Trying to Change Expectations, One Lancet at a Time

There are two sources for most of our expectations in life: experience – both our own, and those related to us by others – and our beliefs of entitlement. For example, we expect traffic to stop at a red light, because we have been told it is an expected behavior, and because we have consistently seen traffic stop at red lights. Because we expect traffic to stop at red lights, we often feel entitled to proceed without caution when the traffic light is green.

Expectations change either because our experiences change, or because we cause others to change to meet them. Often, we cause this change out of a sense of entitlement – for example, we feel we are entitled to work at all jobs for which we are physically capable, regardless of race, gender, or ethnic origin. The Equal Rights and Women’s Rights movements of the 1960’s and 1970’s resulted in the enactment of laws forcing industry to change to meet those expectations.

Cherise Loe writes, both here and in her MyDiabetesCentral blog, of an expectation of sharps-disposal facilities in university public restrooms. This expectation, unmet at her University of Phoenix campus and her husband’s Weber State campus, is based on her experience at Hawkeye Community College in Iowa.

Over the past year, I have seen increasing numbers of sharps disposal facilities in the public restrooms of quasi-publicly-funded facilities (airports, toll-road rest stops, etc.) I have also been told of the disappearance of such facilities from one private venue (an Atlantic City casino) due to its misuse as a standard trash receptacle (to the point where it was unable to accept its designed contents – sharps).

As a libertarian, I loathe the use of statutory force to enact social change, preferring instead the “enlightened self interest” of private economic encouragement and good word-of-mouth. Given the opportunity to patronize two equivalent establishments, I will patronize the one that better meets my needs and my philosophies.

Unfortunately, the particular issues with sharps disposal are legal, as well as economic. On the economic side, one must pay for an appropriately-trained person to empty the disposal unit, and for an appropriate facility to pick up and safely dispose of the medical waste. On the legal side, though, many states have drug paraphernalia laws that can inhibit people with a legitimate need for injectable drugs from traveling with them, and that can penalize establishments that facilitate the safe disposal of any injection disposables as “encouraging” the use of illicit drugs.

(An important aside in this conversation is that diabetes is not the only medical condition that requires the use of blood-barrier-breaking tests and treatments. I have worked with people who’ve had to use portable intravenous sets to treat Lyme Disease. I’ve seen one or two cancer patients with similar setups, and it is my understanding that some of the treatments for HIV and AIDS are injectable as well. Our search for safe public facilities for sharps disposal is in their interests as well.)

There are a couple of ways of influencing our desire for change, and we may need to use more than one of them to win over the hearts and minds of public-facing businesses and public facilities.

The first is, of course, to preferentially patronize those establishments that provide sharps-disposal facilities. This requires knowing in advance where those facilities are. My first thought would be to start a list: state (or province), town, establishment name, whether the facility was spotted in the men’s room, the women’s room, both, or elsewhere, and the last time a list contributor checked it out to see if it were still there. While the setup would be relatively straightforward, maintenance might get to be a chore. And there would be the twin issues of getting the information out while not scaring the establishment from removing those containers due to misuse, vandalism, or prosecution. But it’s one place to start…

A second approach is, if you don’t see a sharps disposal in the public restroom, ask an attendant if one exists. If the attendant doesn’t know, or if there isn’t one, ask for the manager. In a chain establishment, the decision to add sharps disposal units may come from corporate headquarters. Visit the Web site, click on the “contact us” link, and make a request.

Another tack is that of public advocacy. Just like we walk to raise money to support diabetes research, lobby and sue to make sure People With Diabetes are protected under the Americans With Disabilities Act, we can put up signs, lobby, and even consider marching in a few parades to make the cause known.

And we might also approach facilities we own, manage, or operate, or facilities that a number of us patronize, and fund the public sharps disposals ourselves. And, with the facilities’ approval, publicize the heck out of it, just like many restaurants publicize their low-carb and low-fat menus.

As a person with diabetes, I should like to be able to patronize establishments that provide facilities for safe sharps disposal. While I don’t require much personally – only somewhere to dump a couple of dead strips and lancets – I’m willing to step up to the plate not just for my own lancets, but for the needles, disposable syringes, and blood-tainted medical wastes of all persons who must avail themselves of medication delivery away from home.

Are you willing to step up as well? Together, we can make a change.