If a medical institution is not first and foremost held to the highest standards for patient respect and cleanliness that institution should be shut down.  There can be no argument here.  If any life is put in jeopardy because of failed standards then we are all to blame.  Would it matter if these first of all atrocious activities take place in a back alley as some have commented or a facility where the health and possible death of a patient is all too real?  Consider that these institutions are more about making money or collecting money from grants and pharmaceutical companies rather then the health of those being treated.