April 16, 2024

New York case tests informed consent

Michael Cook

Man sues hospital over forced rectal examination

Informed consent to medical
procedures is absolutely necessary: true or false? While nearly every
medical layman would answer “true”, a widely-publicised
lawsuit in New York shows that it’s not so simple. Back in
2003, 38-year-old Brian Persaud received a nasty knock on the head
while working on a Manhattan construction site. He received eight
stitches for a cut over his eye. Then he was told that he needed an
immediate rectal examination to check for spinal cord injury. (For
non-medicos: a gash on the head might have been accompanied by more
severe damage to the spinal cord. An check of rectal sphincter tone
is a quick way to assess this.) Mr Persaud was told about the exam
and immediately resisted. Although he was held down, he managed to
free one arm and punched a doctor. He fell unconscious after an
injection and the examination proceeded.

When he woke up, Mr Persaud found
that he had been handcuffed to the bed. He was arrested and taken in
his hospital gown to be booked for assault. Now he is suing New York
Presbyterian Hospital for assault, battery and false imprisonment.
His lawyer claims that he has post-traumatic stress syndrome and
cannot work as a result of his experience. The hospital counters that
it will “vigorously contest” the lawsuit.

The case provoked a huge number of
comments on a New York Times’s blog. A rectal exam is a
standard ER procedure in such circumstances, emphasised some readers,
although others maintained that alternative methods exist. Others
observed that the staff may have thought that Mr Pernaud’s
decision-making capacity had been impaired by his head injury. Others
felt that paternalistic doctors were negligent in failing to obtain
his informed consent. Now the court will have to decide. ~ New York Times, Jan 16; Women’s Bioethics Blog

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One thought on “New York case tests informed consent”

  1. I don’t know waht to say in this kind of situation. it seems that nowadays people talk of rights and held to it so tightly that there was no more room for basic skill in communication. To my mind the man acted that way because it is a sensitive place to examine ,as such proper care should be taken to make sure that he understood the ‘significantce’ of that examination. Conversely on the part of the doctor, it is just standard er procedure, so there, I have to do it since it’s necessary and poeple , mind you should know what I’m doing, it’s for your own good anyway! well, doctors ,try to be the patient ,next time, i always believe that if you treat the patient with respect, then he will learn to respect you too! Why make a big do out of this thing. Set up a domestic tribunal, talk to to the patient/doctor, ne need to reinterate on who is right or wrong, for me proper communication, respecting human values and good counselling will end this matter. Unless people are unreasonable, then of course u have to go to court!

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