BY BRAD YARBROUGH
Pursuing the Right Actions
A few years ago, country singer
Marshall Dane sang these lyrics: “I’m
not a bad guy, I just make some bad
choices.” This conveys a truism. Good
people make bad choices. Some
are costlier than others. And, when
a choice endangers the health and
welfare of others, the ethics of the
issue becomes more critical.
The medical field has long recognized
its obligation to making good choices.
Ethical choices. It routinely faces the
struggle to allocate limited resources to
essential needs. The entire concept of triage
exemplifies the dilemma, as it rations
treatments based on the severity of one’s
condition when resources are insufficient
for all to be treated immediately.
The health care sector has captured
these often conflicting concerns with the
term, bioethics. Sometimes controversial,
it addresses policy and practice, human
rights and financial interests, needed
research and limited resources.
The relevance of bioethics to our
industry deserves attention. There’s been a
very public, decades-old concern about
America’s deteriorating infrastructure.
Let’s go back to 1984 when Marshall
Kaplan authored “Hard Choices: A
Report on the Increasing Gap Between
America’s Infrastructure Needs and Our
Ability to Pay for Them.” In the report,
Kaplan stated, “…our failure to develop a
long-term coherent infrastructure policy
has resulted in the rapid depreciation
of the country’s roads and its water
and sewer systems. We have not been
wise investors. Continued absence of a
coherent federal infrastructure policy
will result in a significant reduction in
the quality of American life and the
productivity of American society.”
Clearly, infrastructure issues affect
the health and welfare of all Americans.
A few examples will provide proof.
Hurricane Katrina slammed the Gulf
Coast in 2005 and resulted in over 50
failures of the levees and floodwalls
protecting New Orleans. Designed
and built by the U.S. Army Corps of
Engineers, the responsibility for the
maintenance belonged to local levee
boards. The cost of the failure was over
1,000 deaths and roughly $80 billion
in property damage to the historic city,
80 percent of which was ultimately
submerged underwater. In 2007,
the I-35W Mississippi River bridge
collapsed in Minneapolis killing 13
people and injuring 145. Arguably, its
catastrophic failure could have been
prevented if engineering flaws were
noticed through proper maintenance.
The incidence of less costly failures is far
too numerous to mention.
These days, Flint, Michigan is in
the news. There’s been a disastrous
infrastructure failure resulting in its
water supply being unfit for drinking.
The State Attorney General said, “The
situation in Flint is a human tragedy
in which families are struggling with
even the most basic parts of daily life.”
Known as an economically poor city, its
water supply is delivered through aged
pipelines, some known to have lead
content. The decision in 2014 to take
When infrastructure decisions impact the health
and welfare of our citizens