Attempt to Expand Informed Consent Harms Patient Care

The Supreme Court of Washington state is reviewing a case that could have damaging implications in the delivery of patient care if informed consent is expanded beyond its current standards.

As it stands, informed consent is the process by which a provider and patient discuss and agree upon a proposed course of treatment. Now, the state supreme court is reviewing an appellate ruling that expanded informed consent based on a patient who complained that the physician did not inform her of a test for a diagnosis that the physician neither suspected nor treated.

The Litigation Center of the American Medical Association and State Medical Societies joined the Washington State Medical Association, Washington Chapter of the American College of Emergency Physicians, and Washington State Hospital Association in jointly filing an amicus brief with the court to prevent this from becoming legal precedent.

The brief states that the “purpose [of informed consent] is to ensure that the doctor and patients agree about the proposed treatment for the patient’s body, not to have the patient make the diagnosis.”

In practice, upholding the appellate court ruling would mean that providers would be responsible for telling patients all the potential diagnoses based on their current symptoms, regardless of how unlikely they may be. It would also create new avenues for bringing forward liability claims.

The brief emphasizes that if the ruling is allowed to stand, it would “create a massive additional burden on emergency physicians and all physicians…That will slow down, delay or deny care to patients.”

To read more about how seriously this would impact the delivery of health care services, click here.

Health Care Providers Subject to Underlying Circumstances

An opinion piece reflecting on a recent medical tragedy highlights the underlying conditions that health care providers face on the front lines of our medical system every day.

Daniela Lamas, MD, a pulmonary and critical-care physician at Brigham and Women’s Hospital in Boston, cited the recent criminal case of a Tennessee nurse when highlighting the all-around stress faced by health care providers in a New York Times opinion piece.

“The pandemic has brought the health care system to the brink, and the [RaDonda] Vaught case is not unimaginable, especially with current staffing shortages. That is, perhaps, the most troubling fact of all.”

These underlying conditions, coupled with the need to build a culture where providers feel empowered to speak up in the workplace, must be addressed together with critical reforms.

“Health care workers and the public must acknowledge that catastrophic outcomes can happen even to well-intentioned but overworked doctors and nurses who are practicing medicine in an imperfect system.”

Without fixing these systemic issues and enacting meaningful liability reform, health care providers may be less likely to report errors or close calls — reports that would ultimately benefit patients. To read the Times opinion piece in full, click here.

Liability Issues Pending in Iowa Legislature’s Final Days

The Iowa legislature’s session has gone into overtime and past its planned adjournment, focusing on remaining urgent issues — including medical liability reform.

This is just one issue that remains pending as the legislature attends to priority bills in its final days. But in the wake of jackpot non-economic damage awards, there is continued urgency to enact a reasonable limit on such damages before the end of the 2022 session.

Without one, awards such as a recent judgment that allowed for $43.5 million in non-economic damages will continue to increase Iowa patients’ health care costs.

According to an update from the Iowa Medical Society, advocates have continued to press legislators that the liability climate is bad — and getting worse.

“The necessary reforms in the bill under consideration, HF2279, would allow hospitals and health care centers to avoid costly verdicts in medical liability cases while maintaining damages for true victims of medical negligence,” said University of Iowa physician and HCLA spokesperson, Stuart L. Weinstein, MD.

“Recent awards in the tens of millions of dollars make it clear that the legislature needs to take action before this session ends.”

Court Upholds Standards of Medical Experts

Medical experts play a crucial role in liability litigation, and a recent federal court upheld the high standards to which they must be held to testify as standard-of-care witnesses.

The 10th Circuit found that in a Kansas case against a federal health care provider, the plaintiff’s medical expert witness did not qualify under the state’s professional standards.

This federal case sets a strong precedent, requiring any medical expert witness to spend at least half of their professional time actively practicing medicine for the two years prior to the adverse event in the case at hand.

The ruling also clarified that this time can include indirectly providing patient care through consulting, but time advising medical residents would not count towards the 50 percent requirement.

To read more about this decision that upholds the integrity of medical expert witnesses, click here.