Standard Operating Procedure (Soteria Medical)

Soteria Medical Division

Medical Oaths

While Soteria respects that many medical professionals opt to take vows such as the Hippocratic Oath, these are not recognised as legally binding or as a valid reason for exemption from procedure. Soteria staff are reminded that the Institute has always had progress, at any cost, at its heart.

Payment for Treatment

While the Biolab division’s primary purpose is not to turn a profit, medical supplies are not free. Only certain departments should be given routine charge free treatments, namely security while injured in their endeavors to protect the colony. Baring this, all medical treatments should be charged as according to the list that follows.

• Surgery per limb requiring treatment: 150 credits
• Nanopaste Revival Procedure: 150 credits
• Cryopod usage: 100 credits
• Dialysis: 75 credits
• Blood transfusion: 75 credits
• Ointment and gauze: 30 credits per unit.
• Stimulants and medication: 1-10 credits per unit, dependent on the difficulty of creation.

Note that a conscious and stable patient must be informed of the procedure they are about to undergo, and be given the chance to refuse treatment, or request information about alternatives. In cases where a patient cannot give willful consent to treatment, they may only be charged for blood transfusion, cryopod usage, surgery and revival.

Fees may be waived at the discretion of the Soteria medical staff with the permission of a CBO if one is present.

Soteria Biolab Overseers may decide to change these pricing ranges as they see fit during the shift.

Non-Disclosure Policy

All patient records, treatments, and data – almost anything the medical staff does (though not the simple fact a patient is or was being present on medical premises) – are not to be disclosed to other members of the colony outside of the Biolab division without the (unanimous) permission of (all) the patient(s) directly involved. Even the Marshals, Premier or personnel with access to medical records are not exempt from this. The medical death of a patient (see “Death” below) is an exception – medical personnel may choose to disclose a patient’s death to unauthorized personnel at their discretion.

Relevant warrants and Code Blue (or above) situations may still grant security personnel access to medical data. In the event that Biolab personnel believe a colonist’s (physical or mental) medical status poses a threat to others, they are permitted to report this to security staff (in the event there is a risk of harmful criminal action) or otherwise to the colonist’s employer. Such situations include patients who are (provided as an example, not an exhaustive list):

• ...believed to be at risk of causing harm to others.
• ...unable to properly uphold the duties of their work, to an extent that is likely to pose a hazard to others (see “Unfitness for Work”).
• ...at risk of spreading an infectious disease.

Personnel given access to medical data become bound by this Non-Disclosure Policy, just as Biolab staff would be. In the event of an emergency, such as a critically wounded colonist, medical data (such as suit sensor readings) may be released if there is no other feasible method of providing essential care.

Right to Refuse Treatment

All patients have the right to refuse treatment, and consent must be given in advance of treatment whenever possible. If they are determined to have a limited capacity for decision-making, this right may be overruled. This is possible in the following situations:

• The patient is unconscious or in critical condition and cannot provide consent to life-saving medical treatment.
• The patient is mentally unsound and cannot properly understand the nature of treatment, or the condition to be treated. All adult colonists are presumed to be of sound mind and capable of granting or withdrawing consent at will, by default.

In the former case, judgment on a patient’s inability to consent may be made on the spot by medical personnel. If a patient is currently undergoing critical treatment when they regain the ability to consciously offer or withdraw consent (such as after waking up from a critical state), they are presumed to consent to continuation of that treatment unless otherwise specified. In the latter case, the patient must be assessed as incapable of refusal by a Psychiatrist or Chief Biolab Overseer. In the event of physical conditions (i.e. infection-induced delirium or mind-altering drugs) altering a patient’s ability to consent, or the absence of staff capable of making the assessment, this decision may be made by non-Psychiatric personnel. The CBO may always overrule this assessment.

A patient may request alternative treatments. In such cases, the treating doctor should exercise their discretion as to whether the alternative would be sufficient. They may decline to provide treatments that are ineffective or harmful, and should (as detailed under Payment for Treatment) charge if the requested alternative is costly to provide.

Unfitness for Work

In some cases, a colonist may suffer from a medical condition that renders them unable to fulfill their duties properly. This could be a physical impairment or psychological issue. In such cases, the Chief Biolab Overseer may declare that they are unfit for their role (a Doctor or Psychiatrist, whichever is relevant to the condition, may initiate this process in the absence of a CBO) and present a written assessment to the Low Council detailing the reasons for their decision. As outlined in the Non-Disclosure Policy, Council staff are bound by standard confidentiality laws with regard to this information.

The Council is to vote on whether this assessment is valid, as outlined under Council SOP (“Demoting Staff”). In the event that the subject is deemed to be unfit for their role, they must choose to either accept a suspension (as though the Council had voted to demote them) or receive treatment as soon as possible.

What exactly qualifies as “unfit” varies based on the position and condition in question. A medical condition that merely lessens a colonist’s ability to work is not grounds for this procedure, while one that prevents them from fulfilling tasks safely or in a reasonable timeframe is. A Scientist who is wheelchair-bound cannot be assessed as unfit simply because they take slightly longer to navigate the lab, but a Marshal Officer with reduced mobility could be.

Hygiene and Disease Control

Medical staff should wear sterile clothing (such as non-allergenic lab coats and gloves) while treating patients, though this is not required while “standing by provided they can don proper equipment in a reasonable timeframe. Blood, vomit, chemical spills and other janitorial issues should be cleaned as soon as is feasible. In the event that an infectious disease posing a considerable threat to personnel is suspected to exist:

• All infected crew are to be isolated.
• Medical personnel are encouraged to wear biohazard-protective equipment, and are required to at least wear a face covering and gloves at all times. The Chief Biolab Overseer may, and is encouraged to, amend the required equipment to better protect against the disease’s transmission vectors.

These protocols are to remain in place until a vaccine or cure is developed.

Death

While “death” has taken on a number of meanings in the common parlance, for the purpose of Medical SOP, it is defined as indefinite cessation of nervous activity. In such a state, a patient may still show traces of brain activity (see below), but all bodily functions cease. If a patient is recognized as “dead” by medical scanning and diagnosis equipment, they are medically dead.

Note that this state is not necessarily permanent, and can potentially be reversed by a defibrillator (as detailed in medical training materials). In the event of a defibrillator reporting a “mental interface error”, the device is unable to restore substantial brain functions. If interface errors continue, the patient is to be placed into the morgue, where their corpse will be transported to the lower levels of the colony between shifts to assess whether recovery is possible through more intensive treatment.

DNR Orders and Suicide

A “DNR” or Do Not Revive order may be applied to a colonist’s medical records under certain circumstances, and dictates that they should not be treated in the event of death. Should a DNR be found, the patient is not to be revived, and to do so is considered Negligence. In some cases, the order may be subject to conditions, such as specifying that a patient should only be allowed to remain dead if their death is the result of a specific medical condition. A DNR may be placed under the following circumstances:

• A patient, who would typically be fit to refuse treatment, confirms their desire not to be revived. This requires assessment by a Psychiatrist or the Chief Biolab Overseer.
• The subject has been sentenced to execution via the proper legal procedure.
• The subject is an infiltrator, outsider or enemy of the colony and security staff have declared they are not to be revived.

Falsifying a DNR is considered to be Murder.

In cases of suspected suicide, the patient should be revived and security staff contacted to investigate for signs of foul play. Should the patient express a desire to die, they should be detained by security staff for urgent psychiatric evaluation. This paragraph does not apply if the patient possesses a valid Do Not Revive order. ((OOC: As mentioned in the server’s Rules, suicide is almost always OOCly disallowed. Contact an admin if you intend for your character to do it.))

Workplace Structure

The Chief Biolab Overseer is the highest authority in the department. Medical Doctors and Psychologists are considered to be of equal rank. While LifeLine Technicians are generally capable of handling their own duties unguided, they should assist other personnel if requested.