“Harry, what do you think of
this? I want to get some of these
printed up.” Lapius handed me a rough
draft on yellow foolscap. It said:
Dr.
____________________has explained to me the risks of the procedure. I understand them, and willingly undergo the
procedure.
Signed________________________________
“Great. You going into law?”
“Perhaps I should,” he
mused. I figured something had gotten
him charged up, but since I was trying to finish an article I shut up and went
back to my reading. That was always a
sure way to egg Lapius on. The one
thing he hated was peace and quiet, particularly if I was having it. “The California Supreme Court handed down a
landmark decision recently. A patient
underwent surgery for a duodenal ulcer and during the procedure the patient
suffered a severed artery going to his spleen which caused internal
bleeding. Of course the doctor was
sued, not for severing the artery and repairing it and removing the spleen, but
for failing to inform the patient that this risk is incurred in five per cent
of such cases, so the patient could decide whether he wanted to incur the
risk. If the doctor failed to operate
and the patient died of a perforated duodenal ulcer I guess he might have sued
because the doctor didn’t emphasize the risks of not operating.”
“This clearly places a heavy
burden on the physician,” I said dreamily.
Doctors are being sued from so many sides and for so many reasons that I
had learned to accept it as a fact of life, and wasn’t about to get exercised
about it. “So I guess the note you’ve
drawn up is sort of a disclaimer for the patient prior to surgery. Don’t they have these in all hospitals?”
“Sure, but I thought the doctors
should have something like this in their own records, signed not only by the
patient but by a witness, presumably a close relative, in the consultation room
with the patient.”
“There could be some insidious
extensions of this doctrine.”
“How so?”
“How about birth control pills,
or the coil. Women come to the office
demanding them. They are not without
danger. The coil may be the site of
infection. On occasion there is a
perforated uterus. The pill may cause
thrombosis. I think we should get
exempted from lawsuits if one of those devices goes wrong. It seems to me to be the same thing.”
"How about husbands and
lovers, Simon?” I was getting
interested in the possible fall out from this business. “After all, why should they get off scott
free. They have relations with the
women, which is sort of treatment. The
possibility of pregnancy exists. She
may decide to go to a neighboring state to have an abortion. Let’s assume something goes wrong. They sue the doctor, right.”
“Right.”
“Why not sue the lover. He caused this to happen. He injected the medication, so to speak, and
he’s not even licensed to practice. Or
take another instance. After
cohabitation a female (or a male) might find herself not only pregnant, but
contaminated with a venereal disease.
Does she sue her lover? No. But if this same woman goes to a doctor’s
office to have a coil inserted and she gets an infection, she sues the
doctor. If she goes for artificial
insemination and the baby turns out to be malformed, has she grounds for a
lawsuit? Has this possibility occurred
to her? It seems to me that once you
get into informed consent you transcend the boundaries of medicine. Do you sue the fish market if the mercury
content in the tuna is too high and he hasn’t told you about it? Do you sue the movie theater if they don’t
inform you that the horror picture might induce nightmares in your child, and
indeed he has one and breaks his leg?
The possibilities are boundless, Simon.
I think you should go into law.
You can break new ground.” I
turned to him. He was immersed in a
book.
“Simon, you didn’t hear a work I
said.”
“Fortunately not, Harry. You choose to be farcical, and you know I
always find that tedious. Pour me a
bourbon.”
I handed him the yellow foolscap.
“Sign this Simon. Bourbon can
addle your brain, and damage your liver.
You can have your bourbon after you’ve proved you’ve been properly
informed.”