias that makes people
believe that are smarter and more skilled than they are. The professionals instead took selfies
with the patient, adding to the unethical malpractice. Because the professionals were negligent of
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vital medical and ethical principles Joan Rivers’ suffered an avoidable death due to malpractice
in the form of the negligence of the duty principle.
Medical malpractice can also be understood from the perspective of dereliction. All
healthcare workers receive training and education that is vital in caring for patients with diverse
conditions ranging from simple to complex issues. Therefore, when healthcare professionals fail
to act based on the principles and guidelines conveyed through training, dereliction is likely to
occur. Dereliction refers to deviation from the standards of operations. This concept implies the
lack of medical practitioners aligning their treatment modalities to those agreed upon by
consulting and informing the patient of the benefits, risks, and evidence-based outcomes.
Therefore, dereliction is broadly defined as failure to fulfill the duty of care. In the case of Joan
Rivers, the actions of the physician do not reflect the typical behavior of any competent
physician under the same or similar situations. Indeed, due to their education, skill set, and level
of training, doctors are held in high regard and the standard of care they provide should equally
reflect the professional’s competencies. Therefore, when the physician consented to provide
medical assistance to Joan, this acceptance meant that the patient could rely on the doctor’s
training and experience to provide the essential healthcare service. Because the physician
neglected to seek informed consent from the patient, followed by the complications of the
biopsy, he committed medical malpractice due to dereliction.
Protocols During Endoscopy
Determining whether Joan Rivers’ death was a consequence of malpractice requires an
analysis of the protocols followed during the endoscopy. Outpatient Surgery provides essential
insight into the efforts undertaken to save Joan’s life. This article suggests that the ‘propofol’
administered during the surgery may have been the cause of death and complications because it
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was not correctly used. Propofol was the selected sedative for the surgery. However, records
show that it is close to impossible to recover a patient who has overdosed from the same. At this
juncture, the conclusion is that the appropriate sedation protocol was not followed during Joan
Rivers’ surgery. Additionally, there was no anesthesiologist in the room during the surgery.
Hartmann reports that Joan’s vitals were not measured before the administration of propofol. Key
readings such as weight are crucial in determining the appropriate dosage of anesthesia.
Furthermore, while Dr. Cohen was the professional designated with performing the surgery, he
allowed another professional to operate on Joan and they ended up taking turns with the surgery
until the patient’s airway was obstructed. Because the patient's vitals such as weight were not
measured, Joan suffered an overdose of propofol cause the essential protocols were not followed.
Proper Equipment and Staffing
Operating rooms are a complex and critical environment where each member of the
healthcare team plays an important role in realizing positive outcomes. Staffing of the operating
room is one of the primary factors considered in the optimum delivery of care. Every individual
in the surgical team has a specific role that they play in the overall procedure and it accounts for
the success or failure of the undertaken procedures. Common standards define the staffing in the
operating team into those in the sterile area and those in non-sterile zones. The latter division is
comprised of the nurse anesthetist, anesthesiologist, medical equipment representatives, and
nurses. In the current case, reports show that there was no anesthesiologist in the operating room.
This member of the surgical team is important in the current case because the likely cause of
death was an overdose of propofol. While there was an operating surgeon in the operating room,
the respective professional allowed another doctor to start the procedure. Dr. Cohen was tasked
with the surgery but Gwen Korovin – the ear, nose, and throat doctor – took turns during the
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biopsy and subsequent treatment. Because staffing plays a central role in the success of surgery,
Joan Rivers ‘died because she was not attended to by the required surgical team composition.
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Works Listed
Cherry, K. “What Is the Dunning-Kruger Effect?”
Verywellmind,
8 Nov. 2022,
https://www.verywellmind.com/an-overview-of-the-dunning-kruger-effect-4160740
Cook, J. “Joan Rivers unleashes &*%$# at Melody Tent.”
Cape Cod Times
. 12 July 2012,
https://www.capecodtimes.com/story/news/2012/07/09/joan-rivers-unleashes-at-
melody/49565416007/
Hartmann, Margaret. "What Killed Joan Rivers: Federal Report Lists Multiple Errors."
Vulture
,
nos. Bad Doctors, 14 Nov. 2014,
www.vulture.com/2014/11/what-killed-joan-rivers-feds-
list-many-errors.html
.
Hartocollis, Anemona. "Manhattan Clinic That Treated Joan Rivers Will Lose Federal Funding."
New York Times
[New York City], 12 Jan. 2022,
www.nytimes.com/2015/01/13/nyregion/clinic-that-treated-joan-rivers-losing-medicare-
and-medicaid.html?_r=0
.
Liberty, Micha. "Doctor's Unethical Behavior May Have Contributed to Joan Rivers' Death."
Doctor's Unethical Behavior May Have Contributed to Joan Rivers' Death
, 25 Sept.
2014, libertylaw.com/blog/doctors-unethical-behavior-may-contributed-joan-rivers-
death/
.
Outpatient Surgery
. 1 Oct. 2014.
Outpatient Surgery A Division of AORN
,
www.aorn.org/outpatient-surgery/articles/outpatient-surgery-magazine/2014/october/the-
death-of-joan-rivers-what-went-wrong
.