HSA invites public to discuss ethical dilemmas

| 09/04/2013

Yearwood.gif(CNS): The Cayman Islands Health Services Authority (HSA) Ethics Committee is inviting the public to discuss ethical issues at a seminar on 10 April. The aim of the committee is to provide support and advice to healthcare providers, as well as patients and their families when faced with an ethical dilemma. Speaking about the role of the Ethics Committee, Lizzette Yearwood, the HSA’s Chief Executive Officer, said, “We come across many situations where we may be faced with very tough issues with no easy solutions. Where these issues lead to ethical dilemmas, it may be helpful to talk things through with the Ethics Committee."

She added, “We may not always be able to provide a solution but a healthy discussion with a group of people with experience may open up some avenues that lead to better solutions. Our focus is always on the best patient care and looking at any situation with an 360 degree viewpoint.”

The Ethics Committee meets on the second Wednesday of every month at 6:00pm in the Hibiscus Conference Room at the HSA offices in George Town. There is no charge for the event and refreshments will be provided.

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  1. Anonymous says:


    Once again, it's same old, same old. Lot's of people b!tching about the problems (don't get me wrong, there are plenty) and bringing out their axes to grind. And once again, nobody proposes any real solutions to these problems (with about 1 exception) or is actually doing something to try and fix them (with about 1 exception).

    I'm sorry people, but b!tching and whining is all that you are doing and it's completely unproductive. If you want to make changes then for f*ck's sake get off your a$$, go out and start trying! Sitting here and whining is pathetic and accomplishes nothing.

     Start talking with those you work with, try and get everyone on the same page there. Go to the local collegesthat teach new paramedics and meet with the instructors. Get in contact with the department of health. Become actively involved in CI EMS, find out what you can do for them.

     If you can recognize the problems that exist, good. But that's only the first step and it's the easiest. The hard one is doing something about it. Will it be easy? No. Will you have to make personal sacrifices? Yes. Will it be a long process that you may never get any personal rewards from? Yes. But if you actually care about this job enough to want it to improve none of that should matter.

  2. Anonymous says:

    Go to Google search and type in "Cayman Islands EMS". Click on the first link. That will tell you everything you need to know.

  3. Anonymous says:
    I want to get a job as an EMT (and eventually Paramedic) with CI EMS. It is my dream job, but I don't know if they are still in a hiring freeze, and if they are when they will end it. I currently just completed my EMT-B course and will shortly take the Nat'l Registry exam and NY state exam. Thanks!
  4. anonymous says:

    Put on a public awareness campaign about 'advance directives' and 'surrogate decision makers'..what they are, why you should have them etc.. that'd cut down on some on your ethical cases as people would come in there with their does and don'ts for you to follow once they are no longer in a position to consent or reject. Start from early by encouraging schools to include it in their cirriculum of those classes dealing with health or life skills. take it from a former non-clinical employee whose opinion you may not have considered otherwise.

  5. Anonymous says:

    Perhaps Ms Yearwood's time should be spent on considering the ethical dilemma of HSA not providing good or timely service

  6. Anonymous says:

    Here's an ethical conundrum for you – the EMS is vastly understaffed and yet they refuse to hire any new applicants who are non-Caymanians when they do not have the facilities in place to teach Caymanians through to paramedic level. A mass-casualty incident is defined as any incident in which emergency medical services, including personnel and equipment (ambulance, rescue services, emergency rooms at hospitals) are overwhelmed by the number or severity of casualties. Seems to me that with an under-funded, under-staffed EMS we are simply begging for a mass casualty incident to happen. We have an overwhelmed ambulance fleet, with many of the vehicles barely working, and a desperate need for continuing education; yet, the HSA and the CIEMS refuses to hire outside applicants. As a Caymanian, I am more than pleased to have Caymanians be offered first pick at any job on island – but to have an "all-Caymanian" EMS force when there aren't enough properly qualified Caymanians to fill those positions is absolutely ridiculous. What say you, HSA?

    • Anonymous says:

      Totally agree with this. It doesn't matter how you want to cut the figures – we have an island with a population of 50,000+ people and to stand in as the emergency services for our whole island we have 3 ambulance stations (North Side, West Bay and the George Town Hospital) and 3 (maybe 4 if they're all working at once) ambulances. Does that seem sensible to anyone here? 

      • Anonymous says:

        If the Ambulance were called for emergencies only, as that is what it's for.

        Not people with bucktoes and the flu, the 3 will be very adequate.

        Calls that are not emergencies should be stopped.

        • Anonymous says:

          Agreed, if the ambulances were properly used and people knew WHEN it was appropriate to call emergency hotlines then yes, 3 WORKING ambulances may very well be sufficient. However, having done all of my schooling in Cayman there was never once someone from the police/fire/EMS/emergency call center come to school or do a program on when it is appropriate to use emergency numbers and services. Children will grow up thinking it is ok to call the ambulance for a broken nail or a skinned knee. Start some proper education. Common sense isn't so common anymore. Also, there are hundreds of service calls that the EMS have to undertake every year that are non-emergent: bringing people to and from the hospital, people to dialysis units, etc. The government should have a seperately staffed ambulance that deals with daily non-emergent calls otherwise, an ambulance could be tied up taking someone who does not necessarily need an emergency vehicle to their dialysis appointment and then back home while somewhere else on island an actual emergency is happening. 

      • Anonymous says:

        Complain about the number of ambulances, what about the costs?  In what way can we contribute to assist with the purchase of one?  $1.50 per person would go a long way.  Just a thought.

        • Anonymous says:

          No one is saying that it wouldn't be costly. However, somewhere in the HSA budget, some funds should be properly allocated to the EMS. I am friends with quite a few of the professionals who work both in the emergency department, as well as in the EMS and I have heard from their mouths about the fact that they need more funding. The EMS is one of the busiest and most frequently active departments in the HSA and yet they are not funded as adequately as they should be, and at the end of the day – we, the people of Cayman, will ultimately suffer. It isn't right that the paramedics and EMTs should be overworked, underpaid, and over stretched. 

    • Anonymous says:

      Sounds like a former Xpat disgruntled employee…HSA needs to hire more caymanians specially for EMS…20k work permits and counting thats ridiculous .. blount ems is as safe an any other company out there..perhaps you need to review the case well on this incident before you decide to pass judgement..feel free to come to our main office anytime and chat with us about it…….they are called accidents they happen everyday, and this includes emergency vehicles.

      • Anonymous says:

        Definitely not an expat, and definitely not an HSA employee (neither former nor current). Simply someone who works in the public health sector and this has always been a concern of mine. Just trying to make the island we live on as good as it can be. As I said in my first comment, I am more than supportive of the EMS and the HSA hiring Caymanians, as a Caymanian I (and my children) would benefit from this if we worked as health care providers. I do not, however, support the hiring of under-qualified Caymanians preferentially over properly-qualified expats. These are people's lives that are being held in the balance, and as a citizen of a country where I might some day need to rely on a service such as the EMS, I would want the best trained and most qualified individuals avaliable – regardless of their nationality. 

      • Anonymous says:

        When there are properly qualified Caymanian medical professionals then maybe the HSA can start cutting back on their work permits. Until then, I don't care what nationality you are – I want the best care possible. Our health care system is what sets us apart from many of the other Caribbean countries. If we go back to hiring barely qualified individuals just because they are Caymanian then all it does is put us in a bad position. 

        • Anonymous says:

          The first move is to disband the immigration boards.What is needed an employment department where Caymanians go and get registered; if no Caymanian is available, then an employer wold be given permission to get a work permit.Until then,i don't care just hire Caymanians.Shaw-Miller report advise to the fire service/EMS.
          Examples of fire service EMS giving more bang for the buck include the following:
          1- Better response times – part of the system is based in non-transport units. Systems based exclusively on transport units have inherently slower response times than systems based at least partially in non-transport units. Engine trucks are stationed to cover the response area. Having them provide EMS keeps the response times short, as engines don't leave their response area to transport patients.
          2-Employee retention – Fire-based systems tend to have excellent employee retention. There are some non-fire systems that can say the same, but generally speaking, non-fire EMS employees have lower pay, shorter retention, and weaker benefit and retirement systems. Keeping employee turnover low adds long-term value to the system. It also helps with simple things like being familiar with the response district and knowing the roads, building, and neighbors.
          3-Better system-wide support – with the typical larger FD support staff, things like logistics, planning, employee safety programs, public life safety education – all are common in all-hazards fire departments that include EMS in their mission. That leads to excellent research and clinical practice in some of the fire-based EMS systems.
          4- If we have a fire that significantly reduces our resources, we use mix of recalled off-duty personnel,redcross and mutual aid to fill any holes. Our cross-staffing system reduces fire and EMS payroll, benefit, and retirement costs by approximately 40% from the previous seperate system, while getting a 200% increase in ALS ambulance availability. Ask any administrator if they could reduce personnel costs 40% by using dual role/cross trained firefighter-paramedics, and their answer will likely be "It's a no brainer." In other words…more bang for the buck.

        • Anonymous says:

          How many Caymanians do you really see working at our hospital? The problem seems to be too many of one kind of Nationality working there and I dont think that they are the smartest except for a few.

          • Anonymous says:

            There aren't many Caymanians working at the hospital because we as Caymanians don't like working in the health sector. All we want to do is finance, tourism and insurance.

        • anonymous says:

          Waste of time. They promote who they like. Positions hardly become available internally, and there is no clear progression path for anyone. The bright ones get frustrated and leave, or frustrated and bitter. Either way they get frustrated. #trollwin.. although at the same time there is truth to every word I said.

    • Anonymous says:

      We have some of the most capable and professional EMTS one could ever ask for working for the HSA. I had to use them on several occasions and let me tell you that I was proud of my Caymanians. Its about time that we get more of that type of service at the hospital. Mrs Yearwood please keep them as long and increase with more Caymanians like them if necessary.