The Ethics of Visiting Hospitals by Addie Cady

Managua, Nicaragua: The doctor opens the door and I am the first to walk through. A man is stretched out on a bed in the center of the room, surrounded by E.R. workers. His arm, protruding from his body at an odd angle in its plaster cast, juts towards the ceiling. Road rash covers his leg and his blood is seeping into his bed sheet. To his left a girl my age lies in the fetal position, her face contorted in pain. She is holding an oxygen mask to her mouth and breathing haltingly. Her eyes catch mine for a second and I quickly look away, ashamed. I glance to the far end of the room where protruding from behind a half-closed curtain is the wrinkled leg of an old woman. Its whole length is spotted purple with what I can only assume is a massive contusion. Other students file past, but I turn around and leave the urgent care room. I don’t want to see the rest of the woman, and I certainly don’t want her to have to see me.

            I don’t mind blood and shattered bones. The idea of putting a broken person back together is why I became an EMT and why I’m now studying to be a doctor. But here in Managua, Nicaragua, touring a public hospital, I feel powerless, like I’m looking in on a zoo of pain unable to do anything to ease it. Morally, ethically, even sanitarily, it just feels wrong.

            The ethics of visiting hospitals seem much less shaky at the private hospital we visit next. As one of the only two Joint Commission accredited hospitals in Central America, it is pristine in every way. Here, cats don’t wander the hallways. Flies don’t buzz over shoeless sleeping people. Instead, tasteful pictures frame walls of seamless plaster and the floors shine with polish. Doctors in pastel scrubs walk by slowly, smiling. Yet what strikes me most are the rigid standards of privacy they keep at Hospital Metropolitano Vivian Pellas. We are not permitted to enter patient areas. As we look at the near-empty surgery board, the doctor showing us around notes proudly that the names we see on the screen are those of the doctors. “We work hard here to protect our patients’ privacy.”

            It is fascinating to be confronted by the differences between the public and private systems of healthcare. The gross inequity is humbling. It inspires an aching compassion, a desire to give, a need to ease the pained faces of people living on a dollar a day, traveling and waiting for hours to see a tired, overworked, underpaid public physician. I hope that I carry this feeling of frustration and helplessness home with me, that I nurture it and turn it into something productive and meaningful. I am glad to have walked in and seen that urgent care room. But I don’t think it was the right thing to do. I don’t think it is ethically fair to parade a group of foreign students carrying notepads and cameras in front of suffering people. No one deserves to have his or her privacy so flagrantly violated. I very much question the ethics of touring hospitals.