Rejecting the life saving checklist
Last year Johns Hopkins University published a report on a program that installed a simple five-step checklist in every ICU in Michigan. The checklist was an attempt to protect against infection, and it reminded doctors to do simple things like wash their hands thoroughly between patients, or to don sterile gloves and gown before inserting an IV. Past medical studies have identified a profound problem with basic sterility practices that has caused thousands of unnecessary hospital deaths.
The Hopkins' study generated remarkable results: within three months the rate of bloodstream infections from IV lines droppe by two-thirds. The average ICU cut its infection rate from 4 percent to zero. It is estimated that during the 18 months of its existence, the program saved more thatn 1500 lives and nearly 200 million dollars in medical treatment expense.
The Federal Office for Human Research Protection recently shut the Michigan program down, claiming that by introducing the checklist and tracking the results without patient and caregiver written consent, the study was unethical. Hopkins was unable to duplicate the Michigan program in New Jersey and Rhode Island, as had been planned. As medical ethicist and writer Atul Gawande noted, the federal government's decision threatens to improperly elevate theoretical scientific ethics above actual ethical medical care requirements.