Hospital Protocol Question

[lynn cates]

proper protocol

Hello Dave. I was thinking--one doctor; two assaults. On the other hand, I don't know the proper protocol.

Cheers.
LC

[lynn cates]

Q T

Hello (again) Dave. Ah, now I see. Emma wished to remain anonymous? Likely true. One gets the feeling she was hiding something, given her hesitancy.

Cheers.
LC

[Cogidubnus]

Hi Lynn...yes that's my take anyhow...

Dave

[lynn cates]

fear

Hello Dave. Makes sense to me.

But I've always wondered what she feared? The gang that attacked her?

Cheers.
LC

[Errata]

Hi Errata...I hear what you say, but why should the doctor connect them at all? They undoubtedly treated many injured women every day (among them the many unfortunates who were routinely picked upon) and what's to connect this particular pair (the one who could and I suppose may've spoken up, the other who couldn't and was hence mute about her background) ?

Don't get me wrong...I have no particular axe to grind here, but do feel we may be in danger of looking at this with the benefit of hindsight, coloured by a 20th/21st century viewpoint which wouldn't have applied in the LVP.

All the best

Dave

I'm not saying it's negligence at all. I'm saying it's a common cognitive hiccup. Technically it's stereotyping, but it's a little more than that. Say for example a junkie comes in beaten and raped. She describes the attack and her attackers to the best of her ability. Most people would assume that her injuries were a result of her high risk lifestyle (not that it would be her fault, just that her lifestyle was the reason she was chosen). Therefore they would assume that her attackers were like her, junkies, homeless, other people with a high risk lifestyle. We don't think "Oh, it has to be frat boys who did this."

Now take a waitress who comes in unconscious. She doesn't have a high risk lifestyle. We assume her attacker is of her socioeconomic background. In this instance it could be frat boys, a customer, a husband. Nowadays, we might think to link the two as some sort of junkie rampage. But we almost never link the two as some sort of frat boy rampage.

The cognitive hiccup come in here. We assume that attackers know what we know. We assume the attacker of the junkie knew she was a junkie. We assume he knew she had a high risk lifestyle. We assume her high risk lifestyle resulted in her attack. The same with the waitress. We assume the attacker knows what we know. That's a bad assumption, but we can't help but make it.

We had a case here a few years ago where there was an intense amount of rage directed at a man who killed a pregnant prostitute. Clearly we as a society don't care a whole lot about dead prostitutes, but she was 3 months pregnant, so people got very angry. But he couldn't possible have known she was pregnant. She wasn't showing, and by all reports she didn't even know she was pregnant. But because the public knew from the news accounts, they assumed he knew. They assumed he targeted a pregnant woman, or that he was extra callous in his indifference to her pregnancy. He didn't know.

Nowadays we can say that the doctor should have put the two cases together, but you're right. There was no reason to do so. In his mind, there was no doubt what had happened to the prostitute. She was attacked because of what she was. There was no mystery, and there was nothing the cops could do. If she wanted to avoid such treatment in the future, she had to get out of that life. It's not callous, it's a simple truth. But with Malvina Haynes there was a mystery. He knew why the prostitute was attacked. He didn't know why Haynes was attacked. That alone would keep him from linking the two crimes in his mind. But given the futility of trying to protect a prostitute in her given line of work, and the possibility of protecting a decent woman, it's not surprising that the woeful but not unusual tale of the prostitute was quickly forgotten.

[Cogidubnus]

Hi Lynn, Errata

Are we assuming the good doctor actually even knew she was a prostitute? They didn't generally dress, speak, or openly appear different to other women of their class as far as I know...

To my mind it may've been this very thing, that out of shame, she was so intent on concealing...wiki says:-

"Her acquaintances gave her a much higher standing than others of her kind would have received"

which speaks to my mind of someone who may have fallen further than most...sadly we don't seem to have that much info about Emma

All the best

Dave

[lynn cates]

hospital

Hello Dave.

"Are we assuming the good doctor actually even knew she was a prostitute?"

I'm not. I am merely thinking in terms of an assault. The hospital needs to notify the police--I should think.

Cheers.
LC

[Cogidubnus]

Hi Lynn

The hospital needs to notify the police--I should think.

And if the patient wishes to keep schtum that conflicts with:

"Whatever in connection with my professional practice or not in connection with it I may see or hear in the lives of my patients which ought not be spoken abroad, I will not divulge, reckoning that all such should be kept secret."

Pure surmise, but there might even be the fear that she'll attempt to take herself off if the police are involved...either way, her earlier behaviour does certainly tend to indicate an antipathy towards notification though.

I don't think medico-legal practice was quite as prescriptive at that time as it is today...

All the best

Dave

[lynn cates]

antipathy

Hello Dave.

"her earlier behaviour does certainly tend to indicate an antipathy towards notification though."

Agreed.

Cheers.
LC

[Errata]

Hi Lynn, Errata

Are we assuming the good doctor actually even knew she was a prostitute? They didn't generally dress, speak, or openly appear different to other women of their class as far as I know...

To my mind it may've been this very thing, that out of shame, she was so intent on concealing...wiki says:-

"Her acquaintances gave her a much higher standing than others of her kind would have received"

which speaks to my mind of someone who may have fallen further than most...sadly we don't seem to have that much info about Emma

All the best

Dave

Actually prostitutes did (and do) dress differently. But it's subtle. A few buttons undone, the tilt of a hat, not wearing underwear... I mean, if you look at your average streetwalker today, they don't wear anything too different than your average club rat. But it's the way they wear it, and where they are wearing it that provides the context for "prostitute" as opposed to "club kid".

On the other hand, it was also not uncommon for doctor's to ask if their patient was a prostitute. It was deemed a relevant question, and given the nature of LVP diagnostics it may in fact be relevant.

But if I had to guess, I would say the lack of underwear would have been the tip off. That or she revealed it in her account of the attack.

As for doctor/patient confidentiality, it didn't really exist for women in the LVP. Any information on a woman's condition could be shared with any man in her life, as she was technically property of a husband, father, brother etc. If there was no man, and it was deemed to be in her best interest to inform the authorities, then a doctor would absolutely do so. Women didn't even have the right to refuse certain medical procedures, such as hysterectomies or abortions. There really was a whole different set of rules for women.

[Cogidubnus]

Sorry Erata - Underwear or lack of is hardly an issue in this case, bearing in mind the delay between the attack and the presentation at hospital...as I posted she wasn't wearing a miniskirt with fishnet tights either...subtle or not?

Secondly regarding ownership there was no husband...she was (allegedly) a widow...

As regards the confidentiality issue...ok...I'll buy it...but prove it...

Best wishes

Dave

[Tom_Wescott]

Dave,

I don't use invectives. In fact, I don't use any drugs. But back to the subject. You seem to be suggesting that the doctor would have kept what Emma told him to himself, yet when he WAS finally asked by the police what she told him, he not only told them but appeared at the inquest, in front of the press, and repeated it.

He should have told the police immediately.

Yours truly,

Tom Wescott

[Roy Corduroy]

Tom, you have a point which I don't believe has been raised before. But was it hospital protocol to notify police in a case like this? I honestly don't know. Was there any indication that the doctor or hospital was malfeasant in a medico-legal sense? I don't know that either, but don't see any indication in the record. Just the detective's surprise when he learned from the coroner there would be an inquest.

There are certain things we don't know, such as when Emma Smith became unconscious, after she spoke to Dr. Haslip. We know she died the next morning at 9 am.

We don't know what time Malvina Haynes was conveyed to the hospital by a policeman. She lay unconscious for several days.

We don't know the hours of Dr. Haslip's shift and whether he treated a half dozen patients, or forty.

Roy

[Simon Wood]

Hi Tom,

"He [Haslip] should have told the police immediately."

"I'm sorry, Tom, but until we know more this must remain a case of "so says you."

For instance, did the Hippocratic Oath apply?

"What I may see or hear in the course of treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep myself holding such things shameful to be spoken about."

Maybe death moves the ethical goal posts. I don't know. Do you?

Regards,

Simon

[Cogidubnus]

For what it's worth, my own feeling, (based, I admit, in part on the Playfair court case a few years later, in which there was also an element of libel), is that if the victim decidedly didn't want the police involved (as seems clear from her earlier reluctance) then only her death could shift the goalposts...

All the best

Dave