Saturday, April 8, 2017

OSF/Joe Piccione--2017

Yesterday the Peoria Journal Star had this article regarding the Ethical and Religious Directives for Catholic Medical Centers in the United States.

Joe Piccione, OSF's Catholic ethicist said that "we don't live by the ERD." This meant that OSF will follow some of the Directives but don't need to follow all of the Directives established by the US Bishops.

OSF allows its physicians to prescribe oral contraceptives so they don't lose the physicians. This is promoting oral contraceptives which the Directives say cannot be done by medical centers such as OSF.

"When OSF Medical Group was created in the 1990s, some physicians didn’t want to sign on if it meant giving up their ability to prescribe birth control to patients, something that ERD allows for treatment of underlying conditions but not for the purpose of family planning. But OSF was able to create a loophole, allowing those physicians who wished to prescribe birth control to do so of their own volition, covered by their own supplemental liability insurance as a sort of practice within a practice."

This Journal Star article does not mention that it was Joe Piccione who constructed this loophole with the blessings of The Catholic Diocese of Peoria which still continues today. 

Mr. Piccione was also on the Diocesan Haitian Hearts committee which effectively ended Haitian Hearts patients from returning to OSF for follow-up heart surgery. A number of them have died. This action also is against the ERD for Catholic Medical Centers.

Here is the article which is hyperlinked above:

PEORIA — Hospitals and health care organizations have to follow not just state and federal laws, but a moral compass when delivering care to the communities they serve.
While nearly all health care providers and professional organizations have some form of a code of ethics or statement of mission, vision and values, many Catholic-based hospitals and health systems also adhere to a document called “Ethical and Religious Directives for Catholic Health Care Services.” Created by the United States Conference of Catholic Bishops, ERD, as it is more simply known, helps organizations such as OSF HealthCare make policies for how care will be delivered and prioritized within their systems.
“The ERD is not the story of our life,” said Joseph Piccione, senior vice president of ethics for OSF Healthcare.
It’s less of a step-by-step guide for providing health care under a Catholic tradition than it is big-picture advice that sets priority and tone for Catholic health systems.
There are parts of ERD that are quite specific — the definition of abortion, Piccione said, is “one of those directives in which every word counts” — while others give more general advice that hospitals interpret and apply with guidance of their local bishop.
Some parts of the ERD are unoriginal. The first directive under the category of “professional-patient relationship” in ERD states, “The inherent dignity of the human person must be respected and protected.”
Similar sentiments are included in the codes of ethics of the American Medical Association and American Nurses Association, as well as individual health care organizations.
UnityPoint’s Mission, Vision and Values statement, for example, contains the phrase, “We connect with each person treating them with courtesy, compassion, empathy and respect.”
Other parts of ERD are sometimes inapplicable to certain organizations. The ERD explicitly forbids Catholic care organizations from performing euthanasia, though physician-assisted suicide is legal in only six states.
To understand the complexity and varied specificity of ERD, consider its conglomeration of directives for providing end-of-life care, which makes mention of specific interventions without a simple list of dos and do-nots.
ERD states that “a person has a moral obligation to use ordinary or proportionate means of preserving his or her life,” followed by a directive that says “a person may forgo extraordinary or disproportionate means of preserving life” and leaves the determination of what’s extraordinary or not up to the patient. It explains the moral obligation to provide patients with food and water, while stating that providing such becomes “morally optional” when they can’t be expected to prolong life or would be excessively burdensome.
It goes on to recognize “a person has the right to prepare for his or her death while fully conscious” in the same paragraph that it says patients should be “kept as free of pain as possible” and that “patients who experience suffering that cannot be alleviated should be helped to appreciate the Christian understanding of redemptive suffering.”
Because ERD is created by a group of bishops and updated periodically, the Catholic approach to health care has adapted to modern technology.
“When transplantation and organ donation was first clinically available, Catholic health care had a hesitancy about it because there was a thought that could be wounding a human person, the destruction of a person,” Piccione said. “And only as time developed it was clear that this was a work of charity, of love, for someone. Now it’s encouraged and placed in ERD.”
As the bishop of the local diocese is responsible for guiding health care organizations in their application of ERD, each bishop and organization has some ability to maneuver the directives.
When OSF Medical Group was created in the 1990s, some physicians didn’t want to sign on if it meant giving up their ability to prescribe birth control to patients, something that ERD allows for treatment of underlying conditions but not for the purpose of family planning. But OSF was able to create a loophole, allowing those physicians who wished to prescribe birth control to do so of their own volition, covered by their own supplemental liability insurance as a sort of practice within a practice.
The real application of the 72 directives of ERD is much more than restrictions on reproductive treatments.
“It’s an affirmative document,” said Steve Mattern, vice president of mission services.
“The ultimate, ultimate reason that we exist to care for those who are sick, is we want to create an environment where people, at a time of most vulnerability, pain and suffering, are able to experience the greatest care and love. And we hope and pray they also experience something that helps them connect with God’s love for them.”
Laura Nightengale is the Journal Star’s health and lifestyle reporter. 

John A. Carroll, MD

Tuesday, January 3, 2017


Dear Peorians,

Just wanted to let you know that EMS in Peoria is confusing. The only thing that is straightforward is understanding the conflict of interest involved in pre-hospital care.

Now, most people do NOT know the following:

If you suffer a medical problem in the area covered by R1 (main fire house in Peoria), you or your family member or your friend, calls 911. When R1 arrives at your side, which is usually faster than AMT arrives at your side, R1 can only give you Basic Life Support. They cannot give you Advanced Life Support even if R1 has Paramedics working for them and have the knowledge base and the ability to help you. The PFD Paramedic can’t even start an IV. They cannot give you medication. They can only give you Basic Life Support. They have a great knowledge base but they are not allowed to offer advanced life support skills that they have. You must wait for AMT and their paramedic to arrive. Then, and only then, can the PFD Paramedic help you. And this, in turn, helps the AMT medic.

Does this make sense to you? Not really?

Let me tell you something. People's lives in Peoria are being risked every day in medical scenarios where the PFD and their Paramedics are restricted from caring for you. And during the last 15 years, I am aware of many precarious medical situations that have happened after 911 was called.

There is a lot of fear in Peoria about this. AMT has many businesses supporting them. People in Peoria are afraid to like or share a post like this. They do not want to lose their jobs. Rich people do not want anything to change. Poor people are just getting through the day and can’t take on another battle. So both rich and poor are silent on this issue for completely different reasons.

Bishop Daniel Jenky is aware of the problem. The Sisters at OSF are aware of the problem. They will do nothing to improve the prognosis of the 911 patient in Peoria. Trust me. The ethics committees will bury their heads in the sand. The majority of Peoria medical community will stay quiet. Nothing will change until the politicians legislate for improvement in Peoria’s EMS. Or there is a lawsuit.

Please consider the following: Engine 4 is located on the South Side of Peoria. It has been a Paramedic Engine since 2013. During the last 11 months, Engine 4 responded to 2,140 EMS calls. Yes, you read that correctly. And during October and November 2016, just two months, Engine 4 Paramedics provided 49 Advanced Life Support interventions. Yes, you read that correctly also. So, do you think the South Side of Peoria is better off with Engine 4 staffed by Paramedic/Firefighters since 2013? Remember, that for many many years our leaders told us that it was NOT necessary for Engine 4 to advance to Paramedic. Wonder what they say now?

I think it is way past time to listen to the PFD. It is way past time to listen to Rick Waldron who has been a firefighter-paramedic for greater than 10 years working at ground zero in Peoria regarding EMS calls. 

At the scene of an accident, multiple firefighter-paramedics are often needed to extricate and give advanced life support care. This is not hard to understand. When Peoria has a shooting or multiple shootings, multiple paramedics are needed. This is not hard to understand either. 

And at a house fire where there are flames, smoke, and people with smoke inhalation and burns, potentially with superimposed chronic medical problems, there is only one agency to call in Peoria to handle all of these problems—the PFD. This is not hard to understand either.

Peoria needs to wake up before even more lives are lost due to a corrupt and inefficient Peoria Area EMS.

John A. Carroll, MD


Conflict of Interest in Peoria

January 3, 2017

Dear Everyone,

Happy New Year.

Please see this post.

The Peoria Fire Department has three Engines that can give paramedic care--Engines 4, 12, and 20.

During much of 2016, the PFD tried to have Station 19 upgraded to paramedic. So far the powers that be have been able to rebuff these attempts to improve pre-hospital care medical care in Peoria.

Please stay tuned.