Applied Legal Concepts in Healthcare Law

Brewster v. University Hospital This paragraph will include a summary from the case which was obtained from the Healthcare Law Writing Assignment. In December 31, 1987 the Brewster’s had a daughter Emma that was born a week premature. Emma was transported to Children’s Hospital Medical Center the next day when she began showing signs of respiratory distress. She was treated by Dr. Craig Jackson, a neonatologist employed by the University of Washington. Emma suffered from hyperbilirubinemia, or jaundice, caused by elevated levels of bilirubin, a substance that is released into the bloodstream. Jaundice is not uncommon among infants as approximately a third or more of all newborns at the intensive care unit at Children’s hospital have jaundice. Greatly elevated bilirubin levels can result in permanent in brain damage. When Emma was admitted to Children’s Hospital, her serum bilirubin level was 4.2 micrograms per deciliter. It gradually increased to as high as 22.0 mcg/dl on January 7, 1988, then decreased to 5.7 mcg/dl on January 18, 1988. The type of jaundice Emma experience is generally treated with phototherapy. More serious cases are treated with a transfusion of all the blood in the infant’s body, a treatment entailing greater risks including cardiac arrhythmia, bleeding, bacterial infection and the development of air bubbles in the circulatory system. Dr. Martin prescribed phototherapy for Emma, which was unsuccessful, and Emma suffered brain damage. The Brewster’s allegedly were not informed of the risks associated with high bilirubin levels and did not know that Emma’s developmental problems were caused by the high bilirubin levels until almost two years after treatment. (HC Legal Writing Assignment).
Writer’s Opinion if the Jury Should find Dr. Jackson Liable The writer of this paper does feel that the jury should find Dr. Martin liable because he never discussed the risks associated with high bilirubin levels and the benefits of transfusion as an alternative to the phototherapy treatment that was chosen. A patient or authorized representative cannot make an informed health decision if they are not made aware of the risks or benefits of treatment options. A patient or in this case the parent’s want to trust their physician and rely on him to provide all pertinent information pertaining to the treatment. A physician has an obligation to explain the diagnosis and the risk associated with that diagnosis, as well, as alternative treatment options. Dr. Martin did not meet the standard of care. In my opinion, Dr. Martin was negligent in his care and chose the most common method of treatment without informing of the alternatives. The negligence in this case caused irreparable damage to Emma.
Informed Consent As a health professional it is very important to have an understanding of all the elements of informed consent. It is important to know who is fully responsible for the informed consent process. The Healthcare Institution has a role in informed consent as well as the physician, what are those roles and responsibilities? How far must a physician go in the informed consent discussion to ensure that the patient understands the terms of the proposed treatment? (Showalter, p. 369) There are many aspects to consider. The writer of this paper will briefly discuss the aspects that are important as well as the role between the Healthcare Institution and physician. The Healthcare Institution has to ensure that its medical staff physicians are obtaining informed consent from their patients. The hospitals have a risk management department that is there to assist with the informed consent process and to make sure there are detailed consent forms in place for the most common performed procedures in the facility. The hospital has a responsibility to have policies and procedures in place to define who is authorized to consent on a patient’s behalf when the patient is unable to do so themselves. (Showalter, p. 369) Ultimately it is the physician’s place to obtain the informed consent, and the hospital’s role is to make sure there is a process in place to verify that the informed consent has been obtained and that the physician has fulfilled that duty. Hospitals should not be held liable for the inadequate verbal consent discussion by the physician, but they need to have a procedure in place to determine the doctor has fulfilled that responsibility. (Showalter, p. 369). When a procedure is performed at a hospital someone on the hospital staff needs to verify that informed consent has been obtained and if not the procedure needs to be cancelled. The verification process should ensure the correct patient is getting the right procedure and that all forms are signed and in the chart. The writer of this paper feels that the policies and procedures in place at a hospital play an important role in the verification process of informed consent. Informed consent is primarily the physician’s role and cannot be delegated to the nursing staff or other hospital staff. It is the responsibility of the physician to obtain the informed consent and make sure the patient is well informed of the procedure/treatment that will be performed. A patient wants to be able to trust their physician and have confidence that he has discussed the procedure in detail. There are several elements of informed consent and each element must be considered when discussing treatment procedures with a patient. Consent is more than a signature on a form; it must be based on reasonable complete and understanding information about the diagnosis (or suspected diagnosis), explain in lay terms the proposed treatment, discuss the risk and benefits of treatment, probability of success, reasonable alternatives, consequences of refusing treatment and the type of recuperation to expect. All of the listed information must be given by the physician and the patient must be given adequate opportunity to reflect and ask questions. The physician has a responsibility to provide the information and if the information is withheld then he is likely to be held liable. (Showalter, p. 364). The physician role is very important in the patient being able to fully understand and make informed health decisions. Informed consent cases usually result from misrepresentations of the facts, lack of information about consequences, or lack of information about risks. (Showalter, p. 370). Physician’s often times don’t feel it’s necessary to discuss the risks or consequences with patients which can result in a medical malpractice law suit. When a physician is trying to determine what information is to be given, he needs to ask himself important questions. Is the patient likely to be unaware of the risk? Would a reasonable prudent patient withhold consent if aware of the risk? Is the risk, however small, likely to be significant to the patients decision to grant consent? Would I (the physician) disclose this information to my family member if they were my patient? Often times these are very important questions and if a physician would ask himself these questions, then he might disclose pertinent information a patient would want to know. A patient has a right to know everything about their diagnosis, the consequences of the procedure whether good or bad and all associated risks no matter how big or small. Physicians should be liable if they don’t disclose the information to the patient. If the procedure has a negative outcome and the consequences were not discussed before the procedure then the physician is at fault and should be held liable. Physicians have a standard of care they must meet and obtaining informed consent is important.
Conclusion
The writer of this paper, does feel that Dr. Martin from the healthcare law case presented should be held liable for not disclosing risk and alternative treatment options. Dr. Martin did not receive informed consent as he didn’t disclose information that would have helped the Brewster’s make an informed health decision.
Informed Consent must be obtained and the physician has an obligation to verbally explain all pertinent information when concerning a treatment or procedure.
References
Showalter, J. Stuart. (2015). The Law of Healthcare Administration. (7th ed.) Chicago, IL:
Health Administration Press.

HC Legal Writing Assignment.