When retired plastic surgeon and Catawba College alumnus Verne Lanier '62 of Durham visited campus last spring, he came to talk ethics. The students who listened to his presentation came away with some valuable advice and with a little more insight into how complicated making ethical decisions can be.
Lanier explained that "where I am and who I am relates entirely to this institution [Catawba]," and exclaimed, "Wow, what this place did for me!" To the students, he said, "Everything you learn here you'll use."
He spoke about the long road he followed to get into the business of plastic surgery — four years as a student at Vanderbilt School of Medicine, six years of general residency, interrupted by two years spent in the Navy during the Vietnam conflict, and finally three years at Duke University training in plastic surgery. And, he spoke about the long road that the medical industry had followed to get to where it is today.
He noted that in 1966, U.S. President Lyndon Johnson & Congress signed Medicare and Medicaid into law which, he said, "basically meant that hospitals and doctors would be paid for their services," but it also "sets the stage for fraud." In the 1970s, he continued, "lawyers realized they could sue doctors for medical malpractice."
Today, Lanier said in his opinion as a physician, "ethically speaking, we're moving from an intangible issue of compassion [for the patient] to a more tangible issue of money."
He noted how long it would take for his office manager to get an insurance case manager on the phone to talk to them about a procedure a patient might need — as much as 45 minutes in some cases. "You know what you're thinking is they're going to hang up, but that burn on a patient's leg is not going away, so the office manager can't hang up."
Ninety days, he said, was often the average time spent waiting for surgery approval and "sometimes the patients didn't make it." "That situation is probably only going to get worse," he added.
Medical malpractice insurance also presents a huge financial burden for the practicing physician, he said. "When I retired, I was paying $60,000 a year in medical malpractice premiums and I had to have it to practice!"
Nowadays, decisions about euthanasia and the right to die with dignity, abortions, HIV and AIDS take center stage in medical ethics debates. Lanier cited the recent case of Octo-Mom, an unmarried mother artificially impregnated with eight embryos while already mother to six children. He posed the question about the Octo-Mom case: "Why did the doctor do it?"
Another current ethical issue involves whether or not to spray DDT to kill mosquitoes which spread malaria that kill thousands of children every year. He noted the ethical issue involving the release of medical records as well as the issues facing drug companies that may produce vaccines to prevent smallpox — concern over how those companies will be protected from liability stops them from pursuing production of such vaccines.
"These are just the tips of the iceberg regarding medical issues encountered today in this country," Lanier concluded, cautioning his audience of students to: "Always search for truth and to remember that the best way to get what you want out of this life is to help someone else get what they want."
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