Is 24-hour on-call ethical for doctors and patients?

need to finish 24 hour medical guard This adds logic not only from a purely labor and health care perspective. There is political motivation in this change, as evidenced by Health Minister Monica Garcia’s public statements on the matter and conversations with her. social agent To advance in the professional field. Regardless of how the measure materializes – or begins to materialize -, sources from the medical community are consulted. medical writing match: The current guard model is “not ethical” Because it leads to doctor burnout, which puts patients at risk of not receiving adequate care.

Jacinto BatizDirector and Group Head of the Institute of Better Care of the San Juan de Dios Hospital in Santurce bioethics Spanish Society of General and Family Physicians (SEMG), believes that uninterrupted 24-hour working days are “unacceptable” for any professional, but his disapproval is even greater in the case of the medical profession: “It affects patient safety, mental health and the physical well-being of the professional and the dignity of both.”

According to him, the optimum mental and physical condition of a doctor who starts his marathon day on duty After the first eight hours of work at eight in the morning he begins to wind down: “This can undoubtedly lead to poor care which the patient is in no way entitled to.”

In this he agrees Victor PedreraDeputy General Secretary of the State Medical Association Confederation (CESM): “There is increasing fatigue and the ability to concentrate and make decisions is lost, especially if these have to be made in the operating room. “Therefore, the patient is unfortunately exposed to a risk situation that does not exist if there is shift work.”

Although the union leader points out that this situation does not mean that doctors make more mistakes during the night – he actually assures that “in practically all cases”. patient support Well – during the shift, he emphasizes that “the general thing is that these failures, if they occur, occur in circumstances in which doctors are in the worst condition, both alert and physical and mental exhaustion,

Guards deployed 24 hours a day contradict medical ethics

Batiz believes that these types of situations, in fact, jeopardize “Deontological duties” of the physician.Starting from Article 6.3 of the Code of Synonymy, which establishes: “The doctor is obliged to ensure the greatest effectiveness and efficiency of his work, as well as optimal performance of the means that society has at his disposal. keeps.”

The person in charge of bioethics at SEMG also cites Article 18.1, which reminds that “the doctor has a duty to provide for all patients.” Humane and scientific quality care, “I am afraid that this cannot be achieved in 24-hour guard, especially depending on the time at which users are served in the first third, in the second or in the third,” he analyzes.

Finally, he highlighted that Article 19.2 “reminds us to seek help when our judgment or technical capacity is impaired.” “Have we not realized by now that 24-hour uninterrupted security can impair our concentration? Perhaps we should be aware that, in most cases, this overload of working hours not only violates the dignity of the professional, but is also against it. patient dignity“, he repeats.

CESM insists that medical regulations be complied with

To find a solution to this type of situation, Pedrera first explains the need to medical professional templates “huge.” “The guards, with less money and few staff, have provided 24-hour service as if we had adequate staff.”

In fact, although he values ​​the intentions of the Health Ministry, which transferred the head of the department to the union at a meeting held last Friday, he believes the objective is “still very far away”. Presently less number of doctors, “Either the salaries of doctors disguised as guards will increase, or the number of professionals will increase, or we will get nowhere,” he says.

Looking forward to this, in CESM they advocate that, “at least”, existing rules be complied with, within the framework of which there is legislation for complementary measures to be applied. Social Service Guarantee SchemeWhich, since 2012, already regulates, among other things, exemption from medical guard for those over 55 years of age.

“It is unethical to do so Doctors working longer hours than legally establishedAnd it is being systematically violated,” condemns Pedreira, who criticizes the laxity in legislative application due to excessive working hours in the medical field. transport association, “If a truck driver needs to stop every 200 kilometres, it doesn’t make sense that a doctor has to work 24 hours a day continuously,” he compares.

In any case, the head of CESM is committed to “strong changes” to rules he defines as “obsolete”. García’s idea is to regulate through framework legislation this exemption from on-call duty for experienced physicians whose renewal engines have already been restarted. election deadlock since last year.