Sunday, January 14, 2007

The Professional Patient on Trial: What Health Care and Civic Duty Have in Common

Jury duty. Two words synonymous with logistical issues, scheduling conflicts, and all around grumbling, right? (Except for that one person in the jury pool who really, really wants to be impaneled…there’s always one).

I didn’t really want to be put on a jury. It was the first week of classes and not the best time to abandon my students, but I was the second person seated in the jury box. All I knew about criminal trials came from Law and Order (and sadly, this prosecutor was no match for the intrepid Sam Waterson), so at the beginning, none of this seemed real to me.

And then the trial began, the courtroom filled up with friends and family members of the young defendant who were staring at me, and I realized how very real this was to all of them. More than that, I realized that I was entrusted with the deciding this 20-year-old’s future (or, at the very least, the next several years), and it was a power I wasn’t sure I wanted. My only credentials were that I was a citizen, I believed in innocence until proven guilty, and unlike other jury pool members, my time conflicts were not so substantial that I was dismissed for them.

What really struck me was how vulnerable the defendant was. He had to trust the six of us to be fair, impartial, and reasonable, and he gave up all pretenses of privacy the moment he entered the courtroom. As I held his Miranda rights agreement form in my hand and looked at his signature (did he ever think when he signed that form that a total stranger would be scrutinizing it as evidence?) it hit me how personal a signature really was, how all the time we sign forms and waivers and disclosures without really thinking about it.

So what does this have to do with health care? A lot. Namely, that innate vulnerability that comes with signing away our bodies to various forms and consents and entrusting our fates in the hands of other people as a result.

When I was appointed jury foreperson, the weight of our collective responsibility seemed even heavier. We were tired, we were hungry, and we’d already logged some long days in the courtroom, but I emphasized that we couldn’t rush deliberations, that at the end of the day we needed to be able to look at this kid and his family and know we did our best to be thorough and fair.

In the back of my mind was a scene from this past summer, when the cardiac surgeon in charge of my father’s complicated procedures ducked into a conference room and quickly sketched all the blockages he’d found in my father’s heart and ran through the options he had for fixing them. He only had a few minutes to discuss things with us; there was a long line of patients he needed to get into the cardiac cath lab after my father.

He was experienced, smart, and a top-notch surgeon, but that didn’t comfort me in the moment. I wanted him to slow down, to really weigh the different options and potential outcomes and complications with us, to treat my father not as a case to get through so he could move onto other things but as an individual worth all the time and consideration his future required.

Wasn’t that the same fundamental role of the juror?

I’d spent enough time in waiting rooms to know that when the fate of the people you love most in the world rests in someone else’s hands, all you can do is hope and pray they proceed with caution and wisdom. I’d spent enough time resting my own fate and my own body in the hands of doctors and surgeons to know what it feels like to be vulnerable, to wait for a verdict or outcome that may not be what you were hoping to hear.

So maybe I brought something else besides basic citizenship to the deliberation room—after all, vulnerability is an equal-opportunity emotion.

3 comments:

Tina said...

As a lawyer, I think your post has some excellent insights into the jury system, both the underlying principles and the problems. As much as jury duty seems to be a hassle, it is a fundamental part of the legal system and one that requires (and deserves) fair, thoughtful deliberation. The parallels you draw to the healthcare system really draws out the human aspect to jury duty and I think helps reminds of its important role in people's lives.

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