Bioethics Blogs

The Risk of Eliminating Risk in Treatment Environments

Risk, defined in the dictionary as the “exposure to the chance of injury or loss; a hazard or dangerous chance,”   finds a home in the daily dialogue of bioethics when we weight the consequences of decisions, usually related to healthcare decision making. Environmental factors are not commonly prominent in our discussion of risk considerations – we leave these decisions to the architects and designers who create healthcare spaces. In treatment spaces where deeply personal and intimate life experiences take place, we may need to consider the importance of a multi-stakeholder perspective when new spaces are created or existing spaces are re-designed.

Birth experiences, end of life experiences, and acute crises mark the psyche of patients and families permanently. People come into hospitals with expectations of safe, high quality, accessible care. Birth centers and maternity units increasingly offer family centered care with multiple security measures to assure that newborns, neonates, and family members are as safe and protected as possible. End of life experiences may be enhanced by privacy, increased flexibility in time spent at the patient’s side, physically comfortable surroundings, and appropriate levels of emotional support. Times of acute crisis are less well honored in the physical setting of hospitals, as evidenced in behavioral health care crisis units, which seem to be a lagging priority when it comes to assuring patient centered needs of health and healing are enhanced by environmental considerations.

With personal effects removed and checked by strangers, clothing removed in exchange for hospital provided pants and top, the trauma of being in a fragile mental health state may be exacerbated when there are further indignities related to little privacy and exposure to others experiencing their own psychiatric crises.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.