Insurance v/s Integrity
I was in a busy afternoon OPD in the Medicine department last week. I had the relatives of a patient approach me to complete an insurance form as the patient had died two weeks ago due to pneumonia in our hospital. After his death the relatives wanted to claim insurance for it. One of the questions on the insurance form was ‘Were his habits temperate and sober?’ followed by the question; ‘Did his habits contribute to his death?’. When I went through the inpatient record there was a past history of alcohol use documented in the history sheet by one of my junior doctors but the details were not mentioned. I filled in the form truthfully and sent the relatives back. The relatives returned two days later after they were advised by the insurance agent that the mention of the word ‘alcohol’ on the insurance form would lead to them losing their claim. They begged me not to mention this issue on the new form which they brought. I was challenged to re-look at this issue. This middle aged patient had died from a left lower lobe pneumonia with sepsis syndrome. This illness in my opinion was unlikely to be directly related to the amount of alcohol he consumed. Aspiration pneumonias which occur in alcohol abusers are more commonly in the right lower lobe and not in the left lobe. The family was from a lower middle class background and the insurance amount was worth 1 lakh rupees. I was thrown into a dilemma. Would it be best not to mention alcohol as it is unlikely to have contributed to the patients death and the family need the money, or to be honest about his alcohol intake and risk the family losing the money.
After some quick discussions I re-wrote the insurance form slightly differently. I answered the first question that his habits were temperate and sober but there was a past history of consuming alcohol. To the second question I replied that it appears unlikely that the alcohol use is related to the cause of his death. The relatives reluctantly agreed to my explanation and left. Did I do the right thing? What would be an appropriate Christian response?
- Dr. P. H. F, Bihar
I wish to commend the questioner for dealing with the ethical dilemma he/she faced in the most appropriate way. I agree fully with this doctor and recommend similar approach when faced with situations like this. The issues we can learn from this are:
INTEGRITY IN CLINICAL PRACTICE. The specific issue here is medical Certificates given by us. HONESTY in all our CERTIFICATIONS ..factual and truthful not influenced by any PROFIT MOTIVE..See what the Bible says: TRUTH INWARDLY and OUTWARDLY. Pslms.51:"YOU DESIRE TRUTH IN INWARD PARTS"...Zechariah.8:16 ."TELL THE TRUTH,THE WHOLE TRUTH when you speak"-Message, or when we write. The patient's record here says about " alcohol use". Often details are not written clearly or fully..e.g. regarding alcohol use. It is a good practice to write more relevant details viz. "occasional / regular use" or "addicted to/dependent on alcohol" etc whenever possible as it will certainly help us later. GOOD, ACCURATE DOCUMENTATION always helps in TRUTHFUL CERTIFICATION. I specially appreciate the SENSITIVITY with which the questioner dealt with the patient's relatives..LISTENING,UNDERSTANDING and PATIENTLY EXPLAINING to them why the certification is done in this particular way. And so, the relatives accepted the decision: and I feel that, they inwardly would have even appreciated the integrity and sincerity of the doctor. So write not only the truth. WRITE THE TRUTH IN LOVE! (..remember the verse from Ephesians. 4:15), NOT IN SELF RIGHTEOUSNESS but with COMPASSION.