At present in Australia many hospitals are understaffed, doctors are in short supply and the media highlight the stories of people who have had unfortunate experiences in hospitals.
In the light of this grim picture, it can be reassuring, if unwelcome, to experience health care at first hand at a large public hospital. The welcome at Casualty, the care of nurses conducting preliminary inquiries, the friendliness as well as the professional care of nurses and doctors, the continuing aftercare service provided, and all this free of charge. It makes shine the often-tarnished image of public service.
It is also encouraging because it so embodies respect for the human dignity of each human person, regardless of their wealth, mental state or virtue.
A person with advanced dementia receives the same humane and appropriate care as does a person who is evidently highly intelligent and alert. Respect for human dignity entails attending to all the relationships salient to a person’s wellbeing and ensuring that they too are built on respect. These extend beyond keeping persons alive and sheltered to being adequately fed, clothed, clean, provided with medical care, and consulted about any treatment they receive.
Care must also begin with and be supported by the patient’s good personal relationships with people who have time to care, are sufficiently empathetic and have sufficient knowledge of their condition and needs. Where this mission statement is enacted in human relationships it makes for healing. It should mark all medical care.
The understanding that health care must embrace all the complex sets of relationships that mark the difference between health and illness demands constant rethinking. Most recently, for example, the links between health and the living environment have been widely recognised. People who live in areas of disadvantage are more likely to suffer from mental and physical illness, to be obese, to have addictions, to spend time in hospitals, and to live in conditions of extreme heat and cold, with little green space. The same is true of prisoners in gaols.
Health care is inseparable from social justice. In areas where disproportionately many people suffer from mental and physical illness, they are also more likely to suffered from domestic violence, addiction, limited access to education and employment and be exposed to extremes of heat and cold. Good health supposes a good environment.