Patient Consent Violation and Recommendations

The case brought up by Dr. Fredericks’ disregard for written consent reveals several important discrepancies in the hospital practice. I will start from direct recommendations for the case raised by Mr. Davis and then move to its indirect implications.

Dr. Fredericks’ situation, in this case, is unfortunate. According to his testimony, he managed to persuade Mr. Davis to disregard recommendations of Dr. Roso, which, unfortunately, does nullify the signed document which suggests that the patient actually disproved stent insertion. While it is possible for physicians to make decisions based on their own judgment, it only includes the situations where the patient’s life is endangered.

Moreover, the patient, in this case, was able to discuss the details with a doctor prior to the operation, which further undermines the opportunity of Dr. Fredericks to defend himself. The expertise and previous experience as a private practitioner can be an explanation but will hardly qualify as a defense in court. However, another important detail which surfaced during my meeting with Dr. Roso and Dr. Fredericks is both a point to consider and possibly a way to improve the situation.

By approaching the situation from an unbiased perspective, we can see that to Dr. Fredericks the situation may have looked as if he obtained the patient’s informal consent during the conversation with Mr. Davis. This could have impacted his attention upon reviewing the written form prior to operation. The fact that written forms are not ubiquitous and their use is limited to the most responsible cases further undermines their legal reliability.

Admittedly, such approach may result in relocating responsibility from Dr. Fredericks to the nurses who are responsible for ensuring his familiarity with the papers prior to operation, but since cardiologist’s status still puts him in charge in the operation room, it can be viewed as a reason to challenge the written consent – under the condition that the patient confirms his oral agreement to install stents.

The issue does not end there, however. The case illustrates the need to improve the mechanism of obtaining patient consent. Signing the document is obviously inferior to getting an extensive explanation from a specialist and introduces additional complications for the physician as well as the organization. Thus, we should seek an alternative approach to protecting ourselves from legal actions based on last-minute reconsideration.

Additionally, Dr. Fredericks’ negligence evidently comes from a poor understanding of institutional policies of the establishment, which could be prevented with training. Thus, I recommend reviewing our consent policies for complications which can be removed and introduce workshops to capitalize on benefits of cooperation and mutual responsibility.

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