Malpractice Consult

By Johnson, Lee J. | Medical Economics, July 28, 1997 | Go to article overview

Malpractice Consult


Johnson, Lee J., Medical Economics


Informed consent isn't just for surgery

When must a primarycare physician secure informed consent from patients? I always thought the need for consent is restricted to surgical procedures.

You were right in your thinking, but the law regarding informed consent is evolving. The trend has been for courts to expand the requirement that physicians secure consent for many non-surgical treatments.

Traditionally, informed consent has been required for any type of surgery. The law derived from patients' allegations of assault and battery, which means the "touching" of a person without prior consent. Over the years, the focus of consent has shifted to treatment, rather than "touching."

For example, in a recent Pennsylvania case, an appeals court ruled that an intercostal injection of a local anesthetic doesn't require informed consent. A patient had suffered rib fractures. Two months later, to relieve persistent pain, her physician performed an intercostal nerve block. Later that day, the patient became dyspneic, and it was determined that a pneumothorax had occurred. The patient sued the physician and claimed that she hadn't given her specific consent for the procedure and wasn't informed of its risks.

A trial court dismissed the claim. The judge ruled that informed consent was necessary only for operative procedures. An appeals court agreed, but suggested that the state Supreme Court should consider changing the requirement for informed consent to include non-operative regimens.

The basis for informed consent, the appellate court found, is the right of any patient to have "material information necessary to determine whether to proceed with the surgical or operative procedure." The court couldn't find precedent for requiring informed consent in cases involving an oral or injected drug. However, other jurisdictions would have agreed with the patient.

The safest course for you is to tell patients about the material risks and benefits of treatment regimens, and the alternatives. These include the prescribing of certain drugs and invasive but nonoperative procedures such as endoscopy.

Many hospitals require separate consent forms for surgery and anesthesia, even when the anesthesia is to be regional or local. Don't assume that one form works for both.

When a patient alleges "ghost surgery"

A patient signed a consent form stating that her operation would be performed by me or the associates and assistants under my direction. This is a fairly standard form used by surgeons in my area. If I allow an associate to perform most or even some of the procedure, such as closing for me or making the initial incision, can I be sued for "ghost surgery"?

As long as the patient was properly informed that another surgeon might participate in the procedure, you're probably on safe ground. In your informed-consent discussion with the patient, you should tell what will happen if you are unavailable, and make sure the patient consents. The consent form should authorize "Dr. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Malpractice Consult
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Author Advanced search

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.