Medical Decisions

A former chief of Howard County General Hospital's medical staff is suing the hospital and three doctors for at least $80 million, alleging that "bad blood" and racism -- rather than questionable medical decisions -- led to the suspension last year of his privileges at the facility.In a federal lawsuit filed Monday, Dr. Kline A. Price Jr. -- a black gynecologist who claims to be Columbia's first private doctor and is the brother of National Urban League President Hugh B. Price -- lists a host of alleged medical miscues performed at the Columbia hospital by white physicians that were not punished.

A former chief of Howard County General Hospital's medical staff is suing the hospital and three doctors for at least $80 million, alleging that "bad blood" and racism -- rather than questionable medical decisions -- led to the suspension last year of his privileges at the facility.In a federal lawsuit filed Monday, Dr. Kline A. Price Jr. -- a black gynecologist who claims to be Columbia's first private doctor and is the brother of National Urban League President Hugh B. Price -- lists a host of alleged medical miscues performed at the Columbia hospital by white physicians that were not punished.

'TC She is a 92-year-old woman -- anybody's mother, anybody's patient.Because of bad circulation, she developed a foot ulcer, for which surgeons offered two choices: Amputating the foot in a fairly simple surgical procedure, or a more complicated bypass operation to save her foot by grafting other blood vessels onto the decayed area.Her chances of walking were limited either way because of her severe arthritis. But her family wanted to save her foot. So she chose the bypass, and at first things went well.

You've been in an accident and you're unconscious, attached to a life-preserving respirator. You're being kept alive artificially; doctors give you virtually no chance of recovery.Would you want to be kept alive while trying to beat the odds? Or would you want the life-support system withdrawn? Because you can't communicate your decision now, how does anyone know what you want? Should someone choose for you?Baltimore Circuit Judge John Carroll Byrnes says a bill he helped write for consideration in the 1993 General Assembly would allow Marylanders to choose surrogates who would be able to decide whether they should be kept alive on life-support systems.

"My grandmother is 91 and has been in a nursing home for three years. When she was admitted, she and I met with a geriatric psychiatrist and a lawyer, and she signed over medical power of attorney to me. That gives me the legal right to make all medical decisions on her behalf. She told me at the time that she did not want her life extended for any reason, although if she were ill she wanted medication to ease pain."Last week, after suffering a fall, she underwent a series of X-rays at the local emergency room.

A clear majority of elderly Americans oppose the use of life-sustaining medical technologies to prolong their lives, but most have neither signed living wills nor appointed someone to act on their behalf, two new studies indicate.A study of 103 residents at a Rockville nursing home reported that most of them did not want their lives extended by the use of respirators or feeding tubes.Ninety percent of the residents said that if necessary, they would choose a relative to make their health-care decisions for them.

One of the more astonishing notions to come out of the always-polarized abortion controversy is the idea that pregnant women and the fetuses they are carrying are always, or nearly always, in conflict. That notion may be dispelled, at least partly, by the way in which a history-making lawsuit is being settled.The lawsuit is part of a legal saga that has unfolded in the local courts in Washington over the past 3 1/2 years, a painful drama over the life, illness, pregnancy and death of a Laurel woman, Angela Carder.

High-tech medical treatment goes more often to private-pay patients than to people with public insurance or no insurance, according to a new study that found that how a person pays for his medical care may influence the kind of care he gets.The finding, to be published today in the Journal of the American Medical Association, may seem self-evident but, in fact, undercuts what many believe is a basic tenet of medicine -- that a person's care is dictated simply by the state of his health."The finding is alarming because I think the health care system is assumed to be set up in such a way that medical decisions are made on the basis of ... the clinical characteristics of patients," said Joel Weissman, an instructor in health policy at Harvard Medical School and a co-author of the paper.