$0.00 – $6.00
Irma Tyler-Wood and Bruce Patton
Multi-party negotiation among hospital committee members over the allocation of scarce life-saving resources
SCENARIO:
A hospital located in a small town has a serious dilemma: the facility only has two dialysis machines which are now in demand by seven community residents with kidney failure. The patients include: a 33 year-old professional athlete, a middle-aged housewife and mother, a male model in his fifties, a 28 year-old factory worker, a corporate executive in his thirties, a child prodigy, and a middle-aged orthopedic surgeon. Without treatment, each patient will die, but only three patients can use the available machines. The machines are extremely expensive, and money to buy a third, let alone a fourth, is simply unavailable at this time. Accommodating more patients for fewer hours subjects each patient to substantially greater risk, and can postpone a choice for no longer than a week or two. The members of the Kidney Dialysis Committee are members of the community who have been asked to serve by the hospital administration. They have been given information about each patient, and have been asked to decide, confidentially, who will and who won't receive treatment.
MECHANICS:
The exercise works best in a group of three to five; seven is a maximum. Discussion time can range from 10 to 60 minutes depending on the objective, but 10-15 minutes is usual. Videotaping is recommended to illuminate nonverbal behavior. The exercise can be done before the camera and reviewed in front of the full class. (This makes most sense in a small class where everyone is doing an exercise like this, and where participation is voluntary).
MAJOR LESSONS:
- This exercise can be used for a number of purposes. It was originally designed to explore psychological awareness and illustrate emotional reactions and nonverbal communication.
- The intensity of the psychological dimension adds considerable power to struggles over group process and control.
- Substantively, the case brings into high relief the question of what constitutes "fairness," "objective criteria," and societal "norms," and the extent to which those concepts can exist outside perceptions colored by our personal values. In response, some participants can be seen to search for refuge in some absolute standard, while others seem to construct some kind of calculus of partisan perceptions and consensus.
TEACHING MATERIALS:
For all parties:
- General Information
Teacher's Package:
- All of the above
PROCESS THEMES:
Closure; Commitment; Communication; Cost-benefit analysis; Delay tactics; Emotions; Ethics; Fairness; Group process; Interpersonal skills; Legitimacy; Nonverbal communication; Objective criteria; Personality; Psychological games; Separating the people from the problem
Hospital Committee, The Attributes
| Time required: | 30 minutes - 1 hour |
|---|---|
| Number of participants: | 3 |
| Teams involved: | No |
| Agent present: | None |
| Neutral third party present: | None |
| Scoreable: | No |
| Teaching notes available: | No |
