Wednesday, December 8, 1999
must be reducedThe issue: Thousands of Americans die each year because of mistakes made in hospitals.AS long as there are humans there will be mistakes. But when the humans are medical professionals and the mistakes cost lives, every effort must be made to keep errors to a minimum.
Our view: Medical errors are probably unavoidable, but it's possible to substantially reduce them and the number of deaths they cause.
Two studies that estimate hospital errors cost at least 44,000 and perhaps as many as 98,000 lives a year in the United States have brought attention to the problem. To the layman, those estimates are shocking.
In response, President Clinton has announced a program of patient safety initiatives intended to reduce medical errors. He said each of the hundreds of private health plans that sell insurance to federal employees will be required to institute quality improvement and patient safety measures.
Clinton also directed federal agencies that administer health plans to evaluate and, when feasible, implement the latest error reduction techniques.
With Clinton for the announcement was Richard J. Davidson, president of the American Hospital Association, who said doctors and nurses already are making headway in reducing errors. However, Davidson added, "We can and we must do better."
Clinton's initiative includes a partnership with the American Hospital Association, which is asking its 5,000 members to produce a report on ways to cut down on errors.
In addition, Sen. Edward Kennedy, D-Mass., is working on legislation with similar aims. Kennedy's bill would create a national center for patient safety that would set safety goals, track progress in achieving them and serve as a clearinghouse for organizations seeking tips on improving medical safety.
The Institute of Medicine report cited some familiar problems, such as doctors' poor handwriting, which can made the reading of prescriptions by pharmacists a guessing game.
Other problems: Many drug names sound alike, leaving room for confusion.
Advances in medical science are so rapid that health-care workers find it difficult to keep up with the latest treatments and new dangers resulting from chances in medical devices.
Most health professionals do not have their competence regularly retested after they are licensed to practice.
The president called the American health-care system the world's finest, but that is small consolation to its victims and their families and friends.
There is agreement that the number of errors can be reduced -- and it must be. As Clinton said, "Too many families have been the victims of medical errors that are avoidable, mistakes that are preventable, tragedies therefore that are unacceptable."
Hawaiian sovereigntyThe issue: Some Hawaiian activists are calling for restoration of an independent Hawaiian nation.SEVERAL speakers at the federal hearings on Hawaiian reconciliation have called for restoration of the Hawaiian nation, lost in the 1893 overthrow of the monarchy. Other Hawaiian activists contend that the hearings, far from helping Hawaiians achieve their aspirations, are a roadblock to true self-determination.
Our view: Hawaiians would do better to focus on more achievable goals.
As the Star-Bulletin's Pat Omandam reported, these activists point out that any outcome of the reconciliation talks must be within the framework of existing federal law. Since the existing laws dealing with indigenous peoples are based on a "nation-within-a-nation" status, Hawaiians "would get no better than that."
Nalani Minton, a practitioner of traditional Hawaiian culture, contends that federal programs and expenditures for the benefit of Hawaiians only make them more dependent on the United States and have the effect of denying them self-determination.
What these activists are seeking is inclusion of Hawaii on the United Nations list of non-self-governing territories -- areas considered eligible for decolonization. They hope this would be followed by a plebiscite on self-determination overseen by an international observer, which might lead to independence.
Anything is possible, but it seems to us that restoration of a sovereign Hawaiian nation, either by the United States or through a plebiscite authorized by the United Nations, is so highly unlikely as to be beyond the realm of serious consideration.
To begin with, there is no evidence that the Hawaiian community favors such a step. And there is the reality that Hawaiians and part-Hawaiians comprise only about 20 percent of the state's population.
Does anyone think the majority of non-Hawaiian residents would favor relinquishing Hawaii's status as a state and their American citizenship in favor of an independent nation? Or don't the non-Hawaiians count?
Then there is the fact that no state has been allowed to secede from the Union. That's what the Civil War was about.
As for Hawaii being a non-self-governing territory, such a contention cannot be taken seriously. It is inconceivable that the people of Hawaii would have chosen independence rather than statehood at the time of the statehood plebiscite, if independence had been a ballot option.
Hawaiians would do better to focus their efforts on more modest but more achievable goals than full sovereignty. That's not going to happen, at least not in the foreseeable future.
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