Medical Records, Patient Consent, and Information Management, Essay Example

Introduction

In the case “Informed Consent in Louisiana – Lugenbuhl v. Dowling” the defendant is Doctor James Dowling and the plaintiff is Milton C. Lugenbuhl Jr. This case was heard in the Supreme Court of Louisiana. This case discusses the importance of informed consent in addition to the exceptions to the situations in which it is necessary. Ultimately, it is important to strike a balance between the information that a physician is reasonably able to inform his or her clients of due to the understanding of medicine that they have. Even though informed consent documents must be explained using simplistic language so that individuals that have any level of reading ability are able to understand these documents, it is important to consider that the patient will not always comprehend the medical context of certain treatments, which may prevent them from being able to access the best possible care.

Discussion

Informed consent is an important process because it requires that the physician communicate care plans to the patient for final approval. Since the patient has ultimate control over whether they will participate in a procedure or not, it is essential for the physician to communicate this care plan to them in an unbiased manner and be honest about the costs, potential benefits, and potential harms that could result from opting into a procedure. In addition physicians can recommend specific procedures based on the medical history of the patient, explaining to the individual why this is the recommended treatment. In most cases, informed consent is meaningful because it allows the patient to disagree with the physician if he or she believes that the procedure is not within their best interest (Temple Health).

If the informed consent doctrine did not exist, patients’ rights would regularly be violated. Often, physicians would likely engage in risky procedures due to the amount of money that they would be able to make by completing one option instead of the alternative. In addition, it is important to consider that physicians are not always understanding of the wishes of their patients, or even their full medical history. By having a conversation about health care, the physician and patient are able to engage in a dialogue that ensures that the best treatment method is being provided. It gives the physician an opportunity to ask the patient about any contraindications that would prevent the golden standard of treatment or alternative methods from being implemented. Overall, it appears that patient’s rights would be violated if the doctrine of informed consent did not exist.

For informed consent to exist under the law, the patient must provide the physician with free consent and the patient must be able to understand the consent document and/or conversation. Special measures are taken to ensure that the rights of the patient are being represented in these instances. For example, there are some cases in which patients are unable to speak for themselves. This typically occurs when the patient is underage, mentally handicapped, or unconscious. In these cases, the consent will either fall to the family or the physician depending on the severity and urgency of the situation. Furthermore, it is the physician’s responsibility to help the patient understand the content of the consent document and to attempt to explain the procedure without bias. Overall, informed consent requires that the patient or his or her representative make the final decision depending upon the situation.

In a legal case of negligence and liability, the basis for negligence may be battery, unconsented touching, or breach of a duty imposed on the doctor to disclose material information. Broadly, battery is defined as a situation in which there is intentional touching, the touching causes harm to some extent, and there is no consent from the victim. It is important to emphasize that for a treatment to be considered battery, the physician must not have provided the individual with prior consent concerning the specific surgery and this error must cause the patient harm in some way. If these two criteria are met, then a physician can be arrested and tried for a crime of battery.

In this particular situation, it is important to consider that a crime of battery did not occur. While Dr. Dowling did not provide Mr. Lugenbuhl with informed consent for the hernia procedure and specifically disobeyed Mr. Lugenbuhl’s wishes to not have the certain procedure performed on him, it is essential to note that Mr. Lugenbuhl was not harmed. Since he was not harmed, even though he did not provide the doctor with prior consent, this is not considered to be a crime of battery. Furthermore, it is important to consider the rights of the patient and the doctor in this situation. As a physician, Dr. Dowling has sworn that he must always act in the best interests of his patients. On some occasions, acting in the best interest of the patient requires defying their wishes. Since Dr. Dowling is a medical expert and Mr. Lugenbuhl is not, Mr. Lugenbuhl cannot truly be responsible for making his own medical decision in this instance. Based on Dr. Dowling’s knowledge of Mr. Lugenbuhl’s needs and medical history, he was assured that he made the best medical decision in this case and it is likely that many other medical experts would have made the same decision. While the doctor was still awarded monetary damages, it was not considered to be a case of battery.

Conclusion

Overall, this case emphasizes the importance of using informed consent. However, even in cases in which the patient does not agree with the physician’s decision, it is reasonable for the physician to report his intentions prior to the beginning of the treatment. If a consensus cannot be met, it may be beneficial for the physician to recommend the patient to another doctor for a second opinion. “Lugenbuhl v. Dowling” is an interesting case because it demonstrates situations in which informed consent is both necessary and not necessary. It is important for physicians to provide patients with informed consent and to ensure that they understand the related implications of the treatment process (Krames StayWell Blog). However, in some instances, it is important for the physician to emphasize that informed consent can legally be breached in emergency situations or in situations in which evidence indicates that a breach would result in the highest quality of care. While it is important to respect the wishes of patients, it is also important for the physician to help them make decisions that are truly in their best interest. By making his true intentions and thought process known, Dr. Dowling could have avoided this suit.

References

Krames StayWell Blog. (2009). Improving the Informed Consent Process. Retrieved from http://info.staywell.com/BLOG/bid/45437/Six-Tips-for-Enhancing-the-Informed-Consent-Process-Gleaned-at-a-Krames-Patient-Education-Lunch-Learn

Lugenbuhl v. Dowling, 701 So.2d 447 (La. 1997). Retrieved from http://biotech.law.lsu.edu/cases/consent/Lugenbuhl.htm

Temple Health. (2015). A Practical Guide to Informed Consent. Retrieved from http://www.templehealth.org/ICTOOLKIT/html/ictoolkitpage1.html