First, many are not harmed seriously enough (usually $250,000 or more) to warrant the high transaction costs of medical malpractice litigation. Second, while these patients may have preferred to not have the therapy in question, a reasonable patient would probably have consented to the therapy had they been clearly asked.
In the typical case, the patient consents to the treatment but lacks an adequate understanding of what the treatment entails. But in some cases, the patient does not consent at all. For example, I have described successful cases where patients with a DNR order received CPR.
In an opinion published at the end of October the Texas 14th Court of Appeals allowed a case to proceed to trial where a a physician instructed staff to administer a "highly toxic drug” multiple times without obtaining the patient's consent. The patient died approximately one week later.
|Defendant Mohsen Shapouri Arani|
"(1) require annual education on advance care planning, end-of-life care and POLST forms for administrative and professional medical staff"
"(2) provide patients and their families, as appropriate, educational materials on POLST forms, advance directives, and hospice and palliative care"
"(3) implement policies to identify and address end-of-life issues upon patients’ admission to facility."
The Department of Health may suspend the license of a facility that fails to comply. It is unfortunate that such state legislation is needed when these duties were already imposed by the Patient Self Determination Act nearly 30 years ago.
by Lisa Kearns, MS, MA, and Arthur Caplan, PhD
A few months ago we called for a new conflict of interest (COI) disclosure policy. Recent events at Memorial Sloan Kettering Cancer Center (MSK) underscore the urgency in addressing COI. We encourage researchers to create an “ELF,” an electronic long-form disclosure statement that lists financial relationships, as well as any political, advocacy, or religious points of view, pertinent investments, and the like — any information that could help readers assess potential author bias. ELFs would be maintained by faculty and posted online, as part of their professional bios. The ELF could be linked electronically to all journal articles, included as a URL with author bios at the end of print versions or slide presentations, submitted when trials are registered on ClinicalTrials.gov or other databases, and required as part of NIH grant submissions and by agencies forming advisory panels.…